European Heart Journal – Digital Health, April 2023
This study aims to evaluate the ability of a deep-learning-based cardiovascular disease (CVD) retinal biomarker, Reti-CVD,
to identify individuals with intermediate- and high-risk for CVD.
Methods and results
We defined the intermediate- and high-risk groups according to Pooled Cohort Equation (PCE), QRISK3, and modified
Framingham Risk Score (FRS). Reti-CVD’s prediction was compared to the number of individuals identified as intermediateand high-risk according to standard CVD risk assessment tools, and sensitivity, specificity, positive predictive value (PPV), and
negative predictive value (NPV) were calculated to assess the results. In the UK Biobank, among 48 260 participants, 20 643
(42.8%) and 7192 (14.9%) were classified into the intermediate- and high-risk groups according to PCE, and QRISK3, respectively. In the Singapore Epidemiology of Eye Diseases study, among 6810 participants, 3799 (55.8%) were classified
as intermediate- and high-risk group according to modified FRS. Reti-CVD identified PCE-based intermediate- and highrisk groups with a sensitivity, specificity, PPV, and NPV of 82.7%, 87.6%, 86.5%, and 84.0%, respectively. Reti-CVD identified
QRISK3-based intermediate- and high-risk groups with a sensitivity, specificity, PPV, and NPV of 82.6%, 85.5%, 49.9%, and
96.6%, respectively. Reti-CVD identified intermediate- and high-risk groups according to the modified FRS with a sensitivity,
specificity, PPV, and NPV of 82.1%, 80.6%, 76.4%, and 85.5%, respectively
The retinal photograph biomarker (Reti-CVD) was able to identify individuals with intermediate and high-risk for CVD, in
accordance with existing risk assessment tools.