Universität zu Köln

Wahl, Jochen, Barleon, Lorenz, Morfeld, Peter, Lichtmess, Andrea, Haas-Braehler, Sibylle and Pfeiffer, Norbert (2016). The Evonik-Mainz Eye Care-Study (EMECS): Development of an Expert System for Glaucoma Risk Detection in a Working Population. PLoS One, 11 (8). SAN FRANCISCO: PUBLIC LIBRARY SCIENCE. ISSN 1932-6203

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Abstract

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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Wahl, Jochen UNSPECIFIED UNSPECIFIED UNSPECIFIED Barleon, Lorenz UNSPECIFIED UNSPECIFIED UNSPECIFIED Morfeld, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Lichtmess, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Haas-Braehler, Sibylle UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfeiffer, Norbert UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-268116
DOI:	10.1371/journal.pone.0158824
Journal or Publication Title:	PLoS One
Volume:	11
Number:	8
Date:	2016
Publisher:	PUBLIC LIBRARY SCIENCE
Place of Publication:	SAN FRANCISCO
ISSN:	1932-6203
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OPEN-ANGLE GLAUCOMA; INTRAOCULAR-PRESSURE; OPTIC DISC; PREVALENCE; DEFINITIONS; SENSITIVITY; NUMBER; RATIO Multiple languages Multidisciplinary Sciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/26811