Artificial intelligence (AI)-based diagnostic algorithms have achieved ambitious aims through automated image pattern recognition. For neurological disorders, this includes neurodegeneration and inflammation. Scalable imaging technology for big data in neurology is optical coherence tomography (OCT). We highlight that OCT changes observed in the retina, as a window to the brain, are small, requiring rigorous quality control pipelines. There are existing tools for this purpose. Firstly, there are human-led validated consensus quality control criteria (OSCAR-IB) for OCT. Secondly, these criteria are embedded into OCT reporting guidelines (APOSTEL). The use of the described annotation of failed OCT scans advances machine learning. This is illustrated through the present review of the advantages and disadvantages of AI-based applications to OCT data. The neurological conditions reviewed here for the use of big data include Alzheimer disease, stroke, multiple sclerosis (MS), Parkinson disease, and epilepsy. It is noted that while big data is relevant for AI, ownership is complex. For this reason, we also reached out to involve representatives from patient organizations and the public domain in addition to clinical and research centers. The evidence reviewed can be grouped in a five-point expansion of the OSCAR-IB criteria to embrace AI (OSCAR-AI). The review concludes by specific recommendations on how this can be achieved practically and in compliance with existing guidelines.
Bibliographical noteFunding Information:
We (AP and PAK) acknowledge a proportion of our financial support from the National Institute for Health Research (NIHR) Biomedical Research Centre based at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology. JWS is based at the NIHR University College London Hospitals Biomedical Research Centre, which receives a proportion of funding from the UK Department of Health’s Biomedical Research Centres’ funding scheme. He receives support from the UK Epilepsy Society, the Dr. Marvin Weil Epilepsy Research Fund and the Christelijke Vereniging voor de Verpleging van Lijders aan Epilepsie, Netherlands. JNB is supported by the Dutch MS Research Foundation, grant nr. 18-1027. SW is supported by the Medical Research Council through a Clinical Research Training Fellowship. We are grateful to all consortium members, who have contributed on many levels to the conception and development of this manuscript over the course over the past years. Members of the IMSVISUAL and ERN-EYE Consortium include: Orhan Aktas, Jack Antel, Nasrin Asgari, Isabelle Audo, Jagannadha Avasarala, Daly Avril, Francesca R. Bagnato, Brenda Banwell, Amit Bar-Or, Raed Behbehani, Arnaldo Belzunce Manterola, Jeffrey Bennett, Leslie Benson, Jacqueline Bernard, Dominique Bremond-Gignac, Josefine Britze, Jodie Burton, Jonathan Calkwood, William Carroll, Arvind Chandratheva, Jeffrey Cohen, Giancarlo Comi, Christian Cordano, Silvana Costa, Fiona Costello, Ardith Courtney, Anes Cruz-Herranz, Gary Cutter, David Crabb, Lindsey Delott, Jerome De Seze, Ricarda Diem, Helene Dollfuss, Nabil K. El Ayoubi, Christina Fasser, Carsten Finke, Dominik Fischer, Kathryn Fitzgerald, Pedro Fonseca, Jette L. Frederiksen, Elliot Frohman, Teresa Frohman, Kazuo Fujihara, Iñigo Gabilondo Cuellar, Steven Galetta, Elena Garcia-Martin, Gavin Giovannoni, Brigita Glebauskiene, Inés González Suárez, Gorm Pihl Jensen, Steffen Hamann, Hans-Peter Hartung, Joachim Havla, Bernhard Hemmer, Su-Chun Huang, Jaime Imitola, Vytautas Jasinskas, Hong Jiang, Rahele Kafieh, Ludwig Kappos, Randy Kardon, David Keegan, Eric Kildebeck, Ungsoo Samuel Kim, Sasha Klistorner, Benjamin Knier, Scott Kolbe, Thomas Korn, Lauren Krupp, Wolf Lagrèze, Letizia Leocani, Netta Levin, Petra Liskova, Jana Lizrova Preiningerova, Birgit Lorenz, Eugene May, David Miller, Janine Mikolajczak, Saddek Mohand Saïd, Xavier Montalban, Mark Morrow, Ellen Mowry, Joaquim Murta, Carlos Navas, Rachel Nolan, Katarzyna Nowomiejska, Frederike Cosima Oertel, Jiwon Oh, Celia Oreja-Guevara, Christophe Orssaud, Benjamin Osborne, Olivier Outteryck, Catarina Paiva, Jacky Palace, Athina Papadopoulou, Nikos Patsopoulos, Jana Lizrova Preiningerova, Nikolas Pontikos, Markus Preising, Jerry Prince, Daniel Reich, Robert Rejdak, Marius Ringelstein, Luis Rodriguez de Antonio, Jose-Alain Sahel, Bernardo Sanchez-Dalmau, Jaume Sastre-Garriga, Sven Schippling, Joel Schuman, Ken Shindler, Robert Shin, Neil Shuey, Kerstin Soelberg, Svenja Specovius, Agnese Suppiej, Alan Thompson, Ahmed Toosy, Rubén Torres, Valérie Touitou, Susanne Trauzettel-Klosinski, Anneke van der Walt, Patrick Vermersch, Angela Vidal-Jordana, Amy T. Waldman, Christian Waters, Russell Wheeler, Owen White, Helmut Wilhelm, Kimberly M. Winges, Nils Wiegerinck, Lenja Wiehe, Thomas Wisnewski, Sui Wong, Jens Würfel, Shadi Yaghi, Yuyi You, Zhaoxia Yu, Patrick Yu-Wai-Man, Reda Žemaitien≐, and Hanna Zimmermann. More details about these collaborators are provided in Text S1.
A. Petzold is part of the steering committee of the ANGI network which is sponsored by ZEISS, steering committee of the OCTiMS study which is sponsored by Novartis, and reports speaker fees from Heidelberg Engineering. P. Albrecht reports consulting fees, research grants, and nonfinancial support from Allergan, Biogen, Celgene, Ipsen, Merck Serono, Merz Pharmaceuticals, Novartis, and Roche, consulting fees, and nonfinancial support from Bayer Healthcare, and Sanofi‐Aventis/Genzyme, outside the submitted work. L. Balcer reports personal fees from Biogen; she is editor in chief of the Journal of Neuro‐Ophthalmology. E. Bekkers has nothing to disclose. A. Brandt is cofounder and shareholder of startups Motognosis and Nocturne. He is named as inventor on several patent applications description MS serum biomarkers, perceptive visual computing, and retinal image analysis. R. Bremel has served as a consultant for Biogen, EMD Serono, Genzyme/Sanofi, Genentech/Roche, Novartis, and Viela Bio. He receives ongoing research support directed to his institution from Biogen, Genentech, and Novartis. P.A. Calabresi has received consulting fees for serving on scientific advisory boards for Biogen and Disarm Therapeutics, and is PI on grants to Johns Hopkins from Biogen, Gentech, and Annexon. O. Galvin has nothing to disclose. J.S. Graves has grant/contract research support from the National MS Society, Biogen, and Octave Biosciences. She serves on a steering committee for a trial supported by Novartis. She has received honoraria for a nonpromotional, educational activity for Sanofi‐Genzyme. She has received speaker fees from Alexion and BMS and served on an advisory board for Genentech. A. Green reports grants and other support from Inception Biosciences; grants from the National Multiple Sclerosis Society and from the US. National Institutes of Health; additional support from MedImmune, Mylan, Sandoz, Dr Reddy, Amneal, Momenta, Synthon, and JAMA Neurology, outside the submitted work; and that the Multiple Sclerosis Center, Department of Neurology, University of California San Francisco has received grant support from Novartis for participating in the OCTIMS study. P.A. Keane is supported by a Clinician Scientist award (CS‐2014‐14‐023) from the National Institute for Health Research. J. Nij Bijvank has nothing to disclose. J.W. Sander has been consulted by and received research grants and fees for lectures from Eisai, UCB, Zogenix, and GW Pharmaceuticals, outside the submitted work. F. Paul receives funding from Deutsche Forschungsgemeinschaft, Bundesministerium für Bildung und Forschung, and Guthy Jackson Charitable Foundation. FC has received consulting fees from Clene, EMD Serono, and PRIME, and is participating as a site investigator in the Novartis‐funded OCTIMS study. S. Saidha has received consulting fees from Medical Logix for the development of CME programs in neurology and has served on scientific advisory boards for Biogen‐Idec, Genzyme, Genentech Corporation, EMD Serono, and Celgene. He was the site investigator of a trial sponsored by MedDay Pharmaceuticals, and is the PI of investigator‐initiated studies funded by Genentech Corporation and Biogen Idec, and received support from the Race to Erase MS foundation. He has received equity compensation for consulting from JuneBrain LLC, a retinal imaging device developer. P. Villoslada has received an honorarium from Heidelberg Engineering in 2014, has received unrestricted research grants from Novartis (including for the OCTIMS study), Biogen, Genzyme, and Roche, and has participated in advisory boards for Novartis, Roche, Genzyme, and Biogen. PVi holds stocks in the following spin‐off companies: Bionure Inc, Spire Bioventures, Mintlabs, and Health Engineering. S. Wagner has nothing to disclose. E. Ann Yeh has received research funds from NMSS, CIHI, CIHR, NIH, OIRM, MS Society of Canada, Mario Battaglia Foundation, SickKids Foundation, CBMH Innovation Fund, CMSC, Stem Cell Network, Department of Defense, Rare Diseases Foundation, and Biogen. Unrestricted educational funds from Teva and Guthy‐Jackson Foundation. She has served on a scientific advisory panel for Hoffmann‐La Roche and Biogen and has received speaker’s honoraria from Novartis, CMSC, MS at the Limits, and Canadian Rheumatological Association.
We (AP and PAK) acknowledge a proportion of our financial support from the National Institute for Health Research (NIHR) Biomedical Research Centre based at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology. JWS is based at the NIHR University College London Hospitals Biomedical Research Centre, which receives a proportion of funding from the UK Department of Health’s Biomedical Research Centres’ funding scheme. He receives support from the UK Epilepsy Society, the Dr. Marvin Weil Epilepsy Research Fund and the Christelijke Vereniging voor de Verpleging van Lijders aan Epilepsie, Netherlands. JNB is supported by the Dutch MS Research Foundation, grant nr. 18‐1027. SW is supported by the Medical Research Council through a Clinical Research Training Fellowship.
© 2021 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association