New Screening and Diagnostic Tools that Target Cancer, Kidney Disease, and Influenza
As mobile technology has become more powerful and ubiquitous, it was only logical to assume that health and medical apps reaching directly to the consumer could significantly change how healthcare is delivered. From applications that help patients self-monitor their diet to exercise and wellness apps, the public’s appetite for taking greater control of their health via their tablets and smartphones continues to grow. With more than 100,000 apps now available, a 2014 report by research firm Research2Guidance projects the mobile health app market will have produced $26 billion in revenue by the end of 2017, up from only a few billion dollars to date.
And while this consumer health revolution is plain for all to see, a similar revolution, lagging by perhaps only a few years, is picking up steam in the medical imaging and diagnostic field. Leveraging both the improved imaging capabilities of smartphones and their increased computing power, new screening and diagnostic tools that target cancer, kidney disease, and influenza, among a host of others, are showing significant promise in moving the diagnostic lab to remote locations and, in the process, significantly improving the health of the underserved.
“I think we are in a really exciting era. Until now, it has been the case that we have imagined that medical services need to be provided by a single professional who is in direct contact with the patient and that has been because we are limited by time and space,” said Ariel Beery, CEO of Tel Aviv, Israel-based MobileODT, a developer of technology that uses mobile phones to detect cancer. “But we now know that there are ways to expand the capacity of human beings through things like mobile phones, computers and the Internet, and physicians are very clearly interested in extending their capacity this way. But more than that, the thing that mobile phones have done—at least in our case with the biomedical optics—is they have reduced the costs and improved the quality of key components in the diagnostic enterprise so significantly, that now you can do with a few hundred dollars what you could previously only do with tens of thousands of dollars.”
A Picture Is Worth a Thousand Words
In the case of MobileODT, the company got its start in 2012 after developing a mobile colposcope that integrates a mobile phone for high-resolution image capture used for cervical cancer screening. According to Beery, the intent of the company is to use technology that can have the greatest significant impact right away for saving lives.
In the case of cervical cancer, more than 250,000 women each year die from the disease worldwide, despite the fact that roughly 95% of all cases of cervical cancer, when detected early, can be effectively treated for less than $30.
“When we founded the company we began talking to physicians asking them what they believed would be a tool that could save the most lives,” Beery explained. “We discovered that cervical cancer is the leading cause of cancer deaths for women in low-resource settings. At the same time, it is the easiest cancer to treat if you detect it early.”
According to June Sugiyama, director of Vodafone Americas Foundation, the ability to make this immediate impact is what earned the company the top grant of $300,000 in last year’s Wireless Innovation Competition. “One of the reasons MobileODT caught our eye is that their technology is so adaptable,” Sugiyama said. “That has been common among our winners in the past. Not only is it the product itself, but the companies are able to find other uses for their technology.”
Another Mobile Innovation Competition grant winner, eyeMITRA, is also leveraging the mobile capabilities of cell phones with a device that is a modular attachment to the cell phone—or hardware app—designed to capture an image of the retina. “The retina is a mirror of health,” said Karin Roesch, Ph.D., a researcher in the Camera Culture group at Massachusetts Institute of Technology, where the hardware app was developed. “Imaging the retina is quite challenging and existing solutions require complex equipment as well as an analog process to recode and analyze the images. eyeMITRA contains modern optics, illumination, sensors, and computational techniques. By embedding these image-capture technologies in mobile phones, we democratize access to the devices and provide a new computationally driven solution in real-time health status assessment.”
Using this technology, eyeMITRA will initially target the early detection of diabetic retinopathy (DR). As the demand for healthcare soars not only in this country, but around the world, the demand for devices that can provide fast and easy screening and are also easily accessible, will be in high demand. This concept holds true especially for the present–day diabetic population, Dr. Roesch noted, with 366 million diabetics worldwide, a number that is expected to top half-a-billion people by 2030. Roughly one in four diabetic patients develops DR, which is the single largest cause of preventable blindness in the world.
“Early detection of DR is critical to stop vision loss and in managing the costs of care of disease manifestations,” Dr. Roesch said. “While detection can be done with a simple retinal scan, the industry-standard devices for retinal imaging are too expensive and too few to meet the demand of this exponentially growing population. The inefficiencies of these standard approaches, portability, speed of capture, and the requirement for a trained physician to operate, significantly limit the throughput of subjects receiving retinal screening.”
Such mobile screening technologies may also prove to be beneficial for the treatment of patients with chronic kidney disease, if Munich, Germany’s Colorimetrix gains a foothold in the market. The company’s application turns smartphones into portable spectrophotometers to allow for semi-quantitative measurement of colorimetric test strips or solutions. In the case of kidney disease, many patients perform their own urine test using these strips.
As Leo Martinez, founder of Colorimetrix, explained, patients with chronic kidney disease are often elderly and under current methods compare the color on the test strips, which measure uric acid, to a reference chart to help them determine whether they are still in range or should contact their doctor. “But this is subjective and if it is someone with bad eyesight it can be even harder to get make an accurate determination,” he said. “Using our app it can produce a result and then move it into the cloud to be shared with their doctor.”
While chronic kidney disease is the first area of focus for the company, the tool can be broadly applied across any number of diseases where simple colorimetric strips are used to either diagnose disease or to monitor ongoing treatment including diabetes, urinary infections, and HIV.
Many of these new technologies promise to make their most immediate impacts in countries around the world where healthcare workers, facilities, and testing equipment are scarce. MobileODT currently has pilot programs running in Mexico, Haiti, and Kenya. Similarly, eyeMITRA has focused on India where more than 62 million people are diabetic, and the National Council on Ophthalmology estimates there are only nine ophthalmologists for every one million people in the country.
Bruce Kahn, M.D., a research partner with MobileODT at the Scripps Clinic in San Diego, also sees plenty of opportunity in time for this and other mobile imaging and diagnostic technologies in this country. “Here in San Diego, we are in one of the richest counties in the nation and because most women get appropriate cervical screening the incidence of cervical cancer is very low,” Dr. Kahn said. “But the next county east is rural and not as affluent and there you see cancer rates that are very high and almost approaching those across the border in Mexico. So I can see application for this technology in underserved areas here as well since it is inexpensive and you could do the screening using a trained medical assistant.”
Dr. Roesch of eyeMITRA also thinks the time may come where many of these imaging devices cross over into the consumer market. “Consumers will take their health in their own hands,” she said. “With devices such as eyeMITRA consumers will have more factual knowledge in their own hands. Devices such as eyeMITRA will also allow physician to give better more personalized treatment.”
This article was originally published in the March 2015 issue of Clinical OMICs. For more content like this and details on how to get a free subscription to this digital publication, go to www.clinicalomics.com.