Artificial intelligence can enhance patient care after cataract surgery

A study has found that an automated artificial intelligence (AI) voice system enhances patient care after cataract surgery.

The AI-powered system, called Dora, can call patients to ask them questions, understand their answers and accurately identify responses that indicate the need for review by doctors. 

The study, conducted by researchers at Oxford University Hospitals (OUH) NHS Foundation Trust and Imperial College Healthcare NHS Trust, was published in The Lancet’s open access journal eClinicalMedicine. The study was funded by a National Institute for Health and Care Research (NIHR) Artificial Intelligence in Health and Care Award and co-led by Dr Kanmin Xue, honorary consultant ophthalmologist at OUH.

More than 200 patients who had recently undergone cataract surgery, the most common surgery performed by the NHS, received a call from Dora to conduct a follow-up assessment three weeks after their operation. The call was monitored by an ophthalmologist for the purpose of the study.  

The study compared the decisions made independently by Dora and the supervising ophthalmologist about the clinical significance of five symptoms and whether the patient required further review. During the study, Dora’s decisions agreed strongly with those of the clinicians. 

Chief investigator and consultant ophthalmologist at the Western Eye Hospital, Dr Eduardo Normando, said: "The Dora system is able to call patients autonomously by telephone and conduct a conversation that gathers the key information needed to determine whether a patient is recovering well or requires further medical assessment. It was successful in identifying and prioritising those individuals who needed further assessment by a doctor and helped to make sure those patients who were recovering well could continue their recovery at home without unnecessary appointments."

The study also evaluated how easy Dora is to use and whether the system was acceptable to patients recovering from cataract surgery. Researchers also considered the cost impact compared to standard care. Most participants were accepting of the AI follow-up, with some concern around the lack of a ‘human element’ in cases with complications.  

The study's co-Principal Investigator, Professor Edward Meinert, Professor of Digital Health and Clinical AI at Newcastle University, led the acceptability evaluation. He added: “Patient response to the AI system indicates its potential suitability for wider adaptation in other clinical pathways that could free up NHS time and resources.” 

More than 400,000 cataract surgeries are conducted in the NHS each year. Using this telemedicine follow-up assessment was estimated to have saved around £35 per patient compared to standard care. 

Research at Imperial College Healthcare is supported by funding from the National Institute for Health and Care Research (NIHR) Imperial Biomedical Research Centre (BRC), a translational research partnership between Imperial College Healthcare NHS Trust and Imperial College London, which was awarded £95m in 2022 to continue developing new experimental treatments and diagnostics for patients.

The development of Dora by Oxford spin-out company Ufonia was supported by Health Innovation Oxford and Thames Valley, which carried out a feasibility study, assessed feedback from clinicians and evaluated the cost benefits of incorporating Dora into the post-operative patient pathway.