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AI for glaucoma, Are we reporting well? a systematic literature review of DECIDE-AI checklist adherence

Leonard-Hawkhead, B., Higgins, B. E. ORCID: 0000-0002-4530-6156, Wright, D. & Azuara-Blanco, A. (2025). AI for glaucoma, Are we reporting well? a systematic literature review of DECIDE-AI checklist adherence. Eye, 39(6), pp. 1070-1080. doi: 10.1038/s41433-025-03678-5

Abstract

Background/Objectives
This systematic literature review examines the quality of early clinical evaluation of artificial intelligence (AI) decision support systems (DSS) reported in glaucoma care. Artificial Intelligence applications within glaucoma care are increasing within the literature. For such DSS, there needs to be standardised reporting to enable faster clinical adaptation. In May 2022, a checklist to facilitate reporting of early AI studies (DECIDE-AI) was published and adopted by the EQUATOR network.

Methods
The Cochrane Library, Embase, Ovid MEDLINE, PubMed, SCOPUS, and Web of Science Core Collection were searched for studies published between January 2020 and May 2023 that reported clinical evaluation of DSS for the diagnosis of glaucoma or for identifying the progression of glaucoma driven by AI. PRISMA guidelines were followed (PROSPERO registration: CRD42023431343). Study details were extracted and were reviewed against the DECIDE-AI checklist. The AI-Specific Score, Generic-Item Score, and DECIDE-AI Score were generated.

Results
A total of 1,552 records were screened, with 19 studies included within the review. All studies discussed an early clinical evaluation of AI use within glaucoma care, as defined by the a priori study protocol. Overall, the DECIDE-AI adherence score was low, with authors under reporting the AI specific items (30.3%), whilst adhering well to the generic reporting items (84.7%).

Conclusion
Overall, reporting of important aspects of AI studies was suboptimal. Encouraging editors and authors to incorporate the checklist will enhance standardised reporting, bolstering the evidence base for integrating AI DSS into glaucoma care workflows, thus help improving patient care and outcomes.

Publication Type: Article
Additional Information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Publisher Keywords: Education, Medical research
Subjects: R Medicine > RE Ophthalmology
Departments: School of Health & Medical Sciences
School of Health & Medical Sciences > Optometry & Visual Sciences
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