PurposeCompare wide-field Optomap imaging and optical coherence tomography (OCT) with clinical examination in diabetic retinopathy (DR).MethodsPatients referred from Diabetic Eye Screening Programmes to three centres underwent dilated ophthalmoscopy and were assigned a DR grade. Wide-field colour imaging and OCT were then examined by the same clinician at that visit and a combined grade was assigned. Independent graders later reviewed the images and assigned an imaging-only grade. These three grades (clinical, combined, and imaging) were compared. The method that detected the highest grade of retinopathy, including neovascularisation, was determined.ResultsTwo thousand and forty eyes of 1023 patients were assessed. Wide-field imaging compared with clinical examination had a sensitivity and specificity of 73% and 96%, respectively, for detecting proliferative DR, 84% and 69% for sight-threatening DR, and 64% and 90% for diabetic macular oedema. Imaging alone found 35 more eyes with new vessels (19% of eyes with new vessels) and the combined grade found 14 more eyes than clinical examination alone.ConclusionsAssessment of wide-field images and OCT alone detected more eyes with higher grades of DR compared with clinical examination alone or when combined with imaging in a clinical setting. The sensitivity was not higher as the techniques were not the same, with imaging alone being more sensitive. Wide-field imaging with OCT could be used to assess referrals from DR screening to determine management, to enhance the quality of assessment in clinics, and to follow-up patients whose DR is above the screening referral threshold but does not actually require treatment.
In this paper we formulate and solve a distributed binary hypothesis-testing problem. We consider a cooperative team that consists of two decision makers (DM's); one is refered to as the primary DM and the other as the consulting DM. The team objective is to carry out binary hypothesis testing based upon uncertain measurements. The primary DM can declare his decision based only on its own measurements; however, in ambiguous situations the primary DM can ask the consulting DM for an opinion and it incurs a communications cost. Then the consulting DM transmits either a definite recommendation or pleads ignorance. The primary DM has the responsibility of making a final definitive decision. The team objective is the minimization of the probability of error, taking into account different costs for hypothesis misclassification and communication costs. Numerical results are included to demonstrate the dependence of the different decision thresholds on the problem parameters, including different perceptions of the prior information.
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