Title:
A noninvasive, image-based smartphone app for diagnosing anemia

dc.contributor.advisor Lam, Wilbur A.
dc.contributor.author Mannino, Robert G.
dc.contributor.committeeMember Boudreaux, Jeanne
dc.contributor.committeeMember Clifford, Gari D.
dc.contributor.committeeMember Cooper, Lee A. D.
dc.contributor.committeeMember Qiu, Peng
dc.contributor.department Biomedical Engineering (Joint GT/Emory Department)
dc.date.accessioned 2019-05-29T13:58:26Z
dc.date.available 2019-05-29T13:58:26Z
dc.date.created 2018-05
dc.date.issued 2018-03-21
dc.date.submitted May 2018
dc.date.updated 2019-05-29T13:58:26Z
dc.description.abstract Smartphone-based telehealth is steadily transforming the delivery of medical care worldwide, moving diagnosis of disease from the clinic to the home to potentially anywhere in the globe. Smartphone images alone have recently been used by physicians to remotely diagnose a myriad of diseases. However, smartphone telehealth approaches have yet to non-invasively replace blood-based testing, which remains a major cornerstone of disease diagnosis in modern medicine. While the addition of specialized smartphone attachments and supplemental calibration tools may enable point-of-care diagnosis and analysis of tissue and bodily fluid samples, the additional burden of blood and/or tissue sample collections combined with the additional cost and inconvenience associated with this equipment, prevents worldwide use of these potentially disruptive approaches. Therefore, a smartphone-based system, requiring nothing other than the smartphones native technology and capable of non-invasively replacing blood-based diagnostics, would transform the very nature of telehealth and the delivery of healthcare worldwide. Towards that end, I specifically focused on anemia, a potentially life-threatening disorder characterized by low blood hemoglobin (Hgb) levels that affects approximately 2 billion people worldwide. Despite the high prevalence of anemia, all existing diagnostic approaches to measure Hgb require specialized equipment and represent tradeoffs between invasiveness, accuracy, infrastructure needs, and expense. Aside from being cost-prohibitive, the necessary invasive blood sampling to measure Hgb levels causes discomfort and trauma in younger pediatric patients. By examining clinical pallor, a common symptom of anemia, I developed a methodology that quantitatively analyzes patient-sourced photos using smartphone-based algorithms to enable a noninvasive, accurate, and accessible anemia diagnostic. Here, a patient simply takes a picture of their fingernail beds using their smartphone, and the image analysis algorithm analyzes color data and image metadata to measure the corresponding Hgb level. By quantifying clinical pallor, this system non-invasively measures Hgb levels to within a clinically significant and well accepted margin of error (±2.6 g/dL) of the gold standard Hgb measurement tool with a sensitivity and specificity of 0.90 and 0.82, respectively, of predicting anemia (defined as Hgb < 11.0g/dL) in 100 pediatric patients at Children’s Healthcare of Atlanta with anemia of any etiology mixed with healthy subjects. This algorithm has been implemented into a smartphone app that is capable of outperforming trained hematologists in physical examination-based Hgb measurement. Overall, this technology has the capability to change the treatment paradigm for anemia as patients no longer need to visit a clinic to monitor their hemoglobin. In this thesis, I discuss the development of this image analysis algorithm and the implementation of the algorithm into a smartphone app.
dc.description.degree Ph.D.
dc.format.mimetype application/pdf
dc.identifier.uri http://hdl.handle.net/1853/61131
dc.language.iso en_US
dc.publisher Georgia Institute of Technology
dc.subject Anemia
dc.subject Point-of-care diagnostics
dc.subject mHealth
dc.title A noninvasive, image-based smartphone app for diagnosing anemia
dc.type Text
dc.type.genre Dissertation
dspace.entity.type Publication
local.contributor.advisor Lam, Wilbur A.
local.contributor.corporatename Wallace H. Coulter Department of Biomedical Engineering
local.contributor.corporatename College of Engineering
relation.isAdvisorOfPublication 1c1e6049-d691-42bf-8032-715acc6c1bfa
relation.isOrgUnitOfPublication da59be3c-3d0a-41da-91b9-ebe2ecc83b66
relation.isOrgUnitOfPublication 7c022d60-21d5-497c-b552-95e489a06569
thesis.degree.level Doctoral
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