Rhode Island doctors have developed an app that can diagnose anemia – The Boston Globe

Three emergency medicine physicians who work for Lifespan, Rhode Island’s largest hospital system, have pioneered a way to diagnose anemia by uploading photos of a person’s inner eyelid to an iPhone app.

Anemia is a blood disorder that occurs when the body does not have enough healthy red blood cells, or hemoglobin, to distribute oxygen. The doctors co-authored a study that discovered how computation of eyelid tissue can estimate hemoglobin concentration. Dr. James Rayner, one of the study’s physicians who practices at Newport Hospital and The Miriam Hospital, said the app, called eMoglobin, will create an easy first step toward getting care for the common condition, which can be caused by a variety of factors.

Q. What did the study aim to find?

A. This study was looking at trying to develop a noninvasive way that didn’t require taking a sample of blood to calculate someone’s hemoglobin to determine whether they are anemic or not. And what we found was that there’s a correlation between the color of a person’s conjunctiva [membrane that covers the front of the eye and inner eyelid] and the hemoglobin, which allowed us to measure the hemoglobin using an iPhone camera.

Q. What was the process of developing the app?

A. The process started quite a few years ago with Doctors Gregory Jay and Selim Suner doing some studies looking at the color of the conjunctiva with a spectroscope. They found there was in fact a correlation between the readings and the measured hemoglobin of the patient. For years, they and another few other people were trying to get it into a format that was more useful. I came to medicine after getting a degree in engineering science from Oxford, and Dr. Jay said maybe I should work on this project. What we found was in the time since they used the spectroscope, smartphones have developed to a point where they take such great images that we could do analysis on the phone and get pretty good accuracy.

Q. How can this revolutionize anemia diagnosis around the world?

A. It’s particularly useful in resource-poor areas because there are places in the world where it’s hard to get into a lab or have blood drawn. Smartphones are pretty ubiquitous now. How it changes things is, if you have access to a smartphone, you can use the app to take a picture of someone’s eye and get an estimate of whether they’re anemic or not.

Right now there’s a study going on in Rwanda where they’re using the app to see if it’s useful for screening. Anemia, as in having low hemoglobin, is a sign of many conditions. Anemia is kind of a good indicator that something’s wrong and in a lot of parts of the world, sometimes the most common cause of anemia is parasitic infections. The app is certainly quite a good health screening tool to very quickly determine if someone’s anemic or not.

Q. How can people access the app?

A. The app is not publicly available yet, but will be on the Apple App Store when it’s released. It will not be available to Andriod users immediately, but the doctors intend to make it to non-iPhone users eventually.

Initially, we were hoping that it would be able to replace a blood test. It turns out it’s a little less accurate than a blood test, which is often the gold standard. We have been working on various ways to improve the accuracy. We’re trying to decide if we will continue to improve the accuracy before release, or release it as it is. In clinical terms, it works very well in determining if someone is very anemic or has normal hemoglobin, but in the middle area it has less accuracy than we’d like.

Q. What else could the app diagnose in the future?

A. This app has been more accurate than previous attempts in getting the most raw image and analyzing it in a way which is very good for looking for minor changes in the color of the image.

This means it can also be used for anything else which involves changes in color. For example, if people have liver disease, the sclera [tissue that covers most of the outside of the eyeball] can become entirely yellow looking. It will be very simple to apply the app to look at that. Or when people have meningitis, or you’re worried about when people have a possible bleed into the brain, the app can also be modified for that.

Alexa Coultoff can be reached at alexa.coultoff@globe.com. Follow her @alexacoultoff.