An objective structural and functional reference standard in glaucoma

Abstract The current lack of consensus for diagnosing glaucoma makes it difficult to develop diagnostic tests derived from deep learning (DL) algorithms. In the present study, we propose an objective definition of glaucomatous optic neuropathy (GON) using clearly defined parameters from optical cohe...

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Autores principales:	Eduardo B. Mariottoni, Alessandro A. Jammal, Samuel I. Berchuck, Leonardo S. Shigueoka, Ivan M. Tavares, Felipe A. Medeiros
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4b03754d3aa5456abb70e97f011a0064
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spelling	oai:doaj.org-article:4b03754d3aa5456abb70e97f011a00642021-12-02T13:51:05ZAn objective structural and functional reference standard in glaucoma10.1038/s41598-021-80993-32045-2322https://doaj.org/article/4b03754d3aa5456abb70e97f011a00642021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-80993-3https://doaj.org/toc/2045-2322Abstract The current lack of consensus for diagnosing glaucoma makes it difficult to develop diagnostic tests derived from deep learning (DL) algorithms. In the present study, we propose an objective definition of glaucomatous optic neuropathy (GON) using clearly defined parameters from optical coherence tomography and standard automated perimetry. We then use the proposed objective definition as reference standard to develop a DL algorithm to detect GON on fundus photos. A DL algorithm was trained to detect GON on fundus photos, using the proposed objective definition as reference standard. The performance was evaluated on an independent test sample with sensitivity, specificity, area under the receiver operating characteristic curve (AUC), and likelihood ratios (LR). The test sample had 2118 fundus photos from 585 eyes of 405 individuals. The AUC to discriminate between GON and normal was 0.92 with sensitivity of 77% at 95% specificity. LRs indicated that the DL algorithm provided large changes in the post-test probability of disease for the majority of eyes. A DL algorithm to evaluate fundus photos had high performance to discriminate GON from normal. The newly proposed objective definition of GON used as reference standard may increase the comparability of diagnostic studies of glaucoma across devices and populations.Eduardo B. MariottoniAlessandro A. JammalSamuel I. BerchuckLeonardo S. ShigueokaIvan M. TavaresFelipe A. MedeirosNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Eduardo B. Mariottoni Alessandro A. Jammal Samuel I. Berchuck Leonardo S. Shigueoka Ivan M. Tavares Felipe A. Medeiros An objective structural and functional reference standard in glaucoma
description	Abstract The current lack of consensus for diagnosing glaucoma makes it difficult to develop diagnostic tests derived from deep learning (DL) algorithms. In the present study, we propose an objective definition of glaucomatous optic neuropathy (GON) using clearly defined parameters from optical coherence tomography and standard automated perimetry. We then use the proposed objective definition as reference standard to develop a DL algorithm to detect GON on fundus photos. A DL algorithm was trained to detect GON on fundus photos, using the proposed objective definition as reference standard. The performance was evaluated on an independent test sample with sensitivity, specificity, area under the receiver operating characteristic curve (AUC), and likelihood ratios (LR). The test sample had 2118 fundus photos from 585 eyes of 405 individuals. The AUC to discriminate between GON and normal was 0.92 with sensitivity of 77% at 95% specificity. LRs indicated that the DL algorithm provided large changes in the post-test probability of disease for the majority of eyes. A DL algorithm to evaluate fundus photos had high performance to discriminate GON from normal. The newly proposed objective definition of GON used as reference standard may increase the comparability of diagnostic studies of glaucoma across devices and populations.
format	article
author	Eduardo B. Mariottoni Alessandro A. Jammal Samuel I. Berchuck Leonardo S. Shigueoka Ivan M. Tavares Felipe A. Medeiros
author_facet	Eduardo B. Mariottoni Alessandro A. Jammal Samuel I. Berchuck Leonardo S. Shigueoka Ivan M. Tavares Felipe A. Medeiros
author_sort	Eduardo B. Mariottoni
title	An objective structural and functional reference standard in glaucoma
title_short	An objective structural and functional reference standard in glaucoma
title_full	An objective structural and functional reference standard in glaucoma
title_fullStr	An objective structural and functional reference standard in glaucoma
title_full_unstemmed	An objective structural and functional reference standard in glaucoma
title_sort	objective structural and functional reference standard in glaucoma
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/4b03754d3aa5456abb70e97f011a0064
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An objective structural and functional reference standard in glaucoma

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