Non-Invasive Detection of Anaemia Using Digital Photographs of the Conjunctiva
Non-Invasive Detection of Anaemia Using Digital Photographs of the Conjunctiva
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DOI：
10.1371/journal.pone.0153286
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发表时间：
2016-04-12
期刊：
影响因子：
3.7
通讯作者：
Weinkove, Robert
中科院分区：
文献类型：
--
作者：
Collings, Shaun;Thompson, Oliver;Weinkove, Robert
背景和目的贫血是世界范围内的主要健康负担。虽然临床检查发现结膜苍白与贫血有关，但观察者间的变异性很高，贫血的确诊需要血液样本。我们的目的是通过使用消费者相机和流行的智能手机拍摄的数码照片定量结膜苍白来检测贫血。我们的目标是开发一种非侵入性的筛选测试贫血。患者和MethodsThe结膜的血液肿瘤科在和门诊患者拍摄的环境照明使用数码相机（松下DMC-LX 5），和内部的后置摄像头的智能手机（苹果iPhone 5S）旁边的帧内校准卡。图像校准后，计算结膜红斑指数（EI），并与实验室测量的血红蛋白浓度相关。三个临床医生独立评价每个图像结膜pallor.ResultsConjunctival EI图像之间的重复性（平均变异系数为2.96%）。眼睑结膜的EI与血红蛋白浓度的相关性比穹窿结膜更强。使用紧凑型相机，眼睑结膜EI在训练集和内部验证集中检测贫血（血红蛋白< 110 g/L）的灵敏度分别为93%和57%，特异性分别为78%和83%。使用iPhone相机也发现了类似的结果，尽管EI截止值不同。结膜EI分析比较有利的临床评估，具有较高的阳性似然比预测anaemia.ConclusionsErythema指数的睑结膜计算从图像拍摄的紧凑型相机或移动的电话与血红蛋白和比较有利的临床评估预测贫血。如果进一步证实，这项技术可能是有用的贫血的非侵入性筛查。
Background and AimsAnaemia is a major health burden worldwide. Although the finding of conjunctival pallor on clinical examination is associated with anaemia, inter-observer variability is high, and definitive diagnosis of anaemia requires a blood sample. We aimed to detect anaemia by quantifying conjunctival pallor using digital photographs taken with a consumer camera and a popular smartphone. Our goal was to develop a non-invasive screening test for anaemia.Patients and MethodsThe conjunctivae of haemato-oncology in-and outpatients were photographed in ambient lighting using a digital camera (Panasonic DMC-LX5), and the internal rear-facing camera of a smartphone (Apple iPhone 5S) alongside an in-frame calibration card. Following image calibration, conjunctival erythema index (EI) was calculated and correlated with laboratory-measured haemoglobin concentration. Three clinicians independently evaluated each image for conjunctival pallor.ResultsConjunctival EI was reproducible between images (average coefficient of variation 2.96%). EI of the palpebral conjunctiva correlated more strongly with haemoglobin concentration than that of the forniceal conjunctiva. Using the compact camera, palpebral conjunctival EI had a sensitivity of 93% and 57% and specificity of 78% and 83% for detection of anaemia (haemoglobin < 110 g/L) in training and internal validation sets, respectively. Similar results were found using the iPhone camera, though the EI cut-off value differed. Conjunctival EI analysis compared favourably with clinician assessment, with a higher positive likelihood ratio for prediction of anaemia.ConclusionsErythema index of the palpebral conjunctiva calculated from images taken with a compact camera or mobile phone correlates with haemoglobin and compares favourably to clinician assessment for prediction of anaemia. If confirmed in further series, this technique may be useful for the non-invasive screening for anaemia.