Grading
diabetic macular edema, diabetes
RETINA, BLIND, DIABETIC MACULAR EDEMA, MACULAR EDEMA, DIABETES
Thai retina specialists did the grading of fundus images to obtain the baseline grades of patients with diabetes in the baseline visit (there were two retina specialists, each responsible for a separate set of hospitals assigned to them). After this, fundus images and metadata were transferred to coinvestigators at Google Health via a secure Cloud-based server. A single retina specialist from a pool of six U.S. board-certified retina specialists graded each fundus image for DR and diabetic macular edema to define the subsequent visit grade. This would serve as the progression ground truth for the DL model. Images were ordered randomly and assigned randomly to blind the retina specialist to the model scores. Analysis was performed to compare the DR/diabetic macular edema grades assigned by the retina specialist (progression ground truth) with the ranked list to assess the model's effectiveness in prospectively prioritizing cases.