Shah Pratik, Yauney Gregory, Gupta Otkrist, Patalano Ii Vincent, Mohit Mrinal, Merchant Rikin, Subramanian S V
Media Lab, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA.
Department of Ophthalmology, Cambridge Health Alliance, Cambridge, Massachusetts, USA.
BMJ Open. 2018 Apr 20;8(4):e018774. doi: 10.1136/bmjopen-2017-018774.
Technology-enabled non-invasive diagnostic screening (TES) using smartphones and other point-of-care medical devices was evaluated in conjunction with conventional routine health screenings for the primary care screening of patients.
Dental conditions, cardiac ECG arrhythmias, tympanic membrane disorders, blood oxygenation levels, optic nerve disorders and neurological fitness were evaluated using FDA-approved advanced smartphone powered technologies. Routine health screenings were also conducted. A novel remote web platform was developed to allow expert physicians to examine TES data and compare efficacy with routine health screenings.
The study was conducted at a primary care centre during the 2015 Kumbh Mela in Maharashtra, India.
494 consenting 18-90 years old adults attending the 2015 Kumbh Mela were tested.
TES and routine health screenings identified unique clinical conditions in distinct patients. Intraoral fluorescent imaging classified 63.3% of the population with dental caries and periodontal diseases. An association between poor oral health and cardiovascular illnesses was also identified. Tympanic membrane imaging detected eardrum abnormalities in 13.0% of the population, several with a medical history of hearing difficulties. Gait and coordination issues were discovered in eight subjects and one subject had arrhythmia. Cross-correlations were observed between low oxygen saturation and low body mass index (BMI) with smokers (p=0.0087 and p=0.0122, respectively), and high BMI was associated with elevated blood pressure in middle-aged subjects.
TES synergistically identified clinically significant abnormalities in several subjects who otherwise presented as normal in routine health screenings. Physicians validated TES findings and used routine health screening data and medical history responses for comprehensive diagnoses for at-risk patients. TES identified high prevalence of oral diseases, hypertension, obesity and ophthalmic conditions among the middle-aged and elderly Indian population, calling for public health interventions.
结合传统常规健康筛查，对使用智能手机和其他即时医疗设备进行的技术赋能非侵入性诊断筛查（TES）用于患者初级保健筛查进行评估。
使用经美国食品药品监督管理局（FDA）批准的先进智能手机技术对牙齿状况、心脏心电图心律失常、鼓膜疾病、血液氧合水平、视神经疾病和神经健康状况进行评估。同时也进行了常规健康筛查。开发了一个新型远程网络平台，以便专家医生检查TES数据并将其疗效与常规健康筛查进行比较。
该研究于2015年在印度马哈拉施特拉邦的昆巴节期间在一个初级保健中心进行。
对494名年龄在18至90岁、同意参与的2015年昆巴节参与者进行了测试。
TES和常规健康筛查在不同患者中发现了独特的临床状况。口腔内荧光成像将63.3%的人群归类为患有龋齿和牙周疾病。还发现口腔健康不佳与心血管疾病之间存在关联。鼓膜成像在13.0%的人群中检测到鼓膜异常，其中一些人有听力困难病史。在8名受试者中发现了步态和协调问题，1名受试者有心律失常。在吸烟者中观察到低氧饱和度与低体重指数（BMI）之间的交叉相关性（分别为p = 0.0087和p = 0.0122），并且在中年受试者中高BMI与血压升高相关。
TES协同识别出了一些在常规健康筛查中表现正常的受试者中的具有临床意义的异常情况。医生验证了TES的发现，并使用常规健康筛查数据和病史回答对高危患者进行综合诊断。TES发现印度中老年人群中口腔疾病、高血压、肥胖和眼科疾病的患病率很高，这需要公共卫生干预措施。
