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

项目概要/摘要。胎儿酒精谱系障碍（FASD）是一个主要的公共卫生问题， 产前酒精暴露（PAE），影响1-5%的美国人口，也许超过 全球每年有63万儿童。当评估FASD时，必须评估以下面部特征 作为筛查/诊断过程的一部分：睑裂长度（PFL）、上朱红的薄度，以及 人中的光滑PFL通常用米尺或光度法评估，而嘴唇和 对人中的五个李克特尺度的照片系列进行评估。这些传统评估中的每一种都有 方法问题，往往导致不可靠的应用，以具体的诊断标准。还有一个 医疗保健提供者不愿意诊断FASD，因为他们对自己的技能没有信心 在评估这些特征，导致诊断不足或误诊。此外，受影响的人数 这远远超过了专家诊断医生的能力，特别是考虑到PAE的全球影响时。 FASD诊断中涉及的一些问题可以通过简单易用的移动的应用程序来解决， 将采取许多猜测或启发式元素的诊断方程，提供评估 基于专家意见，并可供全球卫生保健提供者使用。智能手机应用程序MorpheusQ 已经开发出使这些面部特征的评估更容易，以及更可靠。第一 本项目的目的是确定个人是否了解FASD，但不是物理专家 FASD中涉及的面部特征的评估，可以使用MorpheusQ获得类似的面部测量， 这些是由畸形学家使用传统方法获得的。第二个目标是将 将MorpheusQ获得的3D图像导入虚拟现实（VR）头戴设备。在VR环境中，用户将 能够使用MorpheusQ的嵌入式版本来获得三个基本面部特征的测量， 以及面部特征和形状的其他测量。专家可以利用这个VR环境来 允许他们评估个人的面部特征以与FASD特征兼容。扫描 在一个地方收集的数据可以由位于其他地方的专家随时进行评估， 从云端获取图像，以3D方式查看图像，并使用应用程序对面部特征进行评分（例如，唇，人中，PFL， 上颌发育不全）。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 和技术专长，继续开发MorpheusQ，评估其可靠性，并获得数据，以帮助 验证调查结果。考虑到问题的范围和缺乏专家诊断，这种移动的 健康应用应该克服至少一些涉及FASD筛查和诊断的问题。

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.