Performance and limitation of machine learning algorithms for diabetic retinopathy screening and its application in health management: a meta-analysis.

Seyyed Kiarash Sadat Rafiei, Mahsa Asadi Anar, Yaser Khakpour, Faezeh Jadidian, Mehrsa Moannaei, Tahereh Doustmohammadi, Amir Mohammad Kiapasha, Romina Bayani, Mohammadreza Rahmani, Mohammad Reza Jahanbazy, Fereshteh Sohrabivafa, Amin Magsudy

Journal: Biomedical engineering online 2025;24(1):34

PMID: 40087776

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Abstract

BACKGROUND

In recent years, artificial intelligence and machine learning algorithms have been used more extensively to diagnose diabetic retinopathy and other diseases. Still, the effectiveness of these methods has not been thoroughly investigated. This study aimed to evaluate the performance and limitations of machine learning and deep learning algorithms in detecting diabetic retinopathy.

METHODS

This study was conducted based on the PRISMA checklist. We searched online databases, including PubMed, Scopus, and Google Scholar, for relevant articles up to September 30, 2023. After the title, abstract, and full-text screening, data extraction and quality assessment were done for the included studies. Finally, a meta-analysis was performed.

RESULTS

We included 76 studies with a total of 1,371,517 retinal images, of which 51 were used for meta-analysis. Our meta-analysis showed a significant sensitivity and specificity with a percentage of 90.54 (95%CI [90.42, 90.66], P < 0.001) and 78.33% (95%CI [78.21, 78.45], P < 0.001). However, the AUC (area under curvature) did not statistically differ across studies, but had a significant figure of 0.94 (95% CI [- 46.71, 48.60], P = 1).

CONCLUSIONS

Although machine learning and deep learning algorithms can properly diagnose diabetic retinopathy, their discriminating capacity is limited. However, they could simplify the diagnosing process. Further studies are required to improve algorithms.

Address: School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.; School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.; Department and Faculty of Health Education and Health Promotion, Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran.; Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran.; Student Research Committee, Zanjan University of Medical Sciences, Zanjan, Iran.; Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.; Health Education and Promotion, Department of Community Medicine, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran.; Student Research Committee, Shahid Beheshti University of Medical Science, Arabi Ave, Daneshjoo Blvd, Velenjak, Tehran, 19839-63113, Iran. [email protected].; Faculty of Medicine, Islamic Azad University Tabriz Branch, Tabriz, Iran.; Student Research Committee, Shahid Beheshti University of Medical Science, Arabi Ave, Daneshjoo Blvd, Velenjak, Tehran, 19839-63113, Iran.; Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

DOI: 10.1186/s12938-025-01336-1

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https://medlineplus.gov/diabeticeyeproblems.html

MeSH Terms: Diabetic Retinopathy, Humans, Machine Learning, Algorithms