Smartphone app could screen for anemia

(Reuters Health) - - For people with chronic anemia who want to monitor their condition or those who just suspect they might be anemic, 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 anemia just from the coloration 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 anemia anytime, anywhere, without the need to draw blood,” said senior study author Dr. Wilbur Lam, an associate professor of biomedical engineering and pediatrics at the Georgia Institute of Technology and Emory University.

Nearly 2 billion people in the world have anemia, according to the World Health Organization. The condition is characterized by low levels of hemoglobin, a molecule on red blood cells that carries oxygen throughout the body. Anemia can be caused by nutritional deficiencies or chronic illnesses like sickle cell disease and beta thalassemia. Currently, diagnosis and monitoring require testing the blood for hemoglobin levels.

The new app Lam and his colleagues are developing uses a form of artificial intelligence to determine levels of hemoglobin by looking at the color of a person’s nailbeds.

“Essentially, our algorithm learns from every time we feed it another smartphone image of someone’s fingernails with a hemoglobin level attached to it,” Lam said. “We’ve created a large database in my clinics. We enroll patients who are already getting their blood drawn to measure hemoglobin 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 anemia and requires monthly transfusions to keep his hemoglobin 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 anemia, the researchers rounded up 100 volunteers, some of whom had anemia from a variety of causes, and some with healthy hemoglobin levels.

The volunteers downloaded the app and then took photos of their fingernails. The app analyzed the images and compared them to the ones it had “seen” before. Ultimately, the app was quite good at detecting anemia, identifying 97 percent of the people who did have the condition.

The app could be even more accurate, Lam said, if it was given one hemoglobin reading paired with a photo for an individual patient. With this accuracy level, the app would allow people with chronic anemia issues to regularly and instantaneously monitor their hemoglobin levels.

The app would be especially useful for certain groups of people, Lam said. For example, “pregnant women are always at risk for anemia 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, who was not involved in the new research. “And if technology can speed up processes and relieve physicians from rote work and that allows them to concentrate on higher processes, so much the better.”

A smart phone app that can analyze a fingernail photo and “be able to diagnose anemia fairly accurately is a movement in the right direction,” said Dr. Rasu Shrestha, chief innovation officer at the University of Pittsburgh Medical Center in Pennsylvania. “This is part of a trend, I think, of moving healthcare closer to the consumer.”

The new app may offer a window on the kind of medical tasks our phones will be able to take over, said Shrestha, who was not involved in the study. “There’s a wealth of data just waiting to be unlocked.”

SOURCE: Nature Communications, online December 4, 2018.