Wu Hui-Qun, Shan Yan-Xing, Wu Huan, Zhu Di-Ru, Tao Hui-Min, Wei Hua-Gen, Shen Xiao-Yan, Sang Ai-Min, Dong Jian-Cheng
Department of Medical Informatics, Medical School of Nantong University, Nantong 226001, Jiangsu Province, China.
School of Information Science and Technology, Nantong University, Nantong 226001, Jiangsu Province, China.
Int J Ophthalmol. 2019 Dec 18;12(12):1908-1916. doi: 10.18240/ijo.2019.12.14. eCollection 2019.
To ensure the diagnostic value of computer aided techniques in diabetic retinopathy (DR) detection based on ophthalmic photography (OP).
PubMed, EMBASE, Ei village, IEEE Xplore and Cochrane Library database were searched systematically for literatures about computer aided detection (CAD) in DR detection. The methodological quality of included studies was appraised by the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). Meta-DiSc was utilized and a random effects model was plotted to summarize data from those included studies. Summary receiver operating characteristic curves were selected to estimate the overall test performance. Subgroup analysis was used to identify the efficiency of CAD in detecting DR, exudates (EXs), microaneurysms (MAs) as well as hemorrhages (HMs), and neovascularizations (NVs). Publication bias was analyzed using STATA.
Fourteen articles were finally included in this Meta-analysis after literature review. Pooled sensitivity and specificity were 90% (95%CI, 85%-94%) and 90% (95%CI, 80%-96%) respectively for CAD in DR detection. With regard to CAD in EXs detecting, pooled sensitivity, specificity were 89% (95%CI, 88%-90%) and 99% (95%CI, 99%-99%) respectively. In aspect of MAs and HMs detection, pooled sensitivity and specificity of CAD were 42% (95%CI, 41%-44%) and 93% (95%CI, 93%-93%) respectively. Besides, pooled sensitivity and specificity were 94% (95%CI, 89%-97%) and 87% (95%CI, 83%-90%) respectively for CAD in NVs detection. No potential publication bias was observed.
CAD demonstrates overall high diagnostic accuracy for detecting DR and pathological lesions based on OP. Further prospective clinical trials are needed to prove such effect.
基于眼科摄影(OP)确保计算机辅助技术在糖尿病视网膜病变(DR)检测中的诊断价值。
系统检索PubMed、EMBASE、Ei村、IEEE Xplore和Cochrane图书馆数据库中有关计算机辅助检测(CAD)在DR检测中的文献。采用诊断准确性研究质量评估工具(QUADAS-2)对纳入研究的方法学质量进行评估。使用Meta-DiSc并绘制随机效应模型来汇总纳入研究的数据。选择汇总受试者工作特征曲线来估计总体测试性能。进行亚组分析以确定CAD在检测DR、渗出物(EXs)、微动脉瘤(MAs)、出血(HMs)以及新生血管(NVs)方面的效率。使用STATA分析发表偏倚。
文献回顾后,本Meta分析最终纳入14篇文章。CAD在DR检测中的合并敏感度和特异度分别为90%(95%CI,85%-94%)和90%(95%CI,80%-96%)。在EXs检测中,CAD的合并敏感度和特异度分别为89%(95%CI,88%-90%)和99%(95%CI,99%-99%)。在MAs和HMs检测方面,CAD的合并敏感度和特异度分别为42%(95%CI,41%-44%)和93%(95%CI,93%-93%)。此外,CAD在NVs检测中的合并敏感度和特异度分别为94%(95%CI,89%-97%)和87%(95%CI,83%-90%)。未观察到潜在的发表偏倚。
基于OP,CAD在检测DR和病理病变方面总体具有较高的诊断准确性。需要进一步的前瞻性临床试验来证实这种效果。