# RFA-DP-24-081 Implementing AI-based Glaucoma Screening within Federally Qualified Health Centers

> **NIH ALLCDC U01** · UNIVERSITY OF ALABAMA AT BIRMINGHAM · 2024 · $750,000

## Abstract

The number of primary open angle glaucoma (POAG) cases will increase by 250% by 2050,
directly affecting over 7 million lives. Development of high-quality, accessible, and cost-effective
strategies for eye care for these individuals is critically important. POAG is 4-5 times higher in
Blacks, progresses more rapidly, and appears about 10 years earlier compared to those of
European descent. This proposal evaluates a novel screening approach developed from our
prior CDC-funded glaucoma detection study (AL-SIGHT), utilizing a hybrid type 2
implementation science design. This will enable evaluating feasibility of program expansion
occurring simultaneously with a comparative effectiveness trial of the intervention. This
implementation study will evaluate a modified streamlined version of our AI-SIGHT screening
protocol by including a validated artificial intelligent algorithm to provide interpretation of ocular
imaging and clinical data obtained within Federally Qualified Health Centers (FQHCs) located in
medically underserved regions. Using this program within FQHC’s will facilitate potential
expansion nationwide. These centers provide primary health care services for lower income
people and treat more than 27 million people yearly at over 12,000 sites. Moreover, we are
targeting patients at-risk for glaucoma living in areas with large Black populations. Our prior
research in FQHC’s has demonstrated a higher prevalence of POAG at FQHCs than when
screening in the general population. This high “pre-test” probability addresses critical concerns
expressed by the US Preventative Screening Task Force (USPSTF) that population screening is
not merited. Moreover, patients in AL-SIGHT demonstrated a high rate of follow-up (at 76%) to
recommended eye examination due to the integration of FQHC’s into their local communities.
We have developed and tested a novel multimodal telemedicine approach in our current CDC-
funded AL-SIGHT study within FQHCs, with good agreement with expert diagnosis and
adherence to follow-up. Patients were satisfied with the screening. Yet this approach is limited
in expandability in that it still requires expert physician guidance. With the new protocol we will
determine the ability of validated AI algorithms to make screening diagnoses, previously shown
to provide diagnostically equivalent recommendations to physician diagnoses, reducing the cost
of implementation. The study will identify POAG screening rates, adherence to follow-up care
rates, cost effectiveness of the protocol, and acceptability for primary care provider and patients.
If our outcomes are successful, we will develop a scalability plan for FQHCs. Our long-range
goal is to reduce the personal burden of POAG in medically underserved areas.

## Key facts

- **NIH application ID:** 11023851
- **Project number:** 1U01DP006827-01
- **Recipient organization:** UNIVERSITY OF ALABAMA AT BIRMINGHAM
- **Principal Investigator:** CHRISTOPHER Anthony GIRKIN
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** ALLCDC
- **Fiscal year:** 2024
- **Award amount:** $750,000
- **Award type:** 1
- **Project period:** 2024-09-30 → 2029-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11023851

## Citation

> US National Institutes of Health, RePORTER application 11023851, RFA-DP-24-081 Implementing AI-based Glaucoma Screening within Federally Qualified Health Centers (1U01DP006827-01). Retrieved via MORVS 2026-10-27 from https://api.morvs.ai/grant/nih/11023851. Licensed CC0.

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