How Can Artificial Intelligence Be Implemented Effectively in Diabetic Retinopathy Screening in Japan?
Diabetic retinopathy (DR) is a major microvascular complication of diabetes, affecting a substantial portion of diabetic patients worldwide. Timely intervention is pivotal in mitigating the risk of blindness associated with DR, yet early detection remains a challenge due to the absence of early symp...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-01-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/60/2/243 |
| _version_ | 1827343214416232448 |
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| author | Ryo Kawasaki |
| author_facet | Ryo Kawasaki |
| author_sort | Ryo Kawasaki |
| collection | DOAJ |
| description | Diabetic retinopathy (DR) is a major microvascular complication of diabetes, affecting a substantial portion of diabetic patients worldwide. Timely intervention is pivotal in mitigating the risk of blindness associated with DR, yet early detection remains a challenge due to the absence of early symptoms. Screening programs have emerged as a strategy to address this burden, and this paper delves into the role of artificial intelligence (AI) in advancing DR screening in Japan. There are two pathways for DR screening in Japan: a health screening pathway and a clinical referral path from physicians to ophthalmologists. AI technologies that realize automated image classification by applying deep learning are emerging. These technologies have exhibited substantial promise, achieving sensitivity and specificity levels exceeding 90% in prospective studies. Moreover, we introduce the potential of Generative AI and large language models (LLMs) to transform healthcare delivery, particularly in patient engagement, medical records, and decision support. Considering the use of AI in DR screening in Japan, we propose to follow a seven-step framework for systematic screening and emphasize the importance of integrating AI into a well-designed screening program. Automated scoring systems with AI enhance screening quality, but their effectiveness depends on their integration into the broader screening ecosystem. LLMs emerge as an important tool to fill gaps in the screening process, from personalized invitations to reporting results, facilitating a seamless and efficient system. However, it is essential to address concerns surrounding technical accuracy and governance before full-scale integration into the healthcare system. In conclusion, this review highlights the challenges in the current screening pathway and the potential for AI, particularly LLM, to revolutionize DR screening in Japan. The future direction will depend on leadership from ophthalmologists and stakeholders to address long-standing challenges in DR screening so that all people have access to accessible and effective screening. |
| first_indexed | 2024-03-07T22:21:59Z |
| format | Article |
| id | doaj.art-9d5db5e4ac19429a99b9c1fd4bf9173b |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-07T22:21:59Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-9d5db5e4ac19429a99b9c1fd4bf9173b2024-02-23T15:26:32ZengMDPI AGMedicina1010-660X1648-91442024-01-0160224310.3390/medicina60020243How Can Artificial Intelligence Be Implemented Effectively in Diabetic Retinopathy Screening in Japan?Ryo Kawasaki0Division of Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Suita 565-0871, JapanDiabetic retinopathy (DR) is a major microvascular complication of diabetes, affecting a substantial portion of diabetic patients worldwide. Timely intervention is pivotal in mitigating the risk of blindness associated with DR, yet early detection remains a challenge due to the absence of early symptoms. Screening programs have emerged as a strategy to address this burden, and this paper delves into the role of artificial intelligence (AI) in advancing DR screening in Japan. There are two pathways for DR screening in Japan: a health screening pathway and a clinical referral path from physicians to ophthalmologists. AI technologies that realize automated image classification by applying deep learning are emerging. These technologies have exhibited substantial promise, achieving sensitivity and specificity levels exceeding 90% in prospective studies. Moreover, we introduce the potential of Generative AI and large language models (LLMs) to transform healthcare delivery, particularly in patient engagement, medical records, and decision support. Considering the use of AI in DR screening in Japan, we propose to follow a seven-step framework for systematic screening and emphasize the importance of integrating AI into a well-designed screening program. Automated scoring systems with AI enhance screening quality, but their effectiveness depends on their integration into the broader screening ecosystem. LLMs emerge as an important tool to fill gaps in the screening process, from personalized invitations to reporting results, facilitating a seamless and efficient system. However, it is essential to address concerns surrounding technical accuracy and governance before full-scale integration into the healthcare system. In conclusion, this review highlights the challenges in the current screening pathway and the potential for AI, particularly LLM, to revolutionize DR screening in Japan. The future direction will depend on leadership from ophthalmologists and stakeholders to address long-standing challenges in DR screening so that all people have access to accessible and effective screening.https://www.mdpi.com/1648-9144/60/2/243diabetic retinopathyartificial intelligencesystematic screeninglarge language models |
| spellingShingle | Ryo Kawasaki How Can Artificial Intelligence Be Implemented Effectively in Diabetic Retinopathy Screening in Japan? Medicina diabetic retinopathy artificial intelligence systematic screening large language models |
| title | How Can Artificial Intelligence Be Implemented Effectively in Diabetic Retinopathy Screening in Japan? |
| title_full | How Can Artificial Intelligence Be Implemented Effectively in Diabetic Retinopathy Screening in Japan? |
| title_fullStr | How Can Artificial Intelligence Be Implemented Effectively in Diabetic Retinopathy Screening in Japan? |
| title_full_unstemmed | How Can Artificial Intelligence Be Implemented Effectively in Diabetic Retinopathy Screening in Japan? |
| title_short | How Can Artificial Intelligence Be Implemented Effectively in Diabetic Retinopathy Screening in Japan? |
| title_sort | how can artificial intelligence be implemented effectively in diabetic retinopathy screening in japan |
| topic | diabetic retinopathy artificial intelligence systematic screening large language models |
| url | https://www.mdpi.com/1648-9144/60/2/243 |
| work_keys_str_mv | AT ryokawasaki howcanartificialintelligencebeimplementedeffectivelyindiabeticretinopathyscreeninginjapan |