{"doi":"10.2147/opth.s422513","title":"Artificial Intelligence Improves Patient Follow-Up in a Diabetic Retinopathy Screening Program","abstract":"Purpose: We examine the rate of and reasons for follow-up in an Artificial Intelligence (AI)-based workflow for diabetic retinopathy (DR) screening relative to two human-based workflows. Patients and Methods: A DR screening program initiated September 2019 between one institution and its affiliated primary care and endocrinology clinics screened 2243 adult patients with type 1 or 2 diabetes without a diagnosis of DR in the previous year in the San Francisco Bay Area. For patients who screened positive for more-than-mild-DR (MTMDR), rates of follow-up were calculated under a store-and-forward human-based DR workflow (“Human Workflow”), an AI-based workflow involving IDx-DR (“AI Workflow”), and a two-step hybrid workflow (“AI–Human Hybrid Workflow”). The AI Workflow provided same-day results, whereas the other workflows took 1– 5 days. Patients were surveyed by phone about follow-up decisions. Results: Under the AI Workflow, 279 patients screened positive for MTMDR. Of these, 69.2% followed up with an ophthalmologist within 90 days. Altogether 70.5% ( N =48) of patients who followed up chose their location based on primary care referral. Under the Human Workflow and AI–Human Hybrid Workflow, 12.0% ( N =14/117) and 11.7% ( N =12/103) of patients with a referrable screening result followed up compared to 35.5% of patients under the AI Workflow ( N =99/279; χ 2 df=2 = 36.70, p < 0.00000001). Conclusion: Ophthalmology follow-up after a positive DR screening result is approximately three-fold higher under the AI Workflow than either the Human Workflow or AI–Human Hybrid Workflow. Improved follow-up behavior may be due to the decreased time to screening result. Keywords: telemedicine, teleophthalmology, fundus photography, deep learning, machine learning, referral","journal":"Clinical ophthalmology","year":2023,"id":328764,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":22,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8967,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":292125,"name":"Karen Chen","orcid":"0000-0002-7585-2713","position":1,"is_corresponding":false},{"id":1050761,"name":"Cindy S. Zhao","orcid":"0000-0001-9925-2985","position":2,"is_corresponding":false},{"id":1051345,"name":"Austen Knapp","orcid":null,"position":3,"is_corresponding":false},{"id":1041411,"name":"Anuradha C. Phadke","orcid":"0000-0001-9682-8184","position":4,"is_corresponding":false},{"id":1042129,"name":"Kirsti Weng","orcid":null,"position":5,"is_corresponding":false},{"id":941135,"name":"V. Diana","orcid":"0000-0003-1935-1241","position":6,"is_corresponding":false},{"id":317223,"name":"Vinit B. Mahajan","orcid":"0000-0003-1886-1741","position":7,"is_corresponding":false},{"id":481036,"name":"Prithvi Mruthyunjaya","orcid":"0000-0003-1087-9736","position":8,"is_corresponding":false},{"id":304777,"name":"Theodore Leng","orcid":"0000-0002-8461-3562","position":9,"is_corresponding":false},{"id":262483,"name":"David Myung","orcid":"0000-0002-7980-3070","position":10,"is_corresponding":false},{"id":1041409,"name":"Eliot R. Dow","orcid":"0000-0001-7409-2049","position":0,"is_corresponding":true}],"reference_count":18,"raw_metadata":null,"created_at":"2026-07-19T01:08:56.940647Z","pmid":"38026608","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}