{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:35:28Z","timestamp":1787016928335,"version":"build-2736575974"},"reference-count":33,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T00:00:00Z","timestamp":1700006400000},"content-version":"unspecified","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004337","name":"St George's, University of London","doi-asserted-by":"crossref","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}],"id":[{"id":"10.13039\/501100004337","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["AI_HI200008"],"award-info":[{"award-number":["AI_HI200008"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["224390\/Z\/21\/Z"],"award-info":[{"award-number":["224390\/Z\/21\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,9,5]]},"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The English National Health Service (NHS) Diabetic Eye Screening Programme (DESP) performs around 2.3\u2009million eye screening appointments annually, generating approximately 13\u2009million retinal images that are graded by humans for the presence or severity of diabetic retinopathy. Previous research has shown that automated retinal image analysis systems, including artificial intelligence (AI), can identify images with no disease from those with diabetic retinopathy as safely and effectively as human graders, and could significantly reduce the workload for human graders. Some algorithms can also determine the level of severity of the retinopathy with similar performance to humans. There is a need to examine perceptions and concerns surrounding AI-assisted eye-screening among people living with diabetes and NHS staff, if AI was to be introduced into the DESP, to identify factors that may influence acceptance of this technology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>People living with diabetes and staff from the North East London (NEL) NHS DESP were invited to participate in two respective focus groups to codesign two online surveys exploring their perceptions and concerns around the potential introduction of AI-assisted screening.<\/jats:p>\n                    <jats:p>Focus group participants were representative of the local population in terms of ages and ethnicity. Participants\u2019 feedback was taken into consideration to update surveys which were circulated for further feedback. Surveys will be piloted at the NEL DESP and followed by semistructured interviews to assess accessibility, usability and to validate the surveys.<\/jats:p>\n                    <jats:p>Validated surveys will be distributed by other NHS DESP sites, and also via patient groups on social media, relevant charities and the British Association of Retinal Screeners. Post-survey evaluative interviews will be undertaken among those who consent to participate in further research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval has been obtained by the NHS Research Ethics Committee (IRAS ID: 316631). Survey results will be shared and discussed with focus groups to facilitate preparation of findings for publication and to inform codesign of outreach activities to address concerns and perceptions identified.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-075558","type":"journal-article","created":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T13:02:03Z","timestamp":1700053323000},"page":"e075558","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["What are the perceptions and concerns of people living with diabetes and National Health Service staff around the potential implementation of AI-assisted screening for diabetic eye disease? 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Understanding Healthcare workers\u2019 confidence in AI: NHS AI lab & health education England. 2022. Available: https:\/\/digital-transformation.hee.nhs.uk\/binaries\/content\/assets\/digital-transformation\/dart-ed\/understandingconfidenceinai-may22.pdf"},{"key":"2025121513254390000_13.11.e075558.2","unstructured":"GOV.UK . National AI strategy. 2021."},{"key":"2025121513254390000_13.11.e075558.3","unstructured":"Topol EJ . The Topol review: preparing the Healthcare workforce to deliver the Digital future. 2019. Available: https:\/\/topol.hee.nhs.uk\/the-topol-review\/ [accessed 8 Mar 2023]."},{"key":"2025121513254390000_13.11.e075558.4","unstructured":"NHS . NHS long term plan. In: Digitally-enabled care will go mainstream across the NHS. 2019. Available: https:\/\/www.longtermplan.nhs.uk\/online-version\/chapter-5-digitally-enabled-care-will-go-mainstream-across-the-nhs\/"},{"key":"2025121513254390000_13.11.e075558.5","unstructured":"Disparities of HI . NHS screening programmes in England. NHS Diabetic Eye Screening (DES) Programme, 2023. Available: https:\/\/www.gov.uk\/government\/publications\/nhs-screening-programmes-annual-report\/nhs-screening-programmes-in-england-2019-to-2020#nhs-diabetic-eye-screening-des-programme [accessed Mar 2023]."},{"key":"2025121513254390000_13.11.e075558.6","unstructured":"Zhelev Z , Peters J , Rogers M , et al . Automated grading in the diabetic eye screening programme: external review against programme appraisal criteria for the UK. 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