Hybrid Integent Staging of Age-Related Macular Degeneration for Decision-Making on Patient Management Tactics

Treatment efficacy for age-related macular degeneration relies on early diagnosis and precise determination of the disease stage. It involves analyzing biomarkers in retinal images, which can be challenging when handling a large flow of patients and compromise the quality of healthcare services. Clinical decision support systems offer a solution to this issue by employing intelligent algorithms to recognize biomarkers and specify the age-related macular degeneration stage through the analysis of retinal images. However, different stages of age-related macular degeneration may exhibit similar biomarkers, complicating the application of intelligent algorithms. This paper introduces an approach to overcome these challenges using hybrid and hierarchical classification. By leveraging the hybrid structure of the classifier, we can effectively manage issues commonly encountered with medical data sets, such as class imbalance and strong correlations between variables. The modifications to the intelligent algorithm proposed in this work for staging age-related macular degeneration resulted in an increase in average accuracy, sensitivity, and specificity by 20% compared to initial values. The Cohen’s Kappa coefficient used for consistency estimation between the regression model and expert assessments of the intermediate class severity was 0.708, indicating a high level of agreement.