Smartphone-based application to assist in the screening/diagnosis of FASD

项目摘要/摘要。胎儿酒精谱系障碍(FASD)是一个重大的公共健康问题 来自产前酒精暴露(PAE)，影响到1-5%的美国人口，可能超过 全球每年有63万名儿童。在评估FASD时，必须评估以下面部特征 作为筛查/诊断过程的一部分：眼睑裂长度(PFL)，上朱砂的厚度，以及 人中的流畅。PFL通常用公制尺子或光度法评估，而嘴唇和 根据一系列五张Likert Scale照片对Philtrum进行了评估。这些传统评估中的每一个都有 方法学问题，往往导致对特定诊断标准的不可靠应用。还有一个 医疗保健提供者不愿诊断FASD，因为他们对自己的技能没有信心 在评估这些特征时，会导致漏诊或误诊。此外，受影响的个人数量 远远超过专家诊断专家的能力，特别是在考虑到PAE的全球影响时。 诊断FASD涉及的一些问题可以通过使用简单的移动应用程序来补救，这些应用程序 会从诊断方程式中去掉大量的猜测或启发式元素，提供评估 基于专家意见，可供全球医疗保健提供者使用。一款智能手机应用程序MorpheusQ， 已经开发出来，使这些面部特征的评估更容易，以及更可靠。第一 这个项目的目的是确定个人是否了解FASD，但不是体能方面的专家 对FASD涉及的面部特征进行评估，可以使用MorpheusQ获得与以下类似的面部测量 由专业的畸形学家使用传统方法获得的。第二个目标是将 将使用MorpheusQ获取的3D图像放入虚拟现实(VR)耳机。在VR环境中，用户将 能够使用嵌入式版本的MorpheusQ获得三个基本面部特征的测量结果， 以及面部特征和形状的其他测量。专家可以利用这种虚拟现实环境来 允许他们评估个人的面部特征与FASD功能的兼容性。扫瞄 在一个位置收集的数据可以由位于其他地方的专家随时进行评估，只需下载 来自云的图像，以3D方式查看它，并使用应用程序来对面部特征(例如，嘴唇、人中、PFL， 上颌骨发育不全)。我们处于一个独特的位置来完成这些努力，因为我们既有临床 和技术专业知识，以继续开发MorpheusQ，评估其可靠性，并能够访问数据以帮助 验证调查结果。考虑到问题的范围和缺乏专家诊断专家的机会，这款手机 健康应用程序至少应该克服FASD筛查和诊断中涉及的一些问题。

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 be evaluated as part of the screening/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 traditional assessments has methodological problems, often resulting in unreliable application to 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 in assessing these features, resulting in under- or misdiagnosis. Furthermore, the number of affected individuals is far greater than the capacity of expert 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 an evaluation based upon expert opinion, and could be used by health care providers globally. A smartphone app, MorpheusQ, has been developed to make the assessment of these facial features easier, as well as more reliable. The first aim of this project is to determine if individuals knowledgeable about FASD, but not expert in the physical assessments of the facial features involved in FASD, can use MorpheusQ to obtain similar facial measures as those obtained by expert dysmorphologists using traditional approaches. The second aim is to incorporate the 3D image obtained with MorpheusQ into a virtual reality (VR) headset. Within the VR environment, the user will be able to use an embedded version of MorpheusQ to obtain measurements of the three cardinal facial features, as well as other measures of facial features and shapes. This VR environment could be utilized by experts to allow for their assessment of an individual’s facial characteristics for compatibility with an FASD feature. Scans collected in one location could be assessed by an expert located elsewhere at any time, simply by downloading the image from the cloud, viewing it in 3D, and using the app to score facial features (e.g., lip, philtrum, PFL, maxillary hypoplasia). We are in a unique position to accomplish these endeavors, as we have both the clinical and technical expertise to continue to develop MorpheusQ, assess its reliability, and have access to data to help validate the findings. Given the scope of the problem and the lack of access to expert diagnosticians, this mobile health application should overcome at least some of the issues involved in the screening and diagnosis of FASD.