Comparing code-free and bespoke deep learning approaches in ophthalmology

Carolyn Yu Tung Wong; Ciara O'Byrne; Priyal Taribagil; Timing Liu; Fares Antaki; Pearse Andrew Keane

doi:10.1007/s00417-024-06432-x

Comparing code-free and bespoke deep learning approaches in ophthalmology

Graefes Arch Clin Exp Ophthalmol. 2024 Mar 6. doi: 10.1007/s00417-024-06432-x. Online ahead of print.

Authors

Carolyn Yu Tung Wong^{1

2

3}, Ciara O'Byrne^{1

2}, Priyal Taribagil^{1

2}, Timing Liu^{1

2}, Fares Antaki^{1

2

4}, Pearse Andrew Keane^{5

6

7}

Affiliations

¹ Institute of Ophthalmology, University College London, 11-43 Bath St, London, EC1V 9EL, UK.
² Moorfields Eye Hospital NHS Foundation Trust, London, UK.
³ Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
⁴ The CHUM School of Artificial Intelligence in Healthcare, Montreal, QC, Canada.
⁵ Institute of Ophthalmology, University College London, 11-43 Bath St, London, EC1V 9EL, UK. p.keane@ucl.ac.uk.
⁶ Moorfields Eye Hospital NHS Foundation Trust, London, UK. p.keane@ucl.ac.uk.
⁷ NIHR Moorfields Biomedical Research Centre, London, UK. p.keane@ucl.ac.uk.

PMID: 38446200
DOI: 10.1007/s00417-024-06432-x

Abstract

Aim: Code-free deep learning (CFDL) allows clinicians without coding expertise to build high-quality artificial intelligence (AI) models without writing code. In this review, we comprehensively review the advantages that CFDL offers over bespoke expert-designed deep learning (DL). As exemplars, we use the following tasks: (1) diabetic retinopathy screening, (2) retinal multi-disease classification, (3) surgical video classification, (4) oculomics and (5) resource management.

Methods: We performed a search for studies reporting CFDL applications in ophthalmology in MEDLINE (through PubMed) from inception to June 25, 2023, using the keywords 'autoML' AND 'ophthalmology'. After identifying 5 CFDL studies looking at our target tasks, we performed a subsequent search to find corresponding bespoke DL studies focused on the same tasks. Only English-written articles with full text available were included. Reviews, editorials, protocols and case reports or case series were excluded. We identified ten relevant studies for this review.

Results: Overall, studies were optimistic towards CFDL's advantages over bespoke DL in the five ophthalmological tasks. However, much of such discussions were identified to be mono-dimensional and had wide applicability gaps. High-quality assessment of better CFDL applicability over bespoke DL warrants a context-specific, weighted assessment of clinician intent, patient acceptance and cost-effectiveness. We conclude that CFDL and bespoke DL are unique in their own assets and are irreplaceable with each other. Their benefits are differentially valued on a case-to-case basis. Future studies are warranted to perform a multidimensional analysis of both techniques and to improve limitations of suboptimal dataset quality, poor applicability implications and non-regulated study designs.

Conclusion: For clinicians without DL expertise and easy access to AI experts, CFDL allows the prototyping of novel clinical AI systems. CFDL models concert with bespoke models, depending on the task at hand. A multidimensional, weighted evaluation of the factors involved in the implementation of those models for a designated task is warranted.

Keywords: Artificial intelligence; Automated-machine learning; Code-free deep learning; Machine learning.

Publication types

Review