{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:15:25Z","timestamp":1790658925658,"version":"4.1.0"},"reference-count":35,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1175405"],"award-info":[{"award-number":["APP1175405"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Global STEM Professorship Scheme","award":["P0046113"],"award-info":[{"award-number":["P0046113"]}]},{"name":"National Critical Research Infrastructure Initiative, Medical Research Future Fund","award":["MRFAI00035"],"award-info":[{"award-number":["MRFAI00035"]}]},{"name":"the State Key Laboratory of Ophthalmology, Project of Investigation on Health Status of Employees in Financial Industry in Guangzhou, China","award":["Z012014075"],"award-info":[{"award-number":["Z012014075"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2025,7,11]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the diagnostic accuracy, feasibility and end-user experiences of an artificial intelligence (AI)-based, automated diabetic retinopathy (DR) screening model in real-world, Australian primary care and endocrinology clinics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a pragmatic trial conducted across five sites including general practice and endocrinology clinics, from August 2021 to June 2023, patients aged \u226550 years, and those aged \u226518 years with diabetes were screened using an AI-integrated, non-mydriatic fundus camera. The AI instantly analysed the retinal images for referable DR. Patients detected with referable DR or ungradable images were referred to eyecare professionals. The accuracy of the AI grading was assessed against gold standard human grading. A satisfaction survey was administered among the participants and care providers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 863 participants enrolled (mean (SD) age: 62.6 (13.2) years; 53.0%\u2009women), the AI system achieved high accuracy of 93.3% (95% CI: 91.4% to 95.5%) for referable DR detection, with a sensitivity of 83.7% (95% CI: 78.2% to 88.3%), specificity of 96.1% (95% CI: 94.7% to 97.2%) and an area under the receiver operating characteristic curve of 0.899 (95% CI: 0.874 to 0.924). The proportion of ungradable images was lower according to the AI grading (13.4%) compared with human grading (15.6%). Most patients (86%) and care providers (85%) expressed high satisfaction with the AI system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The AI-assisted DR screening model was accurate and well received by patients and staff in Australian primary care and endocrinology clinics. This opportunistic screening model holds promise for enhancing early DR detection in non-eyecare settings, potentially preventing vision loss due to DR on a considerable scale.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2025-327447","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T10:25:18Z","timestamp":1755858318000},"page":"76-82","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Effectiveness of artificial intelligence-based diabetic retinopathy screening in primary care and endocrinology settings in Australia: a pragmatic trial"],"prefix":"10.1136","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8467-5544","authenticated-orcid":false,"given":"Sanil","family":"Joseph","sequence":"first","affiliation":[{"name":"Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia"},{"name":"Department 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Lingxue","family":"Jan","sequence":"additional","affiliation":[{"name":"Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia"},{"name":"Department of Surgery (Ophthalmology), The University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balagiri","family":"Sundar","sequence":"additional","affiliation":[{"name":"Lions Aravind Institute of Community Ophthalmology, Aravind Eye Care System, Madurai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9897-1192","authenticated-orcid":false,"given":"Zhuoting","family":"Zhu","sequence":"additional","affiliation":[{"name":"Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia"},{"name":"Department of Surgery (Ophthalmology), The University of Melbourne, Melbourne, Victoria, 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Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J","family":"MacIsaac","sequence":"additional","affiliation":[{"name":"Department of Endocrinology & Diabetes, St Vincent's Hosptial Melbourne, Fitzroy, Victoria, Australia"},{"name":"Department of Medicine, Univeristy of Melbourne, Fitzroy, Victoria, Melbourne"},{"name":"Australian Centre for Accelerating Diabetes Innovations, Univeristy of Melbourne, Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angus W","family":"Turner","sequence":"additional","affiliation":[{"name":"Centre for Ophthalmology and Visual Science, The University of Western Australia, Nedlands, Western Australia, Australia"},{"name":"Lions Outback Vision, Lions Eye Institute, Nedlands, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Van Wijngaarden","sequence":"additional","affiliation":[{"name":"Centre for Eye Research 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