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RESEARCH PRODUCT
The Evonik-Mainz Eye Care-Study (EMECS): Development of an Expert System for Glaucoma Risk Detection in a Working Population
Jochen WahlPeter MorfeldL. BarleonS. Haas-brählerA. LichtmeßNorbert Pfeiffersubject
MaleIntraocular pressureEye Diseasesgenetic structuresOptic disklcsh:MedicineGlaucomacomputer.software_genreNerve Fibers0302 clinical medicineCost of IllnessRisk FactorsAnimal CellsOdds RatioPrevalenceMedicine and Health SciencesMedicine030212 general & internal medicinelcsh:ScienceNeuronsMultidisciplinaryPharmaceuticsApplied MathematicsSimulation and ModelingMiddle AgedVisual fieldPhysical SciencesFemaleAnatomyCellular TypesAlgorithmsResearch ArticleAdultmedicine.medical_specialtyOptic DiskResearch and Analysis MethodsSensitivity and SpecificityDiagnosis DifferentialTonometry Ocular03 medical and health sciencesDrug TherapyOcular SystemOphthalmologyHumansWorking populationIntraocular PressureAgedbusiness.industrylcsh:RBiology and Life SciencesGlaucomaOptic NerveCell BiologyOdds ratioGold standard (test)medicine.diseaseeye diseasesExpert systemOphthalmologyCellular Neuroscience030221 ophthalmology & optometryVisual Field TestsEyesOptometrylcsh:Qsense organsVisual FieldsbusinessHeadcomputerMathematicsNeurosciencedescription
Purpose To develop an expert system for glaucoma screening in a working population based on a human expert procedure using images of optic nerve head (ONH), visual field (frequency doubling technology, FDT) and intraocular pressure (IOP). Methods 4167 of 13037 (32%) employees between 40 and 65 years of Evonik Industries were screened. An experienced glaucoma expert (JW) assessed papilla parameters and evaluated all individual screening results. His classification into “no glaucoma”, “possible glaucoma” and “probable glaucoma” was defined as “gold standard”. A screening model was developed which was tested versus the gold-standard. This model took into account the assessment of the ONH. Values and relationships of CDR and IOP and the FDT were considered additionally and a glaucoma score was generated. The structure of the screening model was specified a priori whereas values of the parameters were chosen post-hoc to optimize sensitivity and specificity of the algorithm. Simple screening models based on IOP and / or FDT were investigated for comparison. Results 111 persons (2.66%) were classified as glaucoma suspects, thereof 13 (0.31%) as probable and 98 (2.35%) as possible glaucoma suspects by the expert. Re-evaluation by the screening model revealed a sensitivity of 83.8% and a specificity of 99.6% for all glaucoma suspects. The positive predictive value of the model was 80.2%, the negative predictive value 99.6%. Simple screening models showed insufficient diagnostic accuracy. Conclusion Adjustment of ONH and symmetry parameters with respect to excavation and IOP in an expert system produced sufficiently satisfying diagnostic accuracy. This screening model seems to be applicable in such a working population with relatively low age and low glaucoma prevalence. Different experts should validate the model in different populations.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2015-09-11 | PLOS ONE |