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1
This retrospective diagnostic accuracy study assessed an on-premises, open-weight LLM for identifying documented pneumatic retinopexy in ophthalmology records from 2 hospitals.
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2
Among 542 keyword-enriched records, 110 (20.3%) documented pneumatic retinopexy, and the model classified 108 true positives, 407 true negatives, 25 false positives, and 2 false negatives.
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3
The model had 0.98 sensitivity, 0.94 specificity, 0.81 positive predictive value, and 0.99 negative predictive value against manual review.
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4
Of 25 false-positive classifications, 14 involved pneumatic displacement for submacular hemorrhage and 11 involved gas tamponade associated with pars plana vitrectomy.
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5
The authors support human-supervised case finding and targeted verification of positive classifications, with external multicenter validation and prospective workflow assessment needed before implemen
