A new artificial intelligence (AI) system could significantly reduce the time and cost required to recruit clinical trial patients for geographic atrophy (GA), an advanced form of age-related macular degeneration (AMD).
The system has been developed by a team from University College London and Moorfields Eye Hospital.1
Until recently there were no effective treatments for GA, which affects five to 10 million people globally, but recent approval in the United States of two medications showing modest efficacy has spurred many new clinical trials for the condition.
The new AI system demonstrates potential for overcoming a major obstacle to GA clinical trials — recruiting enough patients that meet the trial criteria.
the system could quickly differentiate between nuanced stages of the disease and exclude patients with co-existing conditions that may rule them out of trial participation
To assess the AI model, researchers ran an algorithm on 602,826 optical coherence tomography (OCT) retinal scans from an ethnically diverse dataset of 306,651 Moorfields patients spanning 2008 to 2023. They identified a shortlist of patients most likely to be eligible for GA clinical trials.
Compared with the conventional approach of finding clinical trial patients using a keyword search on electronic health records (EHR), the AI system identified almost twice as many candidates and with higher precision.
Crucially, the system could quickly differentiate between nuanced stages of the disease and exclude patients with co-existing conditions that may rule them out of trial participation.
For one particular trial, the AI system shortlisted 1,139 patients with 63% precision compared to the EHR search, which shortlisted 693 patients with 40% precision. A combined approach using both AI and EHR systems identified 604 eligible patients with 86% precision.
Because the model only requires retinal scans to find candidate patients, it could work effectively in clinics and hospitals where text-based electronic records may not be easily searchable, but where stored retinal scans are readily accessible.
In addition, the AI was tested on an ethnically diverse dataset representing the population of London, which may make it transferable to many global sites for potential recruitment of GA clinical trial patients.
“Our AI system shows promise for real-world application in recruiting patients for GA clinical trials more efficiently,” lead author Dominic Williamson, a PhD student at UCL, said.
“It could also be developed to identify individuals who may benefit from new treatments as they become available.”
The study was published in Ophthalmology Science.2
References
1. University College London, AI model to improve clinical trial recruitment for eye disease (media release, 25 June 2024) available at: ucl.ac.uk/news/2024/jun/ai-model-improve-clinical-trial-recruitment-eye-disease [accessed July 2024].
2. Williamson DJ, Stuyven RR, Keane PA, et al., Artificial intelligence to facilitate clinical trial recruitment in age-related macular degeneration. Ophthalmology Science, article in press, published online 19 June 2024. doi: 10.1016/j.xops.2024.100566.
