Evaluation of a computer-based system for plus disease diagnosis in retinopathy of prematurity.
Evaluation of a computer-based system for plus disease diagnosis in retinopathy of prematurity.
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DOI：
10.1016/j.ophtha.2007.10.006
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发表时间：
2007-12-01
期刊：
影响因子：
13.7
通讯作者：
Chiang, Michael F
中科院分区：
文献类型：
--
作者：
Koreen, Susan;Gelman, Rony;Chiang, Michael F
目的：为了测量基于计算机的视网膜图像多尺度分析（RISA）系统的准确性和可靠性，与公认的早产儿视网膜病变（ROP）专家的准确性和可靠性进行比较，用于plus disease diagnosis.DESIGN：评价诊断测试或技术。所有专家使用一个安全的网站，独立审查20个图像的存在加疾病。还通过测量小动脉和小静脉的单个基于计算机的系统参数（积分曲率[IC]、直径和迂曲指数）以及计算这些参数的线性组合和逻辑组合来分析图像。性能进行了比较，与参考标准，定义为大多数投票的experts.MAIN结果MEASURES：诊断准确性进行了测量，通过计算灵敏度，特异性，和接收器工作特征曲线下面积（AUC），加上疾病诊断由每个专家，并通过每个基于计算机的系统参数，与参考标准相比。通过计算每个专家与所有其他专家的平均Kappa值以及每个基于计算机的系统参数与所有专家的平均Kappa值来衡量诊断一致性。11名专家中，敏感性范围为0.167 ~ 1.000，特异性范围为0.714 ~ 1.000，AUC范围为0.798 ~ 1.000，与所有其他专家相比的平均Kappa值范围为0.288至0.689。在单个计算机系统参数中，小动脉IC的诊断准确性最高，灵敏度为1.000;特异性为0.846; AUC为0.962。与专家诊断一致率最高的是小动脉IC，平均Kappa值为0.578。结论：计算机图像分析系统具有向公认的ROP专家进行诊断的潜力。
OBJECTIVE: To measure accuracy and reliability of the computer-based Retinal Image Multiscale Analysis (RISA) system compared with those of recognized retinopathy of prematurity (ROP) experts, for plus disease diagnosis.DESIGN: Evaluation of diagnostic test or technology.PARTICIPANTS: Eleven recognized ROP experts and the RISA image analysis system interpreted a set of 20 wide-angle retinal photographs for presence of plus disease.METHODS: All experts used a secure Web site to review independently 20 images for presence of plus disease. Images were also analyzed by measuring individual computer-based system parameters (integrated curvature [IC], diameter, and tortuosity index) for arterioles and venules and by computing linear combinations and logical combinations of those parameters. Performance was compared with a reference standard, defined as the majority vote of experts.MAIN OUTCOME MEASURES: Diagnostic accuracy was measured by calculating sensitivity, specificity, and receiver operating characteristic area under the curve (AUC) for plus disease diagnosis by each expert, and by each computer-based system parameter, compared with the reference standard. Diagnostic agreement was measured by calculating the mean kappa value of each expert compared with all other experts and the mean kappa value of each computer-based system parameter compared with all experts.RESULTS: Among the 11 experts, sensitivity ranged from 0.167 to 1.000, specificity ranged from 0.714 to 1.000, AUC ranged from 0.798 to 1.000, and mean kappa compared with all other experts ranged from 0.288 to 0.689. Among individual computer system parameters, arteriolar IC had the highest diagnostic accuracy, with sensitivity of 1.000; specificity, 0.846; and AUC, 0.962. Arteriolar IC had the highest diagnostic agreement with experts, with a mean kappa value of 0.578.CONCLUSIONS: A computer-based image analysis system has the potential to perform comparably to recognized ROP experts for plus disease diagnosis.