June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
RETIPROGRAM: A CLINICAL DECISION SUPORT SYSTEM FOR DIABETIC RETINOPATHY WITH PREDICTIVE VALUE
Author Affiliations & Notes
  • Maria Esther Santos Blanco
    Hospital Sant Joan, Spain
  • Pere Romero Aroca
    Hospital Sant Joan, Spain
  • raquel Verges Pujol
    Hospital Sant Joan, Spain
  • Raul Navarro Gil
    Hospital Sant Joan, Spain
  • Marc Baget Bernaldiz
    Hospital Sant Joan, Spain
  • Aida Valls
    Hospital Sant Joan, Spain
  • Domenec Puig
    Hospital Sant Joan, Spain
  • Antonio Moreno
    Hospital Sant Joan, Spain
  • Footnotes
    Commercial Relationships   Maria Esther Santos Blanco, None; Pere Aroca, None; raquel Pujol, None; Raul Gil, None; Marc Bernaldiz, None; Aida Valls, None; Domenec Puig, None; Antonio Moreno, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1126. doi:
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      Maria Esther Santos Blanco, Pere Romero Aroca, raquel Verges Pujol, Raul Navarro Gil, Marc Baget Bernaldiz, Aida Valls, Domenec Puig, Antonio Moreno; RETIPROGRAM: A CLINICAL DECISION SUPORT SYSTEM FOR DIABETIC RETINOPATHY WITH PREDICTIVE VALUE. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1126.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : RETIPROGRAM is a registered clinical decision support system program for diabetic retinopathy (DR) screening. The algorythm calculates the risk of developing DR in the next years attending to medical variables. The initial results were already shown previously in ARVO 2020. Currently the aim is not only to show its accuracy as much as its prediction capability, detecting future DR in short term in patients without DR.

Methods : The program was developed since a statistical analysis was based on fuzzy random forest methodology, assessing different medical variables.
The sample included 98873 of diabetes mellitus type 2 population. The medical variables registered were age, gender, diabetes mellitus duration, arterial hypertension, HbA1, glomerular filtration rate, microalbuminuria and body mass index. Attending to these variables it is calculated an estimated risk and it is suggested a date for the next control.

Results : To validate the results consistency the risk percentage were compared with the presence of DR in the retinography.
The test sensibility was 60.36%, specificity 78,61% and 19644 were considered false positive. The false positive group images were reviewed after two years and it was shown that 11.949 had already DR. The progression rate in the false positive group was 60,82% in two years.
The initial sensitivity and specificity values were good enough, but if they are corrected according the results after two years, the sensitivity (84,20%) and specificity (90,37%) values would be even better.
False positive group, is commonly considered as a test error, but in this case, analyzing it carefully it would report some added test value, the capability of prediction in absence of DR in the retinography.

Conclusions : In general, and also in DR, screening models efficacy means its capability to detect pathologies in early stages and their risk of progression. Currently all patient without DR in the retinography are usually considered into low risk group, ignoring their medical risk and they would be misdiagnosed. On other hand, an isolated retinography offers an accurate information about the current patient status but it has to be completed with medical factors related with the progression risk (RETIPROGRAM).
In our opinion RETIPROGRAM offers a predictive value of DR progression in short term and completes the retinographies information, offering a more personalized and accurate acting plan.

This is a 2021 ARVO Annual Meeting abstract.

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