India's largest eye care provider, Aravind Eye Hospital, has been quietly working for over four years with Google on a project to use artificial intelligence (AI) in ophthalmology. Aravind Eye Hospital, which has branches across India, is headquartered in Madurai, Tamil Nadu. Lily Peng, product manager at Google, who released a paper on the research a year ago, said at the 2017 WIRED Business Conference that Google had just finished a clinical study in India, and that work was underway to get the technology into routine use with patients. India, considered the diabetes capital of the world, has over 70 million diabetes patients who are at risk of blindness due to the disease. India's largest eye care provider, Aravind Eye Hospital, has been quietly working for over three to four years with Google on a project to use artificial intelligence in ophthalmology At the TensorFlow Dev Summit earlier this year, Peng had said that that Google's machine learning algorithm was very close to an ophthalmologist in terms of performance.
Babak Ehteshami Bejnordi, from the Radboud University Medical Center in Nijmegen, Netherlands, and colleagues compared the performance of automated deep learning algorithms for detecting metastases in hematoxylin and eosin-stained tissue sections of lymph nodes of women with breast cancer with pathologists' diagnoses in a diagnostic setting. The researchers found that the area under the receiver operating characteristic curve (AUC) ranged from 0.556 to 0.994 for the algorithms. The lesion-level, true-positive fraction achieved for the top-performing algorithm was comparable to that of the pathologist without a time constraint at a mean of 0.0125 false-positives per normal whole-slide image. Daniel Shu Wei Ting, M.D., Ph.D., from the Singapore National Eye Center, and colleagues assessed the performance of a DLS for detecting referable diabetic retinopathy and related eye diseases using 494,661 retinal images. The researchers found that the AUC of the DLS for referable diabetic retinopathy was 0.936, and sensitivity and specificity were 90.5 and 91.6 percent, respectively.
The AI-powered, cloud-based system will be available for use by primary care providers. Over 30 million Americans have diabetes, and diabetic retinopathy--which occurs when blood sugar levels result in damage to retinal blood vessels--is considered mostly preventable. Still, it causes vision loss in tens of thousands of people each year and is the leading cause of blindness among working-age Americans. "Many patients with diabetes are not adequately screened for diabetic retinopathy since about 50 percent of them do not see their eye doctor on a yearly basis," Malvina Eydelman, MD, said in the FDA's official announcement. She serves as director of the Division of Ophthalmic, and Ear, Nose and Throat Devices at the agency's Center for Devices and Radiological Health.
US health regulators have approved the first ever artificially intelligent medical device that can identify disease without need for a doctor. The device, called IDx-DR, is designed to detect the most common cause of vision loss among more than 30 million Americans living with diabetes. Its in-built camera takes a picture of the patient's eye, which is assessed by an algorithm to determine whether there are signs of diabetic retinopathy. The move, announced on Wednesday, makes this the first AI device to receive FDA approval to screen without need for a doctor to interpret the results. It means any doctor could use it, including primary care physicians who interact far more frequently with patients with diabetes, rather than patients having to seek out eye doctors themselves.