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      Accuracy of a deep convolutional neural network in the detection of myopic macular diseases using swept-source optical coherence tomography

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          Abstract

          This study examined and compared outcomes of deep learning (DL) in identifying swept-source optical coherence tomography (OCT) images without myopic macular lesions [i.e., no high myopia (nHM) vs. high myopia (HM)], and OCT images with myopic macular lesions [e.g., myopic choroidal neovascularization (mCNV) and retinoschisis (RS)]. A total of 910 SS-OCT images were included in the study as follows and analyzed by k-fold cross-validation (k = 5) using DL's renowned model, Visual Geometry Group-16: nHM, 146 images; HM, 531 images; mCNV, 122 images; and RS, 111 images (n = 910). The binary classification of OCT images with or without myopic macular lesions; the binary classification of HM images and images with myopic macular lesions (i.e., mCNV and RS images); and the ternary classification of HM, mCNV, and RS images were examined. Additionally, sensitivity, specificity, and the area under the curve (AUC) for the binary classifications as well as the correct answer rate for ternary classification were examined.

          The classification results of OCT images with or without myopic macular lesions were as follows: AUC, 0.970; sensitivity, 90.6%; specificity, 94.2%. The classification results of HM images and images with myopic macular lesions were as follows: AUC, 1.000; sensitivity, 100.0%; specificity, 100.0%. The correct answer rate in the ternary classification of HM images, mCNV images, and RS images were as follows: HM images, 96.5%; mCNV images, 77.9%; and RS, 67.6% with mean, 88.9%.Using noninvasive, easy-to-obtain swept-source OCT images, the DL model was able to classify OCT images without myopic macular lesions and OCT images with myopic macular lesions such as mCNV and RS with high accuracy. The study results suggest the possibility of conducting highly accurate screening of ocular diseases using artificial intelligence, which may improve the prevention of blindness and reduce workloads for ophthalmologists.

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          The meaning and use of the area under a receiver operating characteristic (ROC) curve.

          A representation and interpretation of the area under a receiver operating characteristic (ROC) curve obtained by the "rating" method, or by mathematical predictions based on patient characteristics, is presented. It is shown that in such a setting the area represents the probability that a randomly chosen diseased subject is (correctly) rated or ranked with greater suspicion than a randomly chosen non-diseased subject. Moreover, this probability of a correct ranking is the same quantity that is estimated by the already well-studied nonparametric Wilcoxon statistic. These two relationships are exploited to (a) provide rapid closed-form expressions for the approximate magnitude of the sampling variability, i.e., standard error that one uses to accompany the area under a smoothed ROC curve, (b) guide in determining the size of the sample required to provide a sufficiently reliable estimate of this area, and (c) determine how large sample sizes should be to ensure that one can statistically detect differences in the accuracy of diagnostic techniques.
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            Inception-v4, Inception-ResNet and the Impact of Residual Connections on Learning

            Very deep convolutional networks have been central to the largest advances in image recognition performance in recent years. One example is the Inception architecture that has been shown to achieve very good performance at relatively low computational cost. Recently, the introduction of residual connections in conjunction with a more traditional architecture has yielded state-of-the-art performance in the 2015 ILSVRC challenge; its performance was similar to the latest generation Inception-v3 network. This raises the question: Are there any benefits to combining Inception architectures with residual connections? Here we give clear empirical evidence that training with residual connections accelerates the training of Inception networks significantly. There is also some evidence of residual Inception networks outperforming similarly expensive Inception networks without residual connections by a thin margin. We also present several new streamlined architectures for both residual and non-residual Inception networks. These variations improve the single-frame recognition performance on the ILSVRC 2012 classification task significantly. We further demonstrate how proper activation scaling stabilizes the training of very wide residual Inception networks. With an ensemble of three residual and one Inception-v4 networks, we achieve 3.08% top-5 error on the test set of the ImageNet classification (CLS) challenge.
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              A comparison of deep learning performance against health-care professionals in detecting diseases from medical imaging: a systematic review and meta-analysis

              Deep learning offers considerable promise for medical diagnostics. We aimed to evaluate the diagnostic accuracy of deep learning algorithms versus health-care professionals in classifying diseases using medical imaging.
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                Author and article information

                Contributors
                Role: Writing – original draft
                Role: ConceptualizationRole: Supervision
                Role: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: Validation
                Role: Conceptualization
                Role: Methodology
                Role: Investigation
                Role: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                16 April 2020
                2020
                : 15
                : 4
                : e0227240
                Affiliations
                [1 ] Department of Ophthalmology, Tsukazaki Hospital, Himeji, Japan
                [2 ] Department of Technology and Design Thinking for Medicine, Hiroshima University Graduate School, Hiroshima, Japan
                [3 ] Ikuno Eye Center, Osaka, Japan
                [4 ] Ohsugi Eye Clinic, Kobe, Japan
                [5 ] Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
                Massachusetts Eye & Ear Infirmary, Harvard Medical School, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0003-3956-9352
                Article
                PONE-D-19-34572
                10.1371/journal.pone.0227240
                7161961
                32298265
                70689ac0-0df4-46d3-8a78-92fffa63a111
                © 2020 Sogawa et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 13 December 2019
                : 29 March 2020
                Page count
                Figures: 3, Tables: 4, Pages: 14
                Funding
                The authors received no specific funding for this work.
                Categories
                Research Article
                Computer and Information Sciences
                Neural Networks
                Biology and Life Sciences
                Neuroscience
                Neural Networks
                Medicine and Health Sciences
                Ophthalmology
                Visual Impairments
                Myopia
                Medicine and Health Sciences
                Diagnostic Medicine
                Diagnostic Radiology
                Tomography
                Research and Analysis Methods
                Imaging Techniques
                Diagnostic Radiology
                Tomography
                Medicine and Health Sciences
                Radiology and Imaging
                Diagnostic Radiology
                Tomography
                Medicine and Health Sciences
                Diagnostic Medicine
                Biology and Life Sciences
                Physiology
                Cardiovascular Physiology
                Vasculogenesis
                Medicine and Health Sciences
                Physiology
                Cardiovascular Physiology
                Vasculogenesis
                Biology and Life Sciences
                Developmental Biology
                Morphogenesis
                Vasculogenesis
                Medicine and Health Sciences
                Geriatrics
                Geriatric Ophthalmology
                Macular Degeneration
                Medicine and Health Sciences
                Ophthalmology
                Geriatric Ophthalmology
                Macular Degeneration
                Medicine and Health Sciences
                Ophthalmology
                Retinal Disorders
                Macular Disorders
                Macular Degeneration
                Medicine and Health Sciences
                Ophthalmology
                Retinal Disorders
                Retinal Degeneration
                Macular Degeneration
                Research and Analysis Methods
                Imaging Techniques
                Biology and Life Sciences
                Anatomy
                Head
                Eyes
                Medicine and Health Sciences
                Anatomy
                Head
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                Biology and Life Sciences
                Anatomy
                Ocular System
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                Medicine and Health Sciences
                Anatomy
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