Forget needles, fingertip anemia detection possible with new smartphone app

A needle-free anemia detection tool is now at your fingertips. Starting today, anyone with a smartphone can download the updated Sanguina app, AnemoCheck Mobile, which uses photos of fingernails to estimate hemoglobin levels in less than a minute, all without the need to draw blood. 

Principal investigator Wilbur Lam, MD, PhD, and former biomedical engineering graduate student Rob Mannino, PhD, first introduced the concept and research results of the anemia detection app in Nature Communications, published on Dec. 4, 2018. 

“This non-invasive anemia detection tool is the only type of app-based system that has the potential to replace a common blood test,” says Lam, who is an associate professor of pediatrics at Emory University School of Medicine. Lam is also a pediatrician at the Aflac Cancer and Blood Disorders Center of Children’s Healthcare of Atlanta, a faculty member in the Wallace H. Coulter Department of Biomedical Engineering at Emory and Georgia Tech, and the co-founder of Sanguina. 

Anemia is a common blood disorder that can lead to fatigue, paleness and cardiac distress if left untreated. It affects two billion people worldwide and three million Americans. Mannino is one of them. The research, part of Mannino’s PhD work, was motivated by his own experience living with beta-thalassemia, an inherited blood disorder caused by a mutation in the beta-globin gene.

“If I could have dynamically updated my blood transfusion schedules based on exactly when I needed, it would have been much safer for me,” says Mannino, who is also Sanguina’s chief technology officer.

During the creation of the app, Mannino took pictures of himself before and after transfusions as his hemoglobin levels were changing, which enabled him to constantly refine and tweak the technology in an efficient manner.

AnemoCheckThe app is designed to be used for screening and monitoring, not clinical diagnosis. Clinical diagnostic tools have strict accuracy requirements, but Mannino and Lam believe that with additional research and the ability to personalize the algorithm, the app can eventually achieve the accuracy needed to replace blood-based anemia testing for clinical diagnosis.

Mannino and Lam say their app could be personalized to enable each chronic anemia patient to manage and monitor their disease, identifying the times when they need to adjust their therapies or receive transfusions. That has the potential to reduce side effects or complications of having transfusions too early or too late.

In the app, the use of fingernail beds, which do not contain melanin, means the test can be valid for people with a variety of skin tones. The accuracy is consistent for dark or light skin tones, Mannino says. The app uses image metadata to correct for background brightness, and can be adapted to phones from multiple manufacturers.

The technology could be especially appropriate for pregnant women, women with abnormal menstrual bleeding, or runners and other athletes.

It could also be used in developing countries where medical infrastructure is lacking but smartphone infrastructure is advanced. While the initial launch is focused on the U.S., Mannino and Lam are evaluating international markets as they move forward with their research. 

A variety of doctors at Emory and Children’s who specialize in geriatric, internal medicine, neonatology, transfusion medicine and global health have collaborated with Mannino and Lam to obtain additional data and better calibrate the app system. 

“I have always wanted to do something that could improve the quality of life for patients, and this is my first shot at it,” says Mannino.

Consumers can download AnemoCheck Mobile at the Apple App Store and the Google Play Store here at no cost.  

Funding and Patent Information

The research was supported by the National Science Foundation (Graduate Research Fellowship DGE-1650044 and Southeastern Nanotechnology Infrastructure Corridor 1542174), the 2017 Massachusetts General Hospital Primary Care Technology Prize, and National Institutes of Health (R21 EB025646).

A patent application has been filed for the anemia app, and Wilbur Lam and Rob Mannino have a financial interest in the success of this product.

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