Effects of Study Population, Labeling and Training on Glaucoma Detection Using Deep Learning Algorithms
Mark Christopher, Ken‐ichi Nakahara, Christopher Bowd, James A. Proudfoot, Akram Belghith, Michael H. Goldbaum, Jasmin Rezapour, Robert N. Weinreb, Massimo A. Fazio, Christopher A. Girkin, Jeffrey M. Liebmann, Gustavo De Moraes, Hiroshi Murata, Kana Tokumo, Naoto Shibata, Yuri Fujino, Masato Matsuura, Yoshiaki Kiuchi, Masaki Tanito, Ryo Asaoka, Linda M. Zangwill
Abstract
Purpose: To compare performance of independently developed deep learning algorithms for detecting glaucoma from fundus photographs and to evaluate strategies for incorporating new data into models. Methods: Two fundus photograph datasets from the Diagnostic Innovations in Glaucoma Study/African Descent and Glaucoma Evaluation Study and Matsue Red Cross Hospital were used to independently develop deep learning algorithms for detection of glaucoma at the University of California, San Diego, and the University of Tokyo. We compared three versions of the University of California, San Diego, and University of Tokyo models: original (no retraining), sequential (retraining only on new data), and combined (training on combined data). Independent datasets were used to test the algorithms. Results: < .001), respectively. Models trained with the combined strategy generally had better performance across all datasets than the original strategy. Conclusions: Deep learning glaucoma detection can achieve high accuracy across diverse datasets with appropriate training strategies. Because model performance was influenced by the severity of disease, labeling, training strategies, and population characteristics, reporting accuracy stratified by relevant covariates is important for cross study comparisons. Translational Relevance: High sensitivity and specificity of deep learning algorithms for moderate-to-severe glaucoma across diverse populations suggest a role for artificial intelligence in the detection of glaucoma in primary care.