Code-Free Deep Learning Glaucoma Detection on Color Fundus Images
Why this work is in the frame
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Bibliographic record
Abstract
Objective: Code-free deep learning (CFDL) allows clinicians with no coding experience to build their own artificial intelligence models. This study assesses the performance of CFDL in glaucoma detection from fundus images in comparison to expert-designed models. Design: Deep learning model development, testing, and validation. Subjects: A total of 101 442 labeled fundus images from the Rotterdam EyePACS Artificial Intelligence for Robust Glaucoma Screening (AIROGS) dataset were included. Methods: Ophthalmology trainees without coding experience designed a CFDL binary model using the Rotterdam EyePACS AIROGS dataset of fundus images (101 442 labeled images) to differentiate glaucoma from normal optic nerves. We compared our results with bespoke models from the literature. We then proceeded to externally validate our model using 2 datasets, the Retinal Fundus Glaucoma Challenge (REFUGE) and the Glaucoma grading from Multi-Modality imAges (GAMMA) at 0.1, 0.3, and 0.5 confidence thresholds. Main Outcome Measures: Area under the precision-recall curve (AuPRC), sensitivity at 95% specificity (SE@95SP), accuracy, area under the receiver operating curve (AUC), and positive predictive value (PPV). Results: The CFDL model showed high performance metrics that were comparable to the bespoke deep learning models. Our single-label classification model had an AuPRC of 0.988, an SE@95SP of 95%, and an accuracy of 91% (compared with 85% SE@95SP for the top bespoke models). Using the REFUGE dataset for external validation, our model had an SE@95SP, AUC, PPV, and accuracy of 83%, 0.960%, 73% to 94%, and 95% to 98%, respectively, at the 0.1, 0.3, and 0.5 confidence threshold cutoffs. Using the GAMMA dataset for external validation at the same confidence threshold cutoffs, our model had an SE@95SP, AUC, PPV, and accuracy of 98%, 0.994%, 94% to 96%, and 94% to 97%, respectively. Conclusion: The capacity of CFDL models to perform glaucoma screening using fundus images presents a compelling proof of concept, empowering clinicians to explore innovative model designs for broad glaucoma screening in the near future. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it