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）旨在消除沙眼，这是世界上主要的传染病。 失明。为了确定在某个区域是否需要沙眼治疗，WHO建议进行眼科检查 在基于人群的儿童样本中，通过三脊髓瘤评分认证的人员。谁成功 沙眼消除运动造成了一个情况，在某些地区有太多的沙眼病例 宣布消除，但太少了沙眼病例，无法证明沙眼分级。采用基于智能手机的 Trachoma远程医疗通过允许几乎没有临床经验的工人来解决这个问题 远程沙眼诊断的三方瘤照片。但是，WHO当前的数据收集平台 对于沙眼调查，热带数据目前不支持眼部摄影。我们在这里建议 将智能手机摄影与热带数据集成并添加功能，以将其转换为更多 用户友好，开放式访问套件的基于智能手机的调查模块。这将提高灵活性和 促进可用于更好地针对有限的健康资源的更广泛的健康调查。 研究的第一部分旨在开发和完善整合所需的硬件和软件 智能手机联合摄影进入热带数据平台，并评估 在秘鲁的基于社区的遥远设置中产生的产品。首先，摄影模块，视力 将添加评估，自动置换，样本收集和用户定义的问卷 热带数据应用。其次，不同的智能手机型号和/或环境照明的影响将是 评估每个模块。第三，更新的移动应用程序将在少数村庄中进行测试 确定每个儿童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， 秘鲁（例如丛林，山区，沙漠）的不同野外位置。我们将检查敏感性和特异性 智能手机摄影相对于经认证的人类毕业生，智能手机视力相对于标准 ETDR的视力和相对于人类折射的自动折射，并假设这些指标将 要优于预定的最低可接受的标准。 秘鲁的UCSF Proctor Foundation和Cayetano University将合作实现这些目标。我们 将与谁和热带数据密切合作，他们将积极参与这项研究 整个开发和测试。这项研究具有广泛传播和积极的巨大潜力 对健康的影响。