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Scan, dwell, decide: Strategies for detecting abnormalities in diabetic retinopathy

DOI:10.1371/journal.pone.0207086 期刊:PLOS ONE 出版年份:2018 更新时间:2025-09-10 09:29:36
摘要: Diabetic retinopathy (DR) is a disease which is widely diagnosed using (colour fundus) images. Efficiency and accuracy are critical in diagnosing DR as lack of timely intervention can lead to irreversible visual impairment. In this paper, we examine strategies for scrutinizing images which affect diagnostic performance of medical practitioners via an eye-tracking study. A total of 56 subjects with 0 to 18 years of experience participated in the study. Every subject was asked to detect DR from 40 images. The findings indicate that practitioners use mainly two types of strategies characterized by either higher dwell duration or longer track length. The main findings of the study are that higher dwell-based strategy led to higher average accuracy (> 85%) in diagnosis, irrespective of the expertise of practitioner; whereas, the average obtained accuracy with a long-track length-based strategy was dependent on the expertise of the practitioner. In the second part of the paper, we use the experimental findings to recommend a scanning strategy for fast and accurate diagnosis of DR that can be potentially used by image readers. This is derived by combining the eye-tracking gaze maps of medical experts in a novel manner based on a set of rules. This strategy requires scrutiny of images in a manner which is consistent with spatial preferences found in human perception in general and in the domain of fundus images in particular. The Levenshtein distance-based assessment of gaze patterns also establish the effectiveness of the derived scanning pattern and is thus recommended for image readers.
作者: Samrudhdhi B. Rangrej,Jayanthi Sivaswamy,Priyanka Srivastava
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To examine strategies for scrutinizing images which affect diagnostic performance of medical practitioners in diagnosing diabetic retinopathy (DR) via an eye-tracking study and to recommend a scanning strategy for fast and accurate diagnosis of DR.

The study found that practitioners use mainly two types of strategies, dwelling and tracing, for diagnosing DR. Dwelling was found to lead to accurate and fast diagnosis irrespective of the expertise of a subject. A recommended scanning strategy was derived, prescribing the order in which retinal zones should be scrutinized and the required dwelling for each zone. This strategy was found to lead to accurate and fast diagnosis.

1. The study was conducted with a small number of images (40), which may not represent the actual number of cases a typical reader or expert handles in a day. 2. The study is limited to lesions related to early detection of DR, and the optimal scanning strategy may not be effective for advanced stages of DR.

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