{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:45:34Z","timestamp":1784868334149,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T00:00:00Z","timestamp":1733788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To compare two artificial intelligence (AI)\u2010based Automated Diabetic Retinopathy Image Assessment (ARIA) softwares in terms of concordance with specialist human graders and referable diabetic retinopathy (DR) diagnostic capacity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective comparative study including 750 consecutive diabetes mellitus patients imaged for non\u2010mydriatic fundus photographs. For each patient four images (45 degrees field of view) were captured, centered on the optic disc and macula. Images were manually graded for severity of DR as no DR, any DR (mild non\u2010proliferative diabetic retinopathy [NPDR] or more), referable DR (RDR (more than mild DR)), or sight\u2010threatening DR (severe NPDR or more severe disease and\/or clinically significant diabetic macular edema [CSDME]). IDx\u2010DR and MONA DR output was compared with manual grading and with each other.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Total sample size was 750 patients, of which 55 were excluded due to ungradable images. Out of the remaining 695 patients 522 (75%) were considered as having no DR by manual consensus grading, and 106 (15%) as having RDR. Agreement between raters varied between moderate to substantial. IDx\u2010DR showed moderate agreement with human grading (<jats:italic>k<\/jats:italic>\u2009=\u20090.4285) while MONA DR had substantial agreement (<jats:italic>k<\/jats:italic>\u2009=\u20090.6797). Out of 106 patients with a ground truth of RDR, IDx\u2010DR identified 105 and MONA DR identified 99. The sensitivity and specificity rates for RDR detection of IDx\u2010DR were 99.1 and 71.5% compared with MONA DR of 93.4 and 89.3% respectively. Of note, both ARIAs had 100% sensitivity for the detection of STDR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Both ARIAs performed well in this study population, both with sensitivity for RDR screening over 90%, with IDx\u2010DR showing higher sensitivity and MONA DR higher specificity. MONA DR showed superior agreement with human certified graders.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.17428","type":"journal-article","created":{"date-parts":[[2024,12,10]],"date-time":"2024-12-10T12:55:06Z","timestamp":1733835306000},"page":"388-395","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Evaluating the efficacy of AI systems in diabetic retinopathy detection: A comparative analysis of Mona DR and IDx\u2010DR"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3724-2391","authenticated-orcid":false,"given":"Andrzej","family":"Grzybowski","sequence":"first","affiliation":[{"name":"Institute for Research in Ophthalmology Foundation for Ophthalmology Development  Poznan Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freya","family":"Peeters","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University Hospitals UZ 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