Smartphone app could screen for anaemia
December 07 2018 12:06 AM
live issues

By Linda Carroll/Reuters Health

For people with chronic anaemia who want to monitor their condition or those who just suspect they might be anaemic, a fast answer could soon come from a smartphone selfie – of their fingernails, researchers say.
An algorithm developed by researchers in Atlanta was able to accurately pick up signs of anaemia just from the colouration of people’s nailbeds, the team reports in Nature Communications.
“The bottom line is that we have created a way for anyone to be able to screen themselves for anaemia anytime, anywhere, without the need to draw blood,” said senior study author Dr Wilbur Lam, an associate professor of biomedical engineering and paediatrics at the Georgia Institute of Technology and Emory University.
Nearly 2 billion people in the world have anaemia, according to the World Health Organisation. The condition is characterised by low levels of haemoglobin, a molecule on red blood cells that carries oxygen throughout the body. Anaemia can be caused by nutritional deficiencies or chronic illnesses like sickle cell disease and beta thalassaemia. Currently, diagnosis and monitoring require testing the blood for haemoglobin levels.
The new app Lam and his colleagues are developing uses a form of artificial intelligence to determine levels of haemoglobin by looking at the colour of a person’s nailbeds.
“Essentially, our algorithm learns from every time we feed it another smartphone image of someone’s fingernails with a haemoglobin level attached to it,” Lam said. “We’ve created a large database in my clinics. We enrol patients who are already getting their blood drawn to measure haemoglobin levels. Every time we do that, the algorithm is getting smarter and smarter.”
The algorithm was developed by the study’s lead author, Robert Mannino, who has been one of Lam’s patients since childhood. Now a Ph.D student at Georgia Tech and Emory, Mannino has a genetic disorder that leads to chronic anaemia and requires monthly transfusions to keep his haemoglobin levels at a normal level. When Mannino needed a dissertation topic, the choice seemed obvious. “He’s a brilliant computer programmer who is working on improving the health of people with his own disease,” Lam said.
To determine how accurately the new app could detect anaemia, the researchers rounded up 100 volunteers, some of whom had anaemia from a variety of causes, and some with healthy haemoglobin levels.
The volunteers downloaded the app and then took photos of their fingernails. The app analysed the images and compared them to the ones it had “seen” before. Ultimately, the app was quite good at detecting anaemia, identifying 97% of the people who did have the condition.
The app could be even more accurate, Lam said, if it was given one haemoglobin reading paired with a photo for an individual patient. With this accuracy level, the app would allow people with chronic anaemia issues to regularly and instantaneously monitor their haemoglobin levels.
The app would be especially useful for certain groups of people, Lam said. For example, “pregnant women are always at risk for anaemia and they know how bad it is for their babies,” he said. “Now they can test whenever they want.”
The app isn’t ready for widespread use yet as the researchers are continuing to refine it. But Lam thinks it might be available to the general public by next spring.
We’re going to see more and more of technology aiding in patient care, said Daniel Barchi, senior vice president and chief information officer at NewYork-Presbyterian Hospital in New York City.
“I think we’re generally going to find that technology, telemedicine and artificial intelligence are going to replace many of the functions we rely on physicians for today,” said Barchi.

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