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

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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.