# Design and Validation of a Responsible Artificial Intelligence-based System for the Referral of Diabetic Retinopathy Patients

arXiv: https://arxiv.org/abs/2508.12506 · HTML: https://mlsanity.com/paper/2508.12506/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 10 of its 48 references that are in the map.
- First posted on arXiv 17 Aug 2025.

## Builds on (most cited first, 10 of 10)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Faster R-CNN: Towards Real-Time Object Detection with Region Proposal Networks](https://mlsanity.com/paper/1506.01497/) (2015)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- ["Why Should I Trust You?": Explaining the Predictions of Any Classifier](https://mlsanity.com/paper/1602.04938/) (2016)
- [MobileNets: Efficient Convolutional Neural Networks for Mobile Vision Applications](https://mlsanity.com/paper/1704.04861/) (2017)
- [EfficientNetV2: Smaller Models and Faster Training](https://mlsanity.com/paper/2104.00298/) (2021)
- [Fairness in Machine Learning: A Survey](https://mlsanity.com/paper/2010.04053/) (2020)
- [Common pitfalls and recommendations for using machine learning to detect and prognosticate for COVID-19 using chest radiographs and CT scans](https://mlsanity.com/paper/2008.06388/) (2020)
- [Understanding How Image Quality Affects Deep Neural Networks](https://mlsanity.com/paper/1604.04004/) (2016)
- [Can Fairness be Automated? Guidelines and Opportunities for Fairness-aware AutoML](https://mlsanity.com/paper/2303.08485/) (2023)

## Abstract (arXiv)

Diabetic Retinopathy (DR) is a leading cause of vision loss in working-age individuals. Early detection of DR can reduce the risk of vision loss by up to 95%, but a shortage of retinologists and challenges in timely examination complicate detection. Artificial Intelligence (AI) models using retinal fundus photographs (RFPs) offer a promising solution. However, adoption in clinical settings is hindered by low-quality data and biases that may lead AI systems to learn unintended features. To address these challenges, we developed RAIS-DR, a Responsible AI System for DR screening that incorporates ethical principles across the AI lifecycle. RAIS-DR integrates efficient convolutional models for preprocessing, quality assessment, and three specialized DR classification models. We evaluated RAIS-DR against the FDA-approved EyeArt system on a local dataset of 1,046 patients, unseen by both systems. RAIS-DR demonstrated significant improvements, with F1 scores increasing by 5-12%, accuracy by 6-19%, and specificity by 10-20%. Additionally, fairness metrics such as Disparate Impact and Equal Opportunity Difference indicated equitable performance across demographic subgroups, underscoring RAIS-DR's potential to reduce healthcare disparities. These results highlight RAIS-DR as a robust and ethically aligned solution for DR screening in clinical settings. The code, weights of RAIS-DR are available at https://gitlab.com/inteligencia-gubernamental-jalisco/jalisco-retinopathy with RAIL.