Integrating smartphone photography for trachoma, smartphone visual acuity assessment, and mobile autorefraction to enhance community-based public health monitoring

整合智能手机沙眼摄影、智能手机视力评估和移动自动验光，加强社区公共卫生监测

• 批准号: 10487468
• 负责人: Jeremy David Keenan
• 金额: $ 18.24万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10487468
• 关键词: 3D Print; Address; Adopted; Affect; Anterior; Area; Blindness; California; Cellular Phone; Certification; Child; Chlamydia trachomatis; Clinical; Collaborations; Communities; Computer software; Cornea; Custom; Data; Data Collection; Development; Diagnosis; Diagnostic tests; Ensure; Eye; Foundations; Goals; Health; Health Personnel; Health Resources; Health Surveys; Hospitals; Human; Human Resources; Image; Individual; Lighting; Location; Modality; Modeling; Monitor; Ophthalmic examination and evaluation; Pan American Health Organization; Participant; Persons; Peru; Photography; Public Health; Questionnaires; Refractive Errors; Research; Research Personnel; Resource-limited setting; Sampling; San Francisco; Sensitivity and Specificity; Structure; Surveys; System; Telemedicine; Testing; Trachoma; Universities; Update; Variant; Vision Screening; Visual Acuity; Work; World Health Organization; automated algorithm; base; experience; feasibility testing; field study; fight against; flexibility; mobile application; neglected tropical diseases; population based; programs; remote communities; remote grading; sample collection; success; tool; uptake; user-friendly

The World Health Organization (WHO) aims to eliminate trachoma, the world's leading infectious cause of blindness. To determine if trachoma treatment is needed in an area, the WHO recommends eye examinations on a population-based sample of children by personnel certified in trachoma grading. The WHO's successful trachoma elimination campaign has created a situation in which some areas have too many to trachoma cases to declare elimination but too few trachoma cases to certify trachoma graders. Adopting smartphone-based trachoma telemedicine addresses this issue by allowing workers with little clinical experience to perform trachoma photo-surveys for remote trachoma diagnoses. However, the WHO's current data collection platform for trachoma surveys, Tropical Data, does not currently support ocular photography. We propose here to integrate smartphone photography with Tropical Data and add functionality that will transform it into a more user-friendly, open access suite of smartphone-based survey modules. This would enhance flexibility and facilitate broader health surveys that can be used to better target limited health resources. This first part of the study aims to develop and refine the hardware and software necessary to integrate smartphone conjunctival photography into the Tropical Data platform, and to assess the feasibility of the resulting product in remote community-based settings in Peru. First, modules for photography, visual acuity assessment, autorefraction, sample collection, and user-defined questionnaires will be added to the existing Tropical Data application. Second, the impact of varying smartphone models and/or ambient lighting will be assessed for each module. Third, the updated mobile application will be tested in a small number of villages to determine the feasibility of testing multiple modules per child. The second part of the study validates the components of the smartphone-based system when used in three different field locations in Peru (e.g., jungle, mountains, desert). We will examine the sensitivity and specificity of smartphone photography relative to certified human graders, smartphone visual acuity relative to standard ETDRS visual acuity, and autorefraction relative to human refraction, and hypothesize that these metrics will be superior to pre-defined minimally acceptable criteria. The UCSF Proctor Foundation and Cayetano University in Peru will collaborate to achieve these goals. We will work in close cooperation with the WHO and Tropical Data, who will be actively engaged in this research throughout development and testing. This research has great potential for wide dissemination and positive impact on health.

世界卫生组织 (WHO) 的目标是消除沙眼这一世界上主要的传染性疾病 失明。为了确定某个地区是否需要沙眼治疗，世界卫生组织建议进行眼科检查 由经过沙眼分级认证的人员对儿童进行人口抽样。世界卫生组织的成功 消除沙眼运动造成部分地区沙眼病例过多 宣布消除，但沙眼病例太少，无法证明沙眼分级员。采用基于智能手机的 沙眼远程医疗通过允许临床经验很少的工作人员进行操作来解决这个问题 用于远程沙眼诊断的沙眼照片调查。然而，世界卫生组织目前的数据收集平台 对于沙眼调查，热带数据目前不支持目镜摄影。我们在此建议 将智能手机摄影与热带数据集成并添加功能，将其转变为更 用户友好、开放访问的基于智能手机的调查模块套件。这将增强灵活性并 促进更广泛的健康调查，从而更好地瞄准有限的卫生资源。 研究的第一部分旨在开发和完善集成所需的硬件和软件 将智能手机结膜摄影纳入热带数据平台，并评估该方案的可行性 由此产生的产品在秘鲁的偏远社区环境中。一、摄影、视力模块 评估、自动验光、样本收集和用户定义的调查问卷将添加到现有的 热带数据应用。其次，不同智能手机型号和/或环境照明的影响将是 对每个模块进行评估。第三，更新后的移动应用程序将在少数村庄进行测试，以 确定每个孩子测试多个模块的可行性。 研究的第二部分验证了基于智能手机的系统的组件在三个方面的使用情况 秘鲁的不同野外地点（例如丛林、山脉、沙漠）。我们将检查敏感性和特异性 智能手机摄影相对于经过认证的人类评分者的比例、智能手机视力相对于标准的比例 ETDRS 视力以及相对于人类验光的自验光，并假设这些指标将 优于预先定义的最低可接受标准。 加州大学旧金山分校普罗克特基金会和秘鲁卡耶塔诺大学将合作实现这些目标。我们 将与世界卫生组织和热带数据组织密切合作，积极参与这项研究 整个开发和测试过程。这项研究具有广泛传播和积极作用的巨大潜力 对健康的影响。