Emma Beede, Elizabeth Baylor, Fred Hersch, Anna Iurchenko, Lauren Wilcox, Paisan Ruamviboonsuk, Laura M. Vardoulakis, A Human-Centered Evaluation of a Deep Learning System Deployed in Clinics for the Detection of Diabetic Retinopathy, CHI '20: Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems, April 2020, Pages 1–12, https://doi.org/10.1145/3313831.3376718.
Referral Determinations
All images were initially assessed by a nurse then sent to an ophthalmologist for review. The ability to assess fundus photos for DR varied from nurse to nurse. While most nurses told us they felt comfortable assessing for the presence of DR, they didn’t know how to determine the severity if present. P4 told us, “I know if it’s not normal, but I don’t know what to call it.” To make the ultimate decision of whether a patient needs to be referred to an ophthalmologist for an exam and potentially for treatment, the nurse turned to the ophthalmologist or retinal specialist, who are most often remote.