학술논문

Proactive Decision Support for Glaucoma Treatment: Predicting Surgical Interventions with Clinically Available Data
Document Type
article
Source
Bioengineering. 11(2)
Subject
Engineering
Biomedical Engineering
Neurosciences
Eye Disease and Disorders of Vision
Bioengineering
Aging
Clinical Research
Neurodegenerative
Prevention
Patient Safety
4.2 Evaluation of markers and technologies
Detection
screening and diagnosis
glaucoma
glaucoma progression
glaucoma surgery
OCT
visual field
machine learning
deep learning
Biomedical engineering
Language
Abstract
A longitudinal ophthalmic dataset was used to investigate multi-modal machine learning (ML) models incorporating patient demographics and history, clinical measurements, optical coherence tomography (OCT), and visual field (VF) testing in predicting glaucoma surgical interventions. The cohort included 369 patients who underwent glaucoma surgery and 592 patients who did not undergo surgery. The data types used for prediction included patient demographics, history of systemic conditions, medication history, ophthalmic measurements, 24-2 VF results, and thickness measurements from OCT imaging. The ML models were trained to predict surgical interventions and evaluated on independent data collected at a separate study site. The models were evaluated based on their ability to predict surgeries at varying lengths of time prior to surgical intervention. The highest performing predictions achieved an AUC of 0.93, 0.92, and 0.93 in predicting surgical intervention at 1 year, 2 years, and 3 years, respectively. The models were also able to achieve high sensitivity (0.89, 0.77, 0.86 at 1, 2, and 3 years, respectively) and specificity (0.85, 0.90, and 0.91 at 1, 2, and 3 years, respectively) at an 0.80 level of precision. The multi-modal models trained on a combination of data types predicted surgical interventions with high accuracy up to three years prior to surgery and could provide an important tool to predict the need for glaucoma intervention.