{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T11:14:22Z","timestamp":1771413262121,"version":"3.50.1"},"reference-count":14,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:00:00Z","timestamp":1709251200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Summit Special Fund of the Clinical Centre for Cornea of the Optometry Hospital of Wenzhou Medical University","award":["YN-YXGF01"],"award-info":[{"award-number":["YN-YXGF01"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,1,12]]},"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Early eye screening and treatment can reduce the incidence of blindness by detecting and addressing eye diseases at an early stage. The Ophthalmologist Robot is an automated device that can simultaneously capture ocular surface and fundus images without the need for ophthalmologists, making it highly suitable for primary application. However, the accuracy of the device\u2019s screening capabilities requires further validation. This study aims to evaluate and compare the screening accuracies of ophthalmologists and deep learning models using images captured by the Ophthalmologist Robot, in order to identify a screening method that is both highly accurate and cost-effective. Our findings may provide valuable insights into the potential applications of remote eye screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This is a multicentre, prospective study that will recruit approximately 1578 participants from 3 hospitals. All participants will undergo ocular surface and fundus images taken by the Ophthalmologist Robot. Additionally, 695 participants will have their ocular surface imaged with a slit lamp. Relevant information from outpatient medical records will be collected. The primary objective is to evaluate the accuracy of ophthalmologists\u2019 screening for multiple blindness-causing eye diseases using device images through receiver operating characteristic curve analysis. The targeted diseases include keratitis, corneal scar, cataract, diabetic retinopathy, age-related macular degeneration, glaucomatous optic neuropathy and pathological myopia. The secondary objective is to assess the accuracy of deep learning models in disease screening. Furthermore, the study aims to compare the consistency between the Ophthalmologist Robot and the slit lamp in screening for keratitis and corneal scar using the Kappa test. Additionally, the cost-effectiveness of three eye screening methods, based on non-telemedicine screening, ophthalmologist-telemedicine screening and artificial intelligence-telemedicine screening, will be assessed by constructing Markov models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>The study has obtained approval from the ethics committee of the Ophthalmology and Optometry Hospital of Wenzhou Medical University (reference: 2023-026\u2009K-21-01). This work will be disseminated by peer-review publications, abstract presentations at national and international conferences and data sharing with other researchers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ChiCTR2300070082.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-077859","type":"journal-article","created":{"date-parts":[[2024,3,2]],"date-time":"2024-03-02T00:00:12Z","timestamp":1709337612000},"page":"e077859","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Evaluating the accuracy of the Ophthalmologist Robot for multiple blindness-causing eye diseases: a multicentre, prospective study protocol"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7228-5817","authenticated-orcid":false,"given":"Qixin","family":"Li","sequence":"first","affiliation":[{"name":"National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Tan","sequence":"additional","affiliation":[{"name":"Global Health Research Center, Duke Kunshan University, Kunshan, China"},{"name":"School of Public Health, Wuhan University, Wuhan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"He","family":"Xie","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Public Health and Management, Wenzhou Medical University, Wenzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qi","family":"Dai","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhongwen","family":"Li","sequence":"additional","affiliation":[{"name":"Ningbo Eye Hospital, Wenzhou Medical University, Ningbo 315000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lijing L","family":"Yan","sequence":"additional","affiliation":[{"name":"Global Health Research Center, Duke Kunshan University, Kunshan, China"},{"name":"School of Public Health, Wuhan University, Wuhan, China"},{"name":"Ningbo Eye Hospital, Wenzhou Medical University, Ningbo 315000, China"},{"name":"Peking University Institute for Global Health and Development, Peking University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Chen","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China"},{"name":"Ningbo Eye Hospital, Wenzhou Medical University, Ningbo 315000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,3,1]]},"reference":[{"key":"2025121513272050000_14.3.e077859.1","unstructured":"Vision impairment and blindness. Available: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/blindness-and-visual-impairment [Accessed 14 Oct 2022]."},{"key":"2025121513272050000_14.3.e077859.2","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2019-314336"},{"key":"2025121513272050000_14.3.e077859.3","doi-asserted-by":"crossref","unstructured":"Li J-P , Liu H , Ting DSJ , et al . Digital technology, TELE-medicine and artificial intelligence in Ophthalmology: A global perspective. Prog Retin Eye Res 2021;82. doi:10.1016\/j.preteyeres.2020.100900","DOI":"10.1016\/j.preteyeres.2020.100900"},{"key":"2025121513272050000_14.3.e077859.4","doi-asserted-by":"crossref","first-page":"3738","DOI":"10.1038\/s41467-021-24116-6","article-title":"Preventing corneal blindness caused by Keratitis using artificial intelligence","volume":"12","author":"Li","year":"2021","journal-title":"Nat Commun"},{"key":"2025121513272050000_14.3.e077859.5","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/j.ajo.2021.01.018","article-title":"Multidisease deep learning neural network for the diagnosis of corneal diseases","volume":"226","author":"Elsawy","year":"2021","journal-title":"Am J Ophthalmol"},{"key":"2025121513272050000_14.3.e077859.6","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1038\/s43587-022-00171-6","article-title":"Detecting visually significant cataract using retinal photograph-based deep learning","volume":"2","author":"Tham","year":"2022","journal-title":"Nat Aging"},{"key":"2025121513272050000_14.3.e077859.7","doi-asserted-by":"crossref","first-page":"e486","DOI":"10.1016\/S2589-7500(21)00086-8","article-title":"Application of comprehensive artificial intelligence retinal expert (CARE) system: a national real-world evidence study","volume":"3","author":"Lin","year":"2021","journal-title":"Lancet Digit Health"},{"key":"2025121513272050000_14.3.e077859.8","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0137913","article-title":"The cost-effectiveness analysis of Teleglaucoma screening device","volume":"10","author":"Thomas","year":"2015","journal-title":"PLoS ONE"},{"key":"2025121513272050000_14.3.e077859.9","doi-asserted-by":"crossref","first-page":"e968","DOI":"10.1016\/S2214-109X(19)30201-3","article-title":"Cost-effectiveness and cost-utility of population-based glaucoma screening in China: a decision-analytic Markov model","volume":"7","author":"Tang","year":"2019","journal-title":"Lancet Glob Health"},{"key":"2025121513272050000_14.3.e077859.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2012.09.002"},{"key":"2025121513272050000_14.3.e077859.11","doi-asserted-by":"crossref","unstructured":"Li R , Yang Z , Zhang Y , et al . Cost-effectiveness and cost-utility of traditional and Telemedicine combined population-based age-related macular degeneration and diabetic retinopathy screening in rural and urban China. Lancet Reg Health West Pac 2022;23. doi:10.1016\/j.lanwpc.2022.100435","DOI":"10.1016\/j.lanwpc.2022.100435"},{"key":"2025121513272050000_14.3.e077859.12","doi-asserted-by":"crossref","first-page":"e456","DOI":"10.1016\/S2214-109X(22)00554-X","article-title":"Economic evaluation of combined population-based screening for multiple blindness-causing eye diseases in China: a cost-effectiveness analysis","volume":"11","author":"Liu","year":"2023","journal-title":"Lancet Glob Health"},{"key":"2025121513272050000_14.3.e077859.13","doi-asserted-by":"crossref","unstructured":"Zhang Z , Wang H , Wang S , et al . Deep learning-based classification of infectious Keratitis on slit-lamp images. Ther Adv Chronic Dis 2022;13. doi:10.1177\/20406223221136071","DOI":"10.1177\/20406223221136071"},{"key":"2025121513272050000_14.3.e077859.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2014.02.013"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-077859","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T21:27:28Z","timestamp":1765834048000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-077859"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3]]},"references-count":14,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,3,1]]},"published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1136\/bmjopen-2023-077859"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-077859","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3]]}}}