Benefits
- Benefit
-
Raised clinic attendance for referable retinopathy from 18.2% to 35.9%
Awaiting review
- Outcome identifiers
-
Unresolved
Not reviewedUnresolved
- Category
-
Improved Accessibility
Awaiting review
- Status
-
Reported benefit
Awaiting review
- Beneficiary groups
-
People. Organizations.
Awaiting review
- Beneficiaries
-
Unresolved
Not reviewedUnresolved
- Reach
-
Unresolved
Not reviewedUnresolved
- Distribution and access
-
Unresolved
Not reviewedUnresolved
- Duration
-
Unresolved
Not reviewedUnresolved
- Expected?
-
Yes
Awaiting review
- Costs and harms
-
Unresolved
Not reviewedUnresolved
AI system
- System
-
SELENA+
Awaiting review
- Model
-
This is an explicit unresolved assignment: the sources on record do not settle this question.
Not reviewedUnresolved
- Release
-
Unresolved
Not reviewedUnresolved
- Provider
-
Unresolved
Not reviewedUnresolved
- Role
-
Unresolved
Not reviewedUnresolved
- Configuration
-
Unresolved
Not reviewedUnresolved
- Inputs and outputs
-
Unresolved
Not reviewedUnresolved
- Autonomy
-
Unresolved
Not reviewedUnresolved
- Workflow
-
The AI gave a grade at the clinic before the person left. Staff counselled people face to face and referred them at once. The comparison was deferred human grading with telephone counselling weeks later.
Awaiting review
- Human oversight
-
Unresolved
Not reviewedUnresolved
- Relation to AI
-
Participants were randomly assigned to AI-supported screening with an immediate result or to standard screening with deferred human grading. The design does not separate the AI result from the face-to-face counselling that it made possible.
Awaiting review
- AI contribution
-
Participants were randomly assigned to AI-supported screening with an immediate result or to standard screening with deferred human grading. The design does not separate the AI result from the face-to-face counselling that it made possible.
Awaiting review
Measurement
- Studies
-
Randomized. [1]
Fully reviewed: supporting details for Studies
Review date: 29 October 2026.
Sources: [1]
- Study design
-
Randomized. [1]
Fully reviewed: supporting details for Study design
Review date: 29 October 2026.
Sources: [1]
- Measurement
-
Attendance at the central ophthalmology clinic within 8 weeks, among participants with referable retinopathy by masked UK-certified graders. [1]
Fully reviewed: supporting details for Measurement
Review date: 29 October 2026.
Sources: [1]
- Setting and sample
-
2,378 adults with diabetes at 24 hospitals in Kilimanjaro and Arusha, 8 March 2023 to 31 August 2024; 904 with referable disease. [1]
Fully reviewed: supporting details for Setting and sample
Review date: 29 October 2026.
Sources: [1]
- Measures
-
Clinic attendance within 8 weeks. [1]
Fully reviewed: supporting details for Measures
Review date: 29 October 2026.
Sources: [1]
- Comparison
-
Deferred human grading and telephone counselling. [1]
Fully reviewed: supporting details for Comparison
Review date: 29 October 2026.
Sources: [1]
- Results
-
35.9% vs 18.2%; odds ratio 2.52. [1]
Fully reviewed: supporting details for Results
Review date: 29 October 2026.
Sources: [1]
- Additional value from AI
-
17.7 percentage points. [1]
Fully reviewed: supporting details for Additional value from AI
Review date: 29 October 2026.
Sources: [1]
- Limitations
-
AI effect not separated from face-to-face counselling; attendance remained low in both groups. [1]
Fully reviewed: supporting details for Limitations
Review date: 29 October 2026.
Sources: [1]
Money
- Kind of value
-
The kind of monetary value is unclear.
Not reviewedUnresolved
- Amount
-
The monetary value is not established.
Not reviewedUnresolved
- Currency and prices
-
The currency and price basis are unclear.
Not reviewedUnresolved
- Period and unit
-
The period and unit of the monetary estimate are unclear.
Not reviewedUnresolved
- Realization
-
Whether the monetary value was realized is unclear.
Not reviewedUnresolved
- Recipients and payers
-
The recipients and payers are unclear.
Not reviewedUnresolved
- Gross or net
-
Whether the monetary figure includes costs is unclear.
Not reviewedUnresolved
- Included costs
-
The costs included in the estimate are unclear.
Not reviewedUnresolved
- Comparison
-
The financial comparison is not established.
Not reviewedUnresolved
- Method
-
The method used to calculate monetary value is unclear.
Not reviewedUnresolved
- Return and payback
-
The return on investment or payback period is not established.
Not reviewedUnresolved
People and places
- Participants
-
Developer: EyRIS. Operator: London School of Hygiene & Tropical Medicine and Kilimanjaro Christian Medical Centre, with diabetes clinics in 24 hospitals.
Awaiting review
- Jurisdictions
-
Benefit: Kilimanjaro and Arusha regions,
Tanzania. Developer: 
Singapore. Operator: Tanzania.Awaiting review
- Ownership and control
-
Unresolved
Not reviewedUnresolved
- Dependencies
-
Unresolved
Not reviewedUnresolved
- Cross-border connections
-
Unresolved
Not reviewedUnresolved
- Geopolitical implications
-
The geopolitical implications are unclear.
Not reviewedUnresolved
Follow-up
- Conditions for replication
-
The AI must work offline and with the local cameras, two criteria that the trial team used to choose it. Staff must be available to counsel people at the point of screening. People must be able to travel to the central eye clinic.
Awaiting review
- Replication attempts
-
2 follow-up entries. Benefit recurred: 2.
Awaiting review
- Later findings
-
Unresolved
Not reviewedUnresolved
- Availability
-
Unresolved
Not reviewedUnresolved
- Institutional decision
-
A relevant institutional decision has not been established.
Not reviewedUnresolved
- Grounds
-
The grounds for an institutional decision are unclear.
Not reviewedUnresolved
- Action and result
-
The result of an institutional decision is not established.
Not reviewedUnresolved
- Success criterion
-
The criterion for a successful institutional decision is unclear.
Not reviewedUnresolved
Evidence
- Source numbers
-
AIBD-0647-source-0001–0002
Awaiting review
- Citations
-
Numbered references below.
Awaiting review
- Language
-
Unresolved
Not reviewedUnresolved
- Source relationships
-
Independent
Awaiting review
- Original evidence
-
Unresolved
Not reviewedUnresolved
- Access and versions
-
Unresolved
Not reviewedUnresolved
- Supported findings
-
Unresolved
Not reviewedUnresolved
- Evidence links
-
Unresolved
Not reviewedUnresolved
- Evidence strength
-
Independently studied. Sources: two independent peer-reviewed studies. The cited evidence includes no finding by a regulator or court. [1] [2]
- Missing evidence
-
Unresolved
Not reviewedUnresolved
Grades
- Assessed benefits
-
People. Organizations.
Awaiting review
- Depth
-
People: 2. Organizations: 2.
Awaiting review
- Reasons
-
People: Among people with referable diabetic retinopathy, 35.9% in the AI group reached the eye clinic within eight weeks against 18.2% in the standard group. Organizations: The screening program doubled the share of referred people who completed the referral.
Awaiting review
- Observed or intended
-
Unresolved
Not reviewedUnresolved
- Rubric
-
Unresolved
Not reviewedUnresolved
- Assessor and date
-
Unresolved
Not reviewedUnresolved
- Alternative assessments
-
Unresolved
Not reviewedUnresolved
- Fill
-
Independently studied
Awaiting review
Entry details
- Kind
-
The case describes an evaluation or a study. An individually randomized controlled trial. [1]
Fully reviewed: supporting details for Kind
Review date: 29 October 2026.
Sources: [1]
- Related entries
-
No incident in the AI Incident Database snapshot of 26 October 2026 concerns the same kind of system harming the same kind of stakeholder.
Partly reviewedUnresolved: supporting details for Related entries
Compared with the incidents in the AI Incident Database snapshot of 26 October 2026.
- Field
-
Healthcare.
Awaiting review
- Purpose
-
SELENA+ was built to grade retinal photographs for diabetic retinopathy. In this trial it gave a result at the point of screening so that staff could counsel and refer people at once; the higher attendance was the purpose of that use.
Awaiting review
- Dates
-
Observed: 31 August 2024. Updated: 29 October 2026.
Awaiting review
- Stage
-
The system was used in a pilot. A randomized trial at 24 hospital clinics in two regions. [1]
Fully reviewed: supporting details for Stage
Review date: 29 October 2026.
Sources: [1]
- Version
-
SHA-256: defe3432c5c4…
Awaiting review: supporting details for Version
SHA-256 of the public case, its assessments, and its displayed answers and notes, excluding its own identifier and the derived coverage summary.
References
- Other identifiers
-
Unresolved
Not reviewedUnresolved
- Category mappings
-
Unresolved
Not reviewedUnresolved
- Citable summary
-
Unresolved
Not reviewedUnresolved
- Revisions
-
1 revision. Latest: 29 October 2026.
Awaiting review
Sources
-
Peer-reviewed study Independent author
Cleland CR, Bascaran C, Makupa WU, et al. Artificial intelligence-supported diabetic retinopathy screening in Tanzania: a randomised controlled trial. Lancet Glob Health. 2026. doi:10.1016/j.langlo.2026.104062
Of the participants in the AI-intervention group, 157 (35·9%) of 437 attended the central ophthalmology clinic within 8 weeks, compared with 85 (18·2%) of 467 in the standard-of-care group, an absolute difference of 17·7 percentage points (95% CI 12·0-23·4; odds ratio 2·52 [95% CI 1·86-3·42]
-
Peer-reviewed study Independent author
Cleland CR, et al. Artificial intelligence-supported diabetic retinopathy screening in Tanzania: rationale and design of a randomised controlled trial. BMJ Open. 2024;14:e075055.
The SELENA+AI software (EyRIS) 15 was the only system to meet all these criteria and was therefore selected.