App to Detect Diabetes by Smartphone Fingertip Scan

Researchers have developed an algorithm using machine learning and smartphone-based photoplethysmography (PPG) to detect diabetes with “reasonable discrimination.”

Because one in three people with diabetes don’t know they have it, and it is a risk factor for cardiovascular disease, the researchers hope that one day the app can improve rates of diabetes diagnosis.

People would still need to visit their healthcare provider to confirm their findings and have regular blood tests.

The researchers used contact PPG to obtain waveforms of color changes in blood vessels with heart beat — which is also used by apps to measure heart rate — to develop the screening test for diabetes.

Specifically, they input waveforms from 54,269 people older than 18 years who transmitted their data from the Azumio Instant Heart Rate smartphone app (and about 2.6 million PPG waveforms) to the Health eHeart Study into a 45-layer deep neural network computer program to “train” the program to develop a better algorithm to predict diabetes.

“Our study is the first [such] proof-of-concept study,” lead author Robert Avram, MD, a cardiology fellow at University of California, San Francisco (UCSF), told theheart.org | Medscape Cardiology.

Avram will present the findings here at the ACC 2019 Scientific Session(ACC.19).

As a next step, the team is validating the algorithm in patients from two cardiovascular prevention clinics at USCF and in Montreal to see how the diabetes detected from the PPG signal compares with that detected from a blood glucose or HbA_1C test.

“Right now we have 40 patients,” Avram said, “and we have an AUC that’s comparable to what was reported in the poster — 0.76 — so it’s performing just as well as in [diabetes] self-report.”

The team is also working with the company to integrate this algorithm into its heart rate app, and they are examining actions that a clinician should take when a patient comes in with an app-based positive test for diabetes.

This diabetes-detection app could potentially be available in the marketplace in 2 years, according to Avram.

Still Need Provider Visits

However, these are early days and consumers need to be careful when using healthcare apps, Nathan Wong, PhD, MPH, Heart Disease Prevention Program, University of California, Irvine, and a member of the ACC Prevention of Cardiovascular Disease Council, told theheart.org | Medscape Cardiology in an email.

“While these technological advances are promising, they need validation against gold-standard tests (such as HbA_1C fingerstick testing in the case of diabetes) and, depending on the manufacturer and [type of test], they can vary substantially in terms in accuracy,” he noted. …

https://www.medscape.com/viewarticle/910476?src=soc_tw_190315_mscpedt_news_tho_diabetes&faf=1