New AI model could mean faster, more accurate patient recruitment for AMD clinical trials 

Until recently there were no effective treatments for GA, which affects 5 to 10 million people globally, but FDA approval in 2023 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 study has been published in Ophthalmology Science.

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 – 2023, and 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.

Development of the AI system relied on the advanced computing infrastructure and curated datasets of the INSIGHT Health Data Research Hub Programme at Moorfields. INSIGHT is the world’s largest bioresource of ophthalmic imaging linked to clinical data.

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.

The study was led by Moorfields Eye Hospital NHS Foundation Trust, University College London’s Institute of Ophthalmology and NIHR Moorfields Biomedical Research Centre in collaboration with researchers at the Centre for Eye Research Australia, University of Melbourne, University of Surrey and Bitfount Ltd. 

Authors: Dominic J. Williamson, Robbert R. Struyven, Fares Antaki, Blaise Thomson, Reena Chopra and Pearse A. Keane