Point-of-care screening: what the evidence shows
AI devices that check for diabetic retinopathy at the point of care, or help primary care physicians decide whether to refer a skin lesion.
LumineticsCore and EyeArt autonomously check retinal images for diabetic retinopathy, and DermaSensor gives primary care physicians a result on a skin lesion to inform referral. The American Medical Association's AI taxonomy cites retinal imaging, Current Procedural Terminology code 92229, as its example of autonomous AI, which generates clinically meaningful conclusions without concurrent physician involvement. Medicare set payment for the code at $45 to $64 per exam from Jan. 1, 2022, according to a 2022 paper. DermaSensor was the first AI-enabled skin cancer device FDA authorized for non-specialists, a commentary noted.
A 2024 meta-analysis of 34 studies on real-world images found pooled sensitivity of 94% and specificity of 89% for AI diabetic retinopathy screening, among gradable images. In a test of seven anonymized algorithms from five companies, sensitivities ranged from 50.98% to 85.90%, most did no better than human graders, and the authors called for real-world testing of every algorithm before clinical use. Open questions include ungradable images in routine care and unnecessary referrals from low specificity.
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