Development of a novel mobile application to assist in the diagnosis of Fetal Alcohol Syndrome (FAS)

开发新型移动应用程序以协助诊断胎儿酒精综合症（FAS）

• 批准号: 9905934
• 负责人: Ganz Chockalingam
• 金额: $ 22.5万
• 依托单位: BLUE RESONANCE, LLC
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-20 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9905934
• 关键词: 3-Dimensional; Affect; Agreement; Automobile Driving; Back; Cellular Phone; Characteristics; Charge; Child; Clinical; Confidence Intervals; Confusion; Consensus; Consultations; Data; Development; Diagnosis; Diagnostic; Diagnostic Procedure; Elements; Equation; Ethnic group; Evaluation; Expert Opinion; Face; Feedback; Fetal Alcohol Exposure; Fetal Alcohol Spectrum Disorder; Fetal Alcohol Syndrome; Fissural; Health Personnel; Health Professional; Image; Individual; Length; Licensing; Lip structure; Manuals; Measurement; Measures; Methodology; Mobile Health Application; Patients; Performance; Phenotype; Physicians; Population; Positioning Attribute; Process; Public Health; Race; Reporting; Sampling; Secure; Series; Services; Sex Differences; Shapes; Side; Structure; Surveys; Tablets; Technical Expertise; Technology; Testing; Thinness; Three-Dimensional Image; Validation; Validity and Reliability; animation; base; clinical Diagnosis; clinically relevant; cloud based; commercialization; cost; experience; falls; fetal diagnosis; heuristics; imaging modality; mobile application; novel; pediatrician; prototype; skills; tool

Project Summary/Abstract. Fetal alcohol spectrum disorder (FASD) is a major public health issue resulting from prenatal alcohol exposure (PAE), impacting between 1-5% of the US population and perhaps more than 630,000 children globally each year. When assessing for FASD the following facial features must to be evaluated as part of the diagnostic process: palpebral fissure length (PFL), thinness of the upper vermillion, and the smoothness of the philtrum. PFL is typically assessed with a metric ruler or photometrically, while the lip and philtrum are evaluated against a series of five Likert scale photos. Each of these assessments has methodological problems often resulting in unreliable application of specific diagnostic criteria. There is also a reluctance on the part of health care providers to diagnose FASD because they don’t feel confident in their skills, resulting in under- or misdiagnosis. Furthermore, the number of affected individuals is far greater than the capacity of diagnosticians, especially when considering the global impact of PAE. Some of the issues involved in the diagnosis of FASD could be remedied by simple-to-use mobile apps that would take much of the guesswork or heuristic elements out of the diagnostic equation, provide evaluation based upon expert opinion, and can be used by health care providers globally. Several aims of this project revolve around replacing the standard Likert scale lip-philtrum guide with an animation, morphing from a full to a thin upper lip on a continuous slider scale that the user controls while examining a subject. A similar morphing tool is proposed for the assessment of the philtrum. This would eliminate much of the confusion that exists between the rankings required for a fetal alcohol syndrome (FAS) or partial FAS (pFAS) diagnosis. The 5-point Likert scale doesn’t provide enough guidance and agreement even among experts is often mediocre. Rather than having a scale with only five demarcations, where really only the demarcation between a Rank 3 and 4 matters for a diagnosis, the apps allow for a more accurate assessment by providing a continuous distribution removing all ambiguity. Dysmorphologists who are expert at diagnosing FAS will determine the demarcation points for an upper lip and a smooth philtrum compatible with a diagnosis of FAS or pFAS for use in the app. Bias in the current diagnostic methods will also be assessed. PFL is an extremely difficult measurement even for experts, and it is proposed that using a smartphone camera with 3D capability would provide a more accurate way to assess this cardinal feature. These apps could be used by health care providers anywhere in the world to receive expert opinion feedback almost instantly to assist them in making a difficult yet critically important clinical diagnosis. We are in a unique position to accomplish these endeavors, as we have both the clinical and technical expertise to develop the apps, and access to data to validate the findings. Given the scope of the problem and the lack of access to expert diagnosticians, these mobile health applications should overcome at least some of the issues involved in the diagnosis of FASD.

项目摘要/摘要。 从产前酒精暴露（PAE）影响美国人口的1-5％，甚至超过 每年有630,000名儿童评估面部特征时 作为诊断过程的一部分：骨裂长（PFL），朱红色的薄度和你 philtrum的平滑度。 对五个李克特秤的照片进行了评估。 方法论问题通常导致不可用的特定诊断标准应用。 不愿对Parth护理提供者诊断FASD，因为他们对自己的技能没有信心， 重新占据不足或误诊。 诊断师的能力，尤其是在考虑PAE的全球影响时。 在诊断FASD中，可以通过简单使用的应用程序来补救，这将占用大部分 从诊断方程式出发的猜测或启发式元素，根据专家的评估， 全球卫生保健提供者可以使用该项目的几个目标。 标准的李克特量表唇刺指南带有ni绕，从完整到a变形。 用户在检查主题时控制的滑块比例。 评估Philtrum。 对于胎儿酒精综合征（FAS）或部分FAS（PFA）诊断。 足够的指导和同意专家通常是平庸的。 五个划分实际上只是 @ 3和4之间的诊断事项之间的分界，应用程序 通过提供连续分配消除所有歧义，允许更准确的评估。 诊断FAS Willmine的专家的畸形学家的上唇和唇部的分界点以及 平滑的菲尔姆与在应用中使用的FAS或PFA的诊断兼容。 方法也将进行评估。 使用具有3D功能WOWLD的智能手机摄像头提供了一种更准确的评估方法 这些应用程序可以由全球任何地方的医疗保健提供者使用 反馈几乎可以立即帮助他们进行稀有重要的临床诊断 我们拥有临床和技术专业知识的独特立场来实现泰西的努力 应用程序，并访问数据以验证发现。 专家诊断师，这些移动健康应用程序应至少克服涉及的一些问题 FASD的诊断。