Validation of automated screening for referable diabetic retinopathy with the IDx‐DR device in the Hoorn Diabetes Care System

Amber A van der Heijden, 1 , 2 Michael D Abramoff, 3 , 4 , 5 Frank Verbraak, 6 Manon V van Hecke, 7 Albert Liem, 8 and Giel Nijpels 1 , 2


To increase the efficiency of retinal image grading, algorithms for automated grading have been developed, such as the IDx‐DR 2.0 device. We aimed to determine the ability of this device, incorporated in clinical work flow, to detect retinopathy in persons with type 2 diabetes

Retinal images of persons treated by the Hoorn Diabetes Care System (DCS) were graded by the IDx‐DR device and independently by three retinal specialists using the International Clinical Diabetic Retinopathy severity scale (ICDR) and EURODIAB criteria. Agreement between specialists was calculated. Results of the IDx‐DR device and experts were compared using sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), distinguishing between referable diabetic retinopathy (RDR) and vision‐threatening retinopathy (VTDR). Area under the receiver operating characteristic curve (AUC) was calculated.