Tele-ophthalmology-enabled and artificial intelligence-ready referral pathway for community optometry referrals of retinal disease: HERMES cluster randomised trial with a diagnostic accuracy study

作者：Anitta Sharma, R Hussain, Annastazia Learoyd, Angela Aristidou, Taha Soomro, Ann Blandford, John G Lawrenson, Gabriela Grimaldi, Abdel Douiri, Ashleigh Kernohan, Tomos Robinson, Najmeh Moradi, Christiana Dinah, Evangelos Minos, Dawn A. Sim, Tariq Aslam, Avinash Manna, Alastair K. Denniston, Praveen J Patel, Pearse A. Keane, Catey Bunce, L. Vale, Konstantinos Balaskas · 发表于：Health Technology Assessment · 年份：2025 · DOI：10.3310/qndf3325 · 被引用次数：4 · 研究领域：Retinal Diseases and Treatments、Retinal Imaging and Analysis、Glaucoma and retinal disorders

Background: Community-based optometrists, a major provider of primary eye care in the United Kingdom, are the main source of referrals to hospital eye services. The widespread introduction of optical coherence tomography devices in community practices provides community-based optometrists with an opportunity to identify a broader range of treatable diseases. Standard referral pathways do not effectively filter unnecessary referrals, with misclassification of urgency, and erroneous diagnoses. Objectives: To assess the effectiveness of a teleophthalmology referral pathway between community-based optometrists and hospital eye services for retinal diseases. To measure the accuracy of an artificial intelligence decision support system for diagnosis and referral management of retinal disease. Design: A multicentre, superiority cluster randomised controlled trial to assess the effectiveness of a teleophthalmology referral pathway. A prospective, observational diagnostic accuracy study to measure the performance of artificial intelligence decision support system. A comprehensive economic evaluation was conducted. Settings: United Kingdom-based community optometry practices with an optical coherence tomography device and hospital eye services. Participants: Adults requiring referral for retinal disease at the opinion of the community-based optometrists. Interventions: Community optometry practices were randomised 1 : 1 to standard care or teleophthalmology. Referrals sent via the tele...