{"id":"AIBD-0648","title":"RAIDERS trial in Kigali, Rwanda: immediate Cybersight AI results raise referral uptake for diabetic retinopathy from 39.6% to 51.5%","summary":"In the RAIDERS trial at four Kigali diabetes clinics, immediate Cybersight AI feedback raised 30-day referral attendance to 51.5% from 39.6% with delayed human grading.","date_observed":"2021-07-01","date_basis":"event","date_precision":"month","benefit_status":"reported","source_collection":null,"source_entry":null,"account":"Orbis International and the Rwanda International Institute of Ophthalmology ran the RAIDERS randomized trial at four diabetes clinics in and around Kigali, Rwanda. Screening ran from March to June 2021, and follow-up continued through July 2021. Retinal images went to Cybersight AI, a grading service that Orbis offers free to eye health professionals in low- and middle-income countries and that returns a result within 60 seconds. The 275 adults whom the AI judged to need referral were randomly assigned to receive the AI result and referral advice at once or to receive referral advice after human grading three to five days later. Within 30 days, 70 of 136 people (51.5%) in the immediate group attended the referral service, against 55 of 139 (39.6%) in the delayed group (P = 0.048). The trial was small and short. Several authors are employees of Orbis, which provides the AI service.","category":"general benefit","unexpected":false,"purpose":"Cybersight AI was built to grade retinal images for referable diabetic retinopathy. In this trial its immediate result let clinics advise referral on the day of screening; the higher referral uptake was the purpose of that use.","system":"Cybersight AI","model_version":null,"developer":"Orbis International","deployer":"Orbis International with the Rwanda International Institute of Ophthalmology, at four diabetes clinics","location":"Kigali, Rwanda","domain":"Healthcare","segment":null,"benefit_type":"Improved Accessibility","taxonomy_note":null,"registry_ids":{},"ratings":[{"group":"personal","depth":2,"reason":"51.5% of people told their AI result at once attended referral services within 30 days against 39.6% of those told after human grading."}],"ai_role":{"status":"assessed","statement":"People who needed referral were randomly assigned to immediate AI feedback or to delayed human grading, so the difference in uptake is attributable to the immediate AI result."},"evidence":[{"kind":"peer-reviewed study","citation":"Leigh JA, Sherrington A, Barber ARJ, Turner AW, Kidd M, Powell J, Pope C. Referral uptake after diabetic retinopathy screening with artificial intelligence-assisted care pathways: a systematic review and meta-analysis. NPJ Digit Med. 2026;9:468. doi:10.1038/s41746-026-02616-3","title":"Referral uptake after diabetic retinopathy screening with artificial intelligence-assisted care pathways: a systematic review and meta-analysis","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13272687/","date":"2026-04-17","written_by":"independent","quote":"Mathenge et al.'s RAIDERS RCT ( n = 275) uniquely isolated the effect of immediate versus delayed feedback by randomising patients to immediate AI result acquisition with a colour-coded report based upon severity, or delayed manual grading (3-5 days) with SMS and phone calls to flag results, finding 51.5% versus 39.6% referral uptake respectively"},{"kind":"peer-reviewed study","citation":"Mathenge W, Whitestone N, Nkurikiye J, et al. Impact of Artificial Intelligence Assessment of Diabetic Retinopathy on Referral Service Uptake in a Low-Resource Setting: The RAIDERS Randomized Trial. Ophthalmol Sci. 2022;2(4):100168. doi:10.1016/j.xops.2022.100168","title":"Impact of Artificial Intelligence Assessment of Diabetic Retinopathy on Referral Service Uptake in a Low-Resource Setting: The RAIDERS Randomized Trial","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC9754978/","date":"2022-04-30","written_by":"makers","quote":"Referral adherence was statistically significantly higher in the intervention group (70/136 [51.5%]) versus the control group (55/139 [39.6%]; P = 0.048), a 30.1% increase."}],"replication":{"produced_by":["The AI returned a grade within 60 seconds of image upload.","Clinic staff gave referral advice on the day of screening.","The comparison was referral advice three to five days later after human grading."],"must_hold":["Clinics need an internet connection to reach the AI service.","Referral services must be reachable for the people referred."],"echoes":[{"date":"2024-08-31","setting":"Randomized trial at 24 hospitals in Kilimanjaro and Arusha, Tanzania (SELENA+)","model_version":null,"outcome":"recurred","source":"https://pubmed.ncbi.nlm.nih.gov/42863478/"}]},"paired_incident":null,"headline":"*Cybersight AI* results on the day lift eye referrals in Kigali","metric":"raised 30-day referral attendance to 51.5% from 39.6% with delayed human grading","comparator":{"against":"Referral advice after human grading three to five days later","before":"39.6% referral attendance within 30 days","after":"51.5% referral attendance within 30 days","basis":"measured","quote":"Referral adherence was statistically significantly higher in the intervention group (70/136 [51.5%]) versus the control group (55/139 [39.6%]; P = 0.048)","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC9754978/"},"later":null,"value":null,"developer_country":"United States","deployer_country":"Rwanda","unrated_because":null,"brief_notes":null,"brief":null,"revisions":[{"date":"2026-10-29","change":"Added the case.","source":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13272687/","editor":"AIBD"}],"confidence":"studied","shade":"high","claim_status":"Independently studied","claim_basis":"Sources: one independent peer-reviewed study and the makers' peer-reviewed study. The cited evidence includes no finding by a regulator or court.","case_jurisdictions":["Rwanda"],"profile":{"case_id":"AIBD-0648","catalog_version":"1.0.0","source_fingerprint":"c40b81ac6ea94a4f0d4778bcb5b983ed9cd250fa4d5cc22a4de5d95e4baa3441","collection_refs":[{"collection_id":"aibd","version":"2026-10-29"},{"collection_id":"viator","version":"2026-10-25"}],"source_ids":["AIBD-0648-source-0001","AIBD-0648-source-0002"],"families":{"strategic assessments":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"Editorial assignment.","review_state":"not_assessed","coverage":"partial","record_ids":[]},"evaluations":{"state":"value_present","value":{"kind":"identifiers","identifiers":["AIBD-0648-evaluation-1"],"role":"Evaluations of the benefit"},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":[],"source_refs":["AIBD-0648-source-0002"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"partial","record_ids":["AIBD-0648-evaluation-1"]},"monetary observations":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"Editorial assignment.","review_state":"not_assessed","coverage":"partial","record_ids":[]},"institutional decisions":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"Editorial assignment.","review_state":"not_assessed","coverage":"partial","record_ids":[]}},"fields":{"actors[]":{"state":"value_present","value":{"kind":"record_fields","fields":{"developer":"Orbis International","deployer":"Orbis International with the Rwanda International Institute of Ophthalmology, at four diabetes clinics"}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["developer","deployer"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"actors[].ownership_control":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"ai_contribution":{"state":"value_present","value":{"kind":"record_fields","fields":{"ai_role":{"status":"assessed","statement":"People who needed referral were randomly assigned to immediate AI feedback or to delayed human grading, so the difference in uptake is attributable to the immediate AI result."}}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["ai_role"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"ai_relationship":{"state":"value_present","value":{"kind":"record_fields","fields":{"category":"general benefit","ai_role":{"status":"assessed","statement":"People who needed referral were randomly assigned to immediate AI feedback or to delayed human grading, so the difference in uptake is attributable to the immediate AI result."}}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["ai_role","category"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"assessments[].alternatives":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"assessments[].assessor_date":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"assessments[].depth":{"state":"value_present","value":{"kind":"record_fields","fields":{"ratings":[{"group":"personal","depth":2,"reason":"51.5% of people told their AI result at once attended referral services within 30 days against 39.6% of those told after human grading."}]}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["ratings"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"assessments[].display_confidence":{"state":"value_present","value":{"kind":"structured","data":{"confidence":"high","evidence_word":"studied","claim_status":"Independently studied","basis":"Sources: one independent peer-reviewed study and the makers' peer-reviewed study. The cited evidence includes no finding by a regulator or court.","interpretation":"Existing display rule preserved; the richer outcome-specific confidence question still needs review."}},"provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"assessments[].rationale":{"state":"value_present","value":{"kind":"record_fields","fields":{"ratings":[{"group":"personal","depth":2,"reason":"51.5% of people told their AI result at once attended referral services within 30 days against 39.6% of those told after human grading."}]}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["ratings"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"assessments[].rubric_version":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"assessments[].status_basis":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"assessments[].target":{"state":"value_present","value":{"kind":"record_fields","fields":{"ratings":[{"group":"personal","depth":2,"reason":"51.5% of people told their AI result at once attended referral services within 30 days against 39.6% of those told after human grading."}]}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["ratings"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"availability":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"brief":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"case_kind":{"state":"value_present","value":{"kind":"structured","data":{"classification":"evaluation or study","answer":"The case describes an evaluation or a study. An investigator-masked parallel-group randomized trial.","scope":"The period and activity described in the case."}},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["account","evidence"],"source_refs":["AIBD-0648-source-0001"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"The case describes an evaluation or a study. An investigator-masked parallel-group randomized trial.","inferred":false}},"case_links[]":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Compared with the incidents in the AI Incident Database snapshot of 26 October 2026.","record_fields":["paired_incident"],"source_refs":[]},"reason":"No incident in the AI Incident Database snapshot of 26 October 2026 concerns the same kind of system harming the same kind of stakeholder.","review_state":"reviewed","coverage":"partial"},"claims[].evidence_links":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"claims[].evidence_strength":{"state":"value_present","value":{"kind":"structured","data":{"answer":"Independently studied. Sources: one independent peer-reviewed study and the makers' peer-reviewed study. The cited evidence includes no finding by a regulator or court.","evidence_word":"studied","claim_status":"Independently studied"}},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0648-source-0001","AIBD-0648-source-0002"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"Independently studied. Sources: one independent peer-reviewed study and the makers' peer-reviewed study. The cited evidence includes no finding by a regulator or court.","inferred":false}},"claims[].missingness":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"claims[].proposition":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"cross_border_flows[]":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"decisions[].action_outcome":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"institutional decisions"},"decisions[].grounds":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"institutional decisions"},"decisions[].institution_task":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"institutional decisions"},"decisions[].success_criterion":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"institutional decisions"},"deployment_stage":{"state":"value_present","value":{"kind":"structured","data":{"classification":"pilot","answer":"The system was used in a pilot. A trial attached to an AI-based screening project at four clinics.","scope":"The period and activity described in the case."}},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["account","evidence"],"source_refs":["AIBD-0648-source-0001"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"The system was used in a pilot. A trial attached to an AI-based screening project at four clinics.","inferred":false}},"economics[].amount":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"economics[].costs[]":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"economics[].counterfactual":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"economics[].currency_price_basis":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"economics[].gross_net":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"economics[].measure_type":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"economics[].period_unit":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"economics[].realization":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"economics[].recipient_payer":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"economics[].return_payback":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"economics[].valuation_method":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"monetary observations"},"evaluations[].ai_uplift":{"state":"value_present","value":{"kind":"text","text":"11.9 percentage points."},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0648-source-0002"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"11.9 percentage points.","inferred":false}},"evaluations[].comparator":{"state":"value_present","value":{"kind":"text","text":"Referral advice after human grading 3 to 5 days later."},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0648-source-0002"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"Referral advice after human grading 3 to 5 days later.","inferred":false}},"evaluations[].design":{"state":"value_present","value":{"kind":"text","text":"Randomized."},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0648-source-0002"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"Randomized.","inferred":false}},"evaluations[].effect":{"state":"value_present","value":{"kind":"text","text":"51.5% vs 39.6% (P = 0.048)."},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0648-source-0002"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"51.5% vs 39.6% (P = 0.048).","inferred":false}},"evaluations[].exposure":{"state":"value_present","value":{"kind":"text","text":"Immediate AI result for the intervention group."},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0648-source-0002"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"Immediate AI result for the intervention group.","inferred":false}},"evaluations[].id":{"state":"value_present","value":{"kind":"identifiers","identifiers":["AIBD-0648-evaluation-1"],"role":"Evaluations of the benefit"},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0648-source-0002"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"Randomized.","inferred":false}},"evaluations[].measurement_method":{"state":"value_present","value":{"kind":"text","text":"Presentation at referral services within 30 days."},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0648-source-0002"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"Presentation at referral services within 30 days.","inferred":false}},"evaluations[].metric":{"state":"value_present","value":{"kind":"text","text":"Referral uptake within 30 days."},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0648-source-0002"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"Referral uptake within 30 days.","inferred":false}},"evaluations[].reproduction_materials":{"state":"value_present","value":{"kind":"text","text":"Registered as PACTR202101512465690."},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0648-source-0002"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"Registered as PACTR202101512465690.","inferred":false}},"evaluations[].setting_sample":{"state":"value_present","value":{"kind":"text","text":"275 adults with referable findings at four diabetes clinics in and around Kigali, March to July 2021."},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0648-source-0002"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"275 adults with referable findings at four diabetes clinics in and around Kigali, March to July 2021.","inferred":false}},"evaluations[].uncertainty_limitations":{"state":"value_present","value":{"kind":"text","text":"Small sample; P value close to 0.05; authors employed by the AI provider."},"provenance":{"kind":"source_review","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":["AIBD-0648-source-0002"],"reviewed_on":"2026-10-29"},"review_state":"reviewed","coverage":"complete","display":{"answer":"Small sample; P value close to 0.05; authors employed by the AI provider.","inferred":false}},"external_references[]":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"follow_up[]":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"human_oversight":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"id":{"state":"value_present","value":{"kind":"record_fields","fields":{"id":"AIBD-0648"}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["id"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"infrastructure_dependencies[]":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"outcomes[].beneficiaries":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"outcomes[].beneficiary_count":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"outcomes[].benefit_type":{"state":"value_present","value":{"kind":"record_fields","fields":{"benefit_type":"Improved Accessibility"}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["benefit_type"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"outcomes[].claim":{"state":"value_present","value":{"kind":"record_fields","fields":{"account":"Orbis International and the Rwanda International Institute of Ophthalmology ran the RAIDERS randomized trial at four diabetes clinics in and around Kigali, Rwanda. Screening ran from March to June 2021, and follow-up continued through July 2021. Retinal images went to Cybersight AI, a grading service that Orbis offers free to eye health professionals in low- and middle-income countries and that returns a result within 60 seconds. The 275 adults whom the AI judged to need referral were randomly assigned to receive the AI result and referral advice at once or to receive referral advice after human grading three to five days later. Within 30 days, 70 of 136 people (51.5%) in the immediate group attended the referral service, against 55 of 139 (39.6%) in the delayed group (P = 0.048). The trial was small and short. Several authors are employees of Orbis, which provides the AI service.","benefit_type":"Improved Accessibility"}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["account","benefit_type"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"outcomes[].distribution":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"outcomes[].duration":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"outcomes[].id":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"outcomes[].stakeholder_group":{"state":"value_present","value":{"kind":"record_fields","fields":{"ratings":[{"group":"personal","depth":2,"reason":"51.5% of people told their AI result at once attended referral services within 30 days against 39.6% of those told after human grading."}]}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["ratings"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"outcomes[].status":{"state":"value_present","value":{"kind":"record_fields","fields":{"benefit_status":"reported"}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["benefit_status"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"outcomes[].tradeoffs":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"outcomes[].unexpected":{"state":"value_present","value":{"kind":"record_fields","fields":{"unexpected":false,"purpose":"Cybersight AI was built to grade retinal images for referable diabetic retinopathy. In this trial its immediate result let clinics advise referral on the day of screening; the higher referral uptake was the purpose of that use."}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["unexpected","purpose"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"places[]":{"state":"value_present","value":{"kind":"record_fields","fields":{"location":"Kigali, Rwanda","developer_country":"United States","deployer_country":"Rwanda"}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["location","developer_country","deployer_country"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"purpose":{"state":"value_present","value":{"kind":"record_fields","fields":{"purpose":"Cybersight AI was built to grade retinal images for referable diabetic retinopathy. In this trial its immediate result let clinics advise referral on the day of screening; the higher referral uptake was the purpose of that use."}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["purpose"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"record_dates":{"state":"value_present","value":{"kind":"record_fields","fields":{"date_observed":"2021-07-01","date_basis":"event","date_precision":"month","revisions":[{"date":"2026-10-29","change":"Added the case.","source":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13272687/","editor":"AIBD"}]}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["date_observed","date_basis","date_precision","revisions"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"replication.attempts[]":{"state":"value_present","value":{"kind":"record_fields","fields":{"replication":{"produced_by":["The AI returned a grade within 60 seconds of image upload.","Clinic staff gave referral advice on the day of screening.","The comparison was referral advice three to five days later after human grading."],"must_hold":["Clinics need an internet connection to reach the AI service.","Referral services must be reachable for the people referred."],"echoes":[{"date":"2024-08-31","setting":"Randomized trial at 24 hospitals in Kilimanjaro and Arusha, Tanzania (SELENA+)","outcome":"recurred","source":"https://pubmed.ncbi.nlm.nih.gov/42863478/"}]}}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["replication"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"replication.conditions":{"state":"value_present","value":{"kind":"record_fields","fields":{"replication":{"produced_by":["The AI returned a grade within 60 seconds of image upload.","Clinic staff gave referral advice on the day of screening.","The comparison was referral advice three to five days later after human grading."],"must_hold":["Clinics need an internet connection to reach the AI service.","Referral services must be reachable for the people referred."],"echoes":[{"date":"2024-08-31","setting":"Randomized trial at 24 hospitals in Kilimanjaro and Arusha, Tanzania (SELENA+)","outcome":"recurred","source":"https://pubmed.ncbi.nlm.nih.gov/42863478/"}]}}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["replication"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"revision_history[]":{"state":"value_present","value":{"kind":"record_fields","fields":{"revisions":[{"date":"2026-10-29","change":"Added the case.","source":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13272687/","editor":"AIBD"}]}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["revisions"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"sector":{"state":"value_present","value":{"kind":"record_fields","fields":{"domain":"Healthcare"}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["domain"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"sources[].access_version":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"sources[].citation_locator":{"state":"value_present","value":{"kind":"record_fields","fields":{"evidence":[{"kind":"peer-reviewed study","citation":"Leigh JA, Sherrington A, Barber ARJ, Turner AW, Kidd M, Powell J, Pope C. Referral uptake after diabetic retinopathy screening with artificial intelligence-assisted care pathways: a systematic review and meta-analysis. NPJ Digit Med. 2026;9:468. doi:10.1038/s41746-026-02616-3","title":"Referral uptake after diabetic retinopathy screening with artificial intelligence-assisted care pathways: a systematic review and meta-analysis","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13272687/","date":"2026-04-17","written_by":"independent","quote":"Mathenge et al.'s RAIDERS RCT ( n = 275) uniquely isolated the effect of immediate versus delayed feedback by randomising patients to immediate AI result acquisition with a colour-coded report based upon severity, or delayed manual grading (3-5 days) with SMS and phone calls to flag results, finding 51.5% versus 39.6% referral uptake respectively"},{"kind":"peer-reviewed study","citation":"Mathenge W, Whitestone N, Nkurikiye J, et al. Impact of Artificial Intelligence Assessment of Diabetic Retinopathy on Referral Service Uptake in a Low-Resource Setting: The RAIDERS Randomized Trial. Ophthalmol Sci. 2022;2(4):100168. doi:10.1016/j.xops.2022.100168","title":"Impact of Artificial Intelligence Assessment of Diabetic Retinopathy on Referral Service Uptake in a Low-Resource Setting: The RAIDERS Randomized Trial","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC9754978/","date":"2022-04-30","written_by":"makers","quote":"Referral adherence was statistically significantly higher in the intervention group (70/136 [51.5%]) versus the control group (55/139 [39.6%]; P = 0.048), a 30.1% increase."}]}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"sources[].id":{"state":"value_present","value":{"kind":"identifiers","identifiers":["AIBD-0648-source-0001","AIBD-0648-source-0002"],"role":"Existing evidence items, in their original order"},"provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"review_state":"record_mapped","coverage":"complete"},"sources[].language":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"sources[].relationship":{"state":"value_present","value":{"kind":"record_fields","fields":{"evidence":[{"kind":"peer-reviewed study","citation":"Leigh JA, Sherrington A, Barber ARJ, Turner AW, Kidd M, Powell J, Pope C. Referral uptake after diabetic retinopathy screening with artificial intelligence-assisted care pathways: a systematic review and meta-analysis. NPJ Digit Med. 2026;9:468. doi:10.1038/s41746-026-02616-3","title":"Referral uptake after diabetic retinopathy screening with artificial intelligence-assisted care pathways: a systematic review and meta-analysis","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13272687/","date":"2026-04-17","written_by":"independent","quote":"Mathenge et al.'s RAIDERS RCT ( n = 275) uniquely isolated the effect of immediate versus delayed feedback by randomising patients to immediate AI result acquisition with a colour-coded report based upon severity, or delayed manual grading (3-5 days) with SMS and phone calls to flag results, finding 51.5% versus 39.6% referral uptake respectively"},{"kind":"peer-reviewed study","citation":"Mathenge W, Whitestone N, Nkurikiye J, et al. Impact of Artificial Intelligence Assessment of Diabetic Retinopathy on Referral Service Uptake in a Low-Resource Setting: The RAIDERS Randomized Trial. Ophthalmol Sci. 2022;2(4):100168. doi:10.1016/j.xops.2022.100168","title":"Impact of Artificial Intelligence Assessment of Diabetic Retinopathy on Referral Service Uptake in a Low-Resource Setting: The RAIDERS Randomized Trial","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC9754978/","date":"2022-04-30","written_by":"makers","quote":"Referral adherence was statistically significantly higher in the intervention group (70/136 [51.5%]) versus the control group (55/139 [39.6%]; P = 0.048), a 30.1% increase."}]}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["evidence"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"sources[].upstream_sources":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"strategic_assessments[]":{"state":"unresolved","review_state":"not_assessed","coverage":"partial","family":"strategic assessments"},"summary":{"state":"value_present","value":{"kind":"record_fields","fields":{"summary":"In the RAIDERS trial at four Kigali diabetes clinics, immediate Cybersight AI feedback raised 30-day referral attendance to 51.5% from 39.6% with delayed human grading.","account":"Orbis International and the Rwanda International Institute of Ophthalmology ran the RAIDERS randomized trial at four diabetes clinics in and around Kigali, Rwanda. Screening ran from March to June 2021, and follow-up continued through July 2021. Retinal images went to Cybersight AI, a grading service that Orbis offers free to eye health professionals in low- and middle-income countries and that returns a result within 60 seconds. The 275 adults whom the AI judged to need referral were randomly assigned to receive the AI result and referral advice at once or to receive referral advice after human grading three to five days later. Within 30 days, 70 of 136 people (51.5%) in the immediate group attended the referral service, against 55 of 139 (39.6%) in the delayed group (P = 0.048). The trial was small and short. Several authors are employees of Orbis, which provides the AI service."}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["summary","account"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"systems[].autonomy_permissions":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"systems[].component_role":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"systems[].deployment_configuration":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"systems[].inputs_outputs":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"systems[].model_name":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"systems[].model_version":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"systems[].product_name":{"state":"value_present","value":{"kind":"record_fields","fields":{"system":"Cybersight AI"}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["system"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"systems[].provider":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"taxonomy_crosswalks[]":{"state":"unresolved","provenance":{"kind":"curatorial","basis":"Editorial assignment.","record_fields":[],"source_refs":[]},"reason":"This is an explicit unresolved assignment: the sources on record do not settle this question.","review_state":"not_assessed","coverage":"partial"},"title":{"state":"value_present","value":{"kind":"record_fields","fields":{"title":"RAIDERS trial in Kigali, Rwanda: immediate Cybersight AI results raise referral uptake for diabetic retinopathy from 39.6% to 51.5%","headline":"*Cybersight AI* results on the day lift eye referrals in Kigali"}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["title","headline"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"},"version":{"state":"value_present","value":{"kind":"identifiers","identifiers":["9fc68acf6064caeae5d44ea3819dc803960aa10bab9ce4dc6ea9c2955e7333b0"],"role":"SHA-256 of the complete public case and its assessments"},"provenance":{"kind":"curatorial","basis":"SHA-256 of the public case, its assessments, and its displayed answers and notes, excluding its own identifier and the derived coverage summary.","record_fields":[],"source_refs":[]},"review_state":"record_mapped","coverage":"complete"},"workflow":{"state":"value_present","value":{"kind":"record_fields","fields":{"account":"Orbis International and the Rwanda International Institute of Ophthalmology ran the RAIDERS randomized trial at four diabetes clinics in and around Kigali, Rwanda. Screening ran from March to June 2021, and follow-up continued through July 2021. Retinal images went to Cybersight AI, a grading service that Orbis offers free to eye health professionals in low- and middle-income countries and that returns a result within 60 seconds. The 275 adults whom the AI judged to need referral were randomly assigned to receive the AI result and referral advice at once or to receive referral advice after human grading three to five days later. Within 30 days, 70 of 136 people (51.5%) in the immediate group attended the referral service, against 55 of 139 (39.6%) in the delayed group (P = 0.048). The trial was small and short. Several authors are employees of Orbis, which provides the AI service.","replication":{"produced_by":["The AI returned a grade within 60 seconds of image upload.","Clinic staff gave referral advice on the day of screening.","The comparison was referral advice three to five days later after human grading."],"must_hold":["Clinics need an internet connection to reach the AI service.","Referral services must be reachable for the people referred."],"echoes":[{"date":"2024-08-31","setting":"Randomized trial at 24 hospitals in Kilimanjaro and Arusha, Tanzania (SELENA+)","outcome":"recurred","source":"https://pubmed.ncbi.nlm.nih.gov/42863478/"}]}}},"provenance":{"kind":"legacy_record","basis":"Editorial assignment.","record_fields":["account","replication"],"source_refs":[]},"review_state":"record_mapped","coverage":"partial"}},"summary":{"total":91,"addressed":91,"known":42,"reviewed":15,"reviewed_complete":14,"reviewed_partial":1,"record_mapped":28,"review_not_assessed":48,"not_assessed":0,"complete":false,"by_state":{"value_present":42,"not_reported":0,"unresolved":49,"not_assessed":0,"not_applicable":0,"withheld":0,"source_unavailable":0}}},"presentation_version":"dd69cd62059b49887d0c8311ab689d68425eab1d6cfcd463b05bf1bc9a3ce4f3"}