Validation of automated screening for referable diabetic retinopathy with the IDx-DR device in the Hoorn Diabetes Care System

AI Generated Summary*

IDx-DR 2.0 automated grading was evaluated in routine care at the Hoorn Diabetes Care System. Of 1415 people with type 2 diabetes, 898 had images judged gradable by both the software and three masked retinal specialists. Referable retinopathy affected 22 (2.4%) under EURODIAB and 73 (8.1%) under ICDR. Sensitivity, specificity and AUC reached 91%, 84% and 0.94 against EURODIAB, versus 68%, 86% and 0.87 against ICDR, with positive predictive values of only 12% and 30%. Sensitivity for vision-threatening disease was 62% to 64%. Grader agreement was limited, and a post hoc review tied ICDR discrepancies to single haemorrhages scored as moderate disease. Authors call the method valid for primary care, though a third of images were rejected for quality.

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