This document discusses non-invasive methods for screening anemia, specifically smartphone apps that use images of fingernails. It provides background on anemia and current invasive screening methods. It then describes several non-invasive methods studied, including pulse oximetry, occlusion spectroscopy, and photoplethysmography. The document focuses on smartphone apps that use algorithms to analyze fingernail images and measure hemoglobin levels without a blood draw. Studies found good agreement between hemoglobin measurements from app analyses of images and evaluations by hematologists. Non-invasive screening via smartphone app offers an easy, economic method for anemia screening.
2. INTRODUCTION
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• Hemoglobin: an important constituent of the human blood responsible for
gaseous transportation for respiratory process.
• Changes in hemoglobin concentration (Hb) below or above normal levels affect the
overall function of the human body leading to Anemia or Polycythemia .
• Anemia caused by iron deficiency has a very high prevalence in developing nations.
• Therefore, measurement of blood hemoglobin concentration is important for the
diagnosis of these diseases.
3. Anemia
one of the most serious public health problem
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world’s second-leading disability
reduced hemoglobin concentration lower ability for the blood to carry
oxygen to the body tissues.
4. Cyanmethemoglobin
Hemoglobin estimation
In rural areas, less expensive and more reliable method must be used
Different invasive and non-invasive methods were analyzed
Hemocue
Widely used invasive methods
5. Invasive method
DRAWBACKS
More risk of infection
More discomfort for patients
requirement of skilled clinical staff
inability for continuous measurement
Cost- effective
6. NON-INVASIVE METHODS
“Type of hemoglobin estimation methods that has been
introduced with the aim of preventing ache to blood donor.”
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8. ADVANTAGES
Accurate, fast, easy to operate
Avoids tissue injury
eliminates the production of biohazardous waste
sampling error proof
reduces the need for trained workers
Non-invasive methodS
11. a form of non-invasive Spectrophotometric method used for monitoring O2
and MetHb, carboxyHb, & total Hb by this multi-wavelength technique
Procedure:
Illuminating
the skin
Measures changes in
light absorption of
oxygenated and
deoxygenated blood
Light passing as of the LED
through the finger is
calculated by a photo
detector positioned
contradictory to LED
the software determines the
disparity between absorption during
diastole and systole at both
wavelengths.
PULSE OXIMETRY
12. Occlusion spectroscopy
Procedure:
Pressurizing assembly (Occluder)
Measuring & Control unit
1. Operates via a ring-shaped sensor,
fitted on the donor’s finger
2. device applies pressure, temporarily gently
squeezing the finger to over-systolic pressure,
3. This occludes the blood flow
4. optical elements in the sensor, using an array of
calibrated light sources, measure absorption, and
scattering of the light transmitted through the finger.
13. “optical measurement method- uses a light source and a
photodetector at the surface of the skin to measure volumetric
variations of blood circulation”
PHOTOPLETHYSMOGRAPHY (IMAGE PROCESSING)
14. Procedure:
• Saif Al Zahir and Han Donker gave the non invasive method to estimate Hb
level in the blood, which utilizes the approach to estimate hemoglobin using
color-analysis.
• Method: is to get signal image scanning using photoplethysmographic
technique, when extremity is placed near proximity to Near Infrared (NIR).
• The model fetches the color information from the image of the fingertip under
standard conditions.
15. • The method-in-use creates two images for each person without
applying pressure on the fingertip so that there is deposition of blood
at the fingertip.
• The clip-on sensor concerns NIR on one side and a photo diode on the
other side.
• NIR emit infrared rays which are captured by photonic detector.
• The signal from the device is recorded and then the recorded signal
was processed.
• Then signal to image conversion is done finally.
16. APP DEVELOPMENT
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The Hgb level measurement algorithm was incorporated into
mobile apps.
Android OS Open Source Integrated Development
Environment (IDE) Android Studio
iOS IDE Xcode
17. Anemo Check
SMARTPHONE APPS
for non-invasive detection of
anemia using only patient-
sourced photos.
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Hema Check
Anaemia
algorithm
App
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19. As smartphone images with fingernail
irregularities such as camera flash reflections
or leukonychia may affect Hgb level
measurements, a quality control algorithm
integrated within the Hgb level measurement
app detects and omits those irregularities to
preserve measurement integrity and accuracy.
To that end, the user selects regions of
interest from within the fingernail image.
20. Any color values that fall outside of expected color ranges are excluded from Hgb measurement.
21. Calibration phase
Custom algorithm generation relating fingernail color
Images taken
&
Testing phase
Custom algorithm applied to images
Hemoglobin levels measured
22. Studies conducted
Robert G. Mannino et al conducted a study on Smartphone app for non-invasive detection
of anemia using only patient-sourced photos.
• Images of fingernails were taken of 50 subjects ages ranged from 1 to 62 years old.
• Hematologists were instructed to analyze each image and measure Hgb levels.
• For comparison, images were loaded into the app, and the Hgb measurement
protocol was performed on these images.
• All images and analysis were taken using smart mobile.
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23. Studies conducted
• Intraclass Correlation Coefficient (ICC) reflects agreement between
measurements, and ranges between 0 and 1, with values closer to 1 representing
stronger reliability.
• The ICC is able to incorporate the reliability of more than 2 raters-as in the
case of the 5 hematologists evaluating nail beds.
Patients and the physicians were assumed to be random samples from the respective
populations they represent.
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24. CONCLUSION
o As invasive and non invasive methods are present, but non
invasive methods like by using app is easy for screening.
o Future research can be done on developing more rapid
and advance economic methods for anemia.
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