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CompletedNCT04723160Updated Dec 30, 2021

Computer Aided Diagnosis of Multiple Eye Fundus Diseases From Color Fundus Photograph

An observational study in Diabetic Retinopathy, Retinal Vein Occlusion and Retinal Artery Occlusion, sponsored by Visionary Intelligence Ltd.. Completed at 5 sites in China. Open to participants aged 18 Years to 75 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2021-12-30.

Sponsored by Visionary Intelligence Ltd. · Observational

Study type
Observational
Model
Case-control
Time perspective
Prospective
Enrollment
748
Ages
18 Years to 75 Years
Sex
All
01

Study summary

Blindness can be caused by many ocular diseases, such as diabetic retinopathy, retinal vein occlusion, age-related macular degeneration, pathologic myopia and glaucoma. Without timely diagnosis and adequate medical intervention, the visual impairment can become a great burden on individuals as well as the society. It is estimated that China has 110 million patients under the attack of diabetes, 180 million patients with hypertension, 120 million patients suffering from high myopia and 200 million people over 60 years old, which suggest a huge population at the risk of blindness. Despite of this crisis in public health, our society has no more than 3,000 ophthalmologists majoring in fundus oculi disease currently. As most of them assembling in metropolitan cities, health system in this field is frail in primary hospitals. Owing to this unreasonable distribution of medical resources, providing medical service to hundreds of millions of potential patients threatened with blindness is almost impossible.

To solve this problem, this software (MCS) was developed as a computer-aided diagnosis to help junior ophthalmologists to detect 13 major retina diseases from color fundus photographs. This study has been designed to validate the safety and efficiency of this device.

Read the detailed description

As a prospective clinical trial, This study enjoys multicentric, blind film reading, self-control and superiority test design. In total, 1,500 retinal fundus images from 750 individuals in need of fundus examination (one image for every single eye) were selected. Then a test group, along with a control group was set up in our study. For the test group, ophthalmologists read images with the aid of the assistant software(MCS). In contrast, the same work in the control group was finished by ophthalmologists independently. Meanwhile, the gold standard were obtained from the cooperation of senior ophthalmologists. Diagnoses of both groups were compared with those of the gold standard, thus the investigators could evaluated the safety and effectiveness of this assistant software in diagnosis.

The primary endpoint of this study is the superiority of the consistency rate of the test group. A diagnosis for an image is consistent if it gives the same negative result as the reference standard, or reveals any one condition indicated by the reference standard. The consistency rate is the rate of consistent diagnoses for all the involved images. One control group is designed, where each doctor reads and diagnoses, and give at most 3 possible conditions for each image. In the test group, doctors do the same thing with the help of this software. The investigators in the test group and control group are the same and they are chosen from ophthalmologists with 1\~3 years experience. The reference standard of each fundus image is collaboratively given by retinal specialists/fellows from 5 centers. The investigator of XieHe center is the arbitrator if full consensus cannot be reached for any image during the building of reference standard.

02

Conditions studied

  • Diabetic Retinopathy
  • Retinal Vein Occlusion
  • Retinal Artery Occlusion
  • Central Serous Chorioretinopathy
  • Pathologic Myopia
  • Retinitis Pigmentosa
  • Epiretinal Membrane
  • Macular Holes
  • Nonexudative Age-related Macular Degeneration
  • Exudative Age Related Macular Degeneration
  • Suspect Glaucoma
  • Optic Atrophy
  • Retinal Detachment

Keywords

  • multiple eye fundus diseases
03

Who can participate

Ages eligible
18 Years to 75 Years
Sexes eligible
All
Accepts healthy volunteers
Yes
Sampling method
Non-probability sample

Study population

Any patients who meet the eligibility criteria.

Inclusion criteria

  • Age between 18 and 75.
  • Anyone need to take fundus photograph in clinical.
  • Understand the study and volunteer to sign the informed consent.
  • For fundus images of participants, the optic disc, fovea, the upper and lower vessel bow should be included in the fundus field.

Exclusion criteria

Exclusion Criteria:

  • Participants has any eye that cannot take fundus photos.
  • Participants have joined or is participating in other clinical trial within one month.
  • Participants who have any other issue that cannot be enrolled.
  • Participants with cloudy refractive media that cannot take fundus photos or get clouding fundus photos.
  • Participants with low quality fundus photos like incompetent vision field, overexposed/underexposed, out of focus, too many shadow or dirties and so on.
04

Study design

Observational model
Case-control
Time perspective
Prospective
Enrollment
748 participants (actual)
Patient registry
No

Groups and cohorts

  • Test Group

    ophthalmologists read images applying the assistant software

    Diagnostic Test: Software assisted imaging diagnosis

  • Control Group

    ophthalmologists read images independently

Interventions

  • Diagnostic testSoftware assisted imaging diagnosis

    In the test group, diagnoses are given with the help of the software.

05

What researchers measure

Primary outcomes

  1. consistent rate of diagnoses

    Formula for calculation: consistent rate of diagnoses=number of images with consistent diagnosis/ total number of images × 100%. Method: the diagnoses from the test group and the control group were compared with diagnoses from the gold standard. For each image, if one or more diagnoses were consistent with those of the gold standard, which means at least one label existed in the intersection of diagnoses from the test group(or the control group)and those from the gold standard, it would be classified as "image with consistent diagnosis". Otherwise, it would be classified as "image without consistent diagnosis". After above-mentioned steps, the investigators had obtained the number of images with consistent diagnosis in each group. As images with 1-2 labels account for the majority in actual work, the investigators stipulated that each image in both groups could be marked with 3 labels at most in case of invalid improvement in consistent rate owing to multiple selections.

    Time frame: through study completion, an average of 1 year

Secondary outcomes

  1. sensitivity and specificity of software's diagnoses for each diseases

    sensitivity and specificity of software's diagnoses for each diseases

    Time frame: through study completion, an average of 1 year

  2. PPV and NPV of software's diagnoses for each diseases

    PPV(Positive Predictive Value) and NPV(Negative Predictive Value) of software's diagnoses for each diseases

    Time frame: through study completion, an average of 1 year

  3. full coincidence rate of software's diagnoses

    The full consistency rate is the rate of fully consistent diagnoses in the set. A diagnosis is fully consistent it is exactly the same as the reference standard.

    Time frame: through study completion, an average of 1 year

06

Study locations

5 sites
  • Peking Union Medical College Hospital, Chinese Academy of Medical Sciences
    BeiJing, Beijing 100730, China
  • The Second Hospital of Hebei Medical University
    Shijia Zhuang, Hebei, China
  • West China Hospital of Sichuan University
    Chengdu, Sichuan, China
  • Tianjin Medical University Eye Hospital
    Tianjin, Tianjin, China
  • Eye Hospital, WMU Zhejiang Eye Hospital
    Wenzhou, Zhejiang, China
07

Registry details

Key details

Study ID
NCT04723160
Lead sponsor
Visionary Intelligence Ltd.
Collaborators
Peking University First Hospital, Beijing Municipal Science & Technology Commission
Responsible party
Sponsor
First posted
Jan 25, 2021
Start date
Aug 10, 2020
Primary completion
Mar 10, 2021
Completion
May 30, 2021
Last update
Dec 30, 2021

Study contacts

You xin Chen, PHD
study chair · Peking Union Medical College

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
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