A universal artificial intelligence platform for collaborative management of cataracts

Abstract

Purpose : The current healthcare system is unsatisfactory for the management of high incidence diseases, such as cataract, due to inadequate medical resources and limited accessibility. Artificial intelligence (AI) holds great promises, meanwhile, remains to be improved to integrate into primary healthcare services for increased patient coverage. This study was to establish and validate a universal AI platform for collaborative management of cataracts involving multilevel clinical scenarios and explored an AI-based medical referral pattern to improve collaborative efficiency and resource coverage.

Methods : The training and validation datasets were derived from the Chinese Medical Alliance for Artificial Intelligence (CMAAI), covering multilevel healthcare facilities and capture modes. The datasets were labeled using a three-step strategy: (1) capture mode recognition; (2) cataract diagnosis as a normal lens, cataract or a postoperative eye; and (3) detection of referable cataracts with respect to etiology and severity. Moreover, we integrated the cataract AI agent with a real-world multilevel referral pattern involving self-monitoring at home, primary healthcare, and specialized hospital services.

Results : The universal AI platform and multilevel collaborative pattern showed robust diagnostic performance in three-step tasks: (1) capture mode recognition (AUC 99.28%-99.71%), (2) cataract diagnosis (normal lens, cataract or postoperative eye with AUCs of 99.96%, 99.99%, and 100.00%; AUCs >99% for other capture modes), and (3) detection of referable cataracts (AUC>85% in all tests). In the real-world tertiary referral pattern, the agent suggested 30.3% of people be “referred”, substantially increasing the ophthalmologist-to-population service ratio for 10.2 times compared to the traditional pattern.

Conclusions : The universal AI platform and multilevel collaborative pattern showed robust diagnostic performance and effective service for cataracts. The context of our AI based medical referral pattern will be extended to other common disease conditions and resource-intensive situations to provide cost-effective health care for an increasing number of patients.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

The overall training pipeline for the cataract AI agent

 

The novel tertiary healthcare referral system based on the cataract AI agent and comparison with the traditional healthcare system.