Overcome the barriers of vision care in Africa using smartphones

使用智能手机克服非洲视力保健障碍

• 批准号: 10689279
• 负责人: JOHN H KEMPEN
• 金额: $ 24.51万
• 依托单位: SCHEPENS EYE RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10689279
• 关键词: Address; Affect; Africa; Africa South of the Sahara; African; African ancestry; Asian; Blindness; Caring; Cataract; Caucasians; Cellular Phone; Child; China; Clinical; Collaborations; Communities; Custom; Darkness; Data Set; Detection; Diagnosis; Distant; Educational Activities; Ethiopia; Ethnic Origin; Eye; Eyeglasses; Face; Foundations; Glass; Glaucoma; Goals; Grant; Health Technology; Healthcare; High Prevalence; Hospitals; Income; Legal patent; Life; Light; Macular degeneration; Mathematics; Measurement; Measures; Mission; Modeling; Multicenter Studies; Myopia; Neural Network Simulation; Ophthalmologist; Optometrist; Patients; Personal Satisfaction; Persons; Phase; Population; Prevalence; Protocols documentation; Refractive Errors; Rural; Rural Community; Sensitivity and Specificity; Services; Skin; Technology; Telephone; Testing; Training; Underrepresented Populations; United States National Institutes of Health; Update; Validation; Vision; Vision Screening; Vision Tests; Visual Acuity; Visual impairment; Work; access disparities; artificial intelligence algorithm; care systems; cost; cost effective; deep neural network; design; empowerment; face skin; feasibility testing; field study; health care availability; improved; innovation; large scale production; lens; low and middle-income countries; low income country; mHealth; member; mobile application; mobile computing; neural network; programs; prototype; research clinical testing; response; scale up; screening; social; transfer learning; volunteer; young adult

PROJECT SUMMARY / ABSTRACT Worldwide, 671 million people have uncorrected refractive error out of which 161 million people have distance vision impairments due to uncorrected refractive error (URE). Distance vision impairment due to URE especially affects children and young adults, limiting their educational activities and social life. Although the prevalence of refractive error is lower, the prevalence of blindness due to URE in Africa is 6 times as that in high-income regions of the world. This indicates widespread disparities in access to eye care in Africa, which leads to long term negative effects. As a matter of fact, there are only 2.5 ophthalmologists per million population in Sub-Saharan Africa, against a global mean of about 32 ophthalmologists per million. Innovative community-based approaches are needed to tackle the increasing burden of providing the needed healthcare. In response to the grant opportunity to improve healthcare access to low and middle-income countries using mobile health, we propose to develop an AI-powered mobile application for measurement of refractive error and validate it by performing field tests in Ethiopia. With its relatively simple protocol, the app can allow lay people measure myopic refractive error using only a smartphone, without needing any phone attachments. Thus, it overcomes the main barriers of cost and accessibility. A recent study on this refraction app showed good consistency with clinical measurements of refraction in a multi-center study in the US and China. Given the bias and inaccuracies of AI algorithms in people of underrepresented African ethnicities, in the R21 phase, we will train a custom neural network on face datasets of African origin to make the current version of the app more suitable for dark-skinned Africans. We will validate the app measurements of refraction in Ethiopia by comparing it with standard clinical measurement, and also by determining the improvements in the visual acuity resulting from the app-based refractive correction. After the validation of the mobile technology for prescribing affordable eyeglasses in hospital settings, we will further evaluate community vision care programs in the R33 phase, including vision testing and dispensing of eyeglasses. Community volunteers will be trained to perform vision screening with the app and a field test will be performed in rural Ethiopia to determine the sensitivity and specificity of community-based myopia screening approach in real-world settings. With the mHealth solution, we are poised to make significant impact on the eye care in under-served Africa.

项目摘要 /摘要 全球，有6.71亿人未纠正折射错误，其中1.61亿人有距离 视力障碍是由于未校正的屈光误差（URE）。距离远距离视力障碍 特别影响儿童和年轻人，限制了他们的教育活动和社会生活。虽然 折射率的患病率较低，非洲因ure引起的失明率是6倍 世界上的高收入地区。这表明在非洲获得眼保健方面的广泛差异，这 导致长期的负面影响。实际上，百万只有2.5个眼科医生 撒哈拉以南非洲以下的人口，违反全球约32名眼科医生的全球平均值。创新的 需要采取基于社区的方法来应对提供所需医疗保健的越来越多的负担。 回应赠款的机会，以改善医疗保健的机会 移动健康，我们建议开发一个AI驱动的移动应用程序，以测量折射率 并通过在埃塞俄比亚进行现场测试来验证它。借助其相对简单的协议，该应用程序可以允许LIE 人们仅使用智能手机来测量近视折射率错误，而无需任何手机附件。 因此，它克服了成本和可及性的主要障碍。有关此折射应用程序的最新研究显示 在美国和中国的多中心研究中，与折射的临床测量良好一致。给出 在R21阶段，AI算法的偏见和不准确性， 我们将在非洲起源的面部数据集上训练一个自定义的神经网络，以使该应用的当前版本 更适合黑皮肤的非洲人。我们将通过 将其与标准临床测量以及通过确定视觉的改进进行比较 基于应用程序的屈光校正产生的敏锐度。在验证移动技术之后 在医院环境中开处方负担得起的眼镜，我们将进一步评估社区视觉护理计划 在R33阶段，包括视力测试和眼镜的分配。社区志愿者将接受培训 使用该应用程序进行视力筛查，并将在埃塞俄比亚进行现场测试，以确定 现实世界中基于社区的近视筛查方法的敏感性和特异性。与 MHealth解决方案，我们准备对服务不足的非洲的眼部护理产生重大影响。