Cell Phones to the Rescue: Dial a Diagnosis

Almost seven billion of us use one, and now researchers say that phone you talk, text, and tweet with could one day do much more for your health.
Hannah Gooch is allergic to eggs.
“We did a strict avoidance,” Necia Joy Gooch, Hannah’s mom, told Ivanhoe.
Spike Loy has diabetes.
“Since I was seven and a half, I had to take between two and 10 blood tests a day,” Spike said.
Both could one day benefit from a medical breakthrough that you carry around every day.
“You can imagine your cell phone working like a very advanced microscope for looking at various different specimen,” Aydogan Ozcan, PhD, Associate Professor of Electrical Engineering and BioEngineering, UCLA, told Ivanhoe.
Researchers at UCLA created various attachments that fit on smart phones. One can perform an HIV screening. Another ONE detects allergens in food. A special tube measures allergens optically with the phone’s camera.
“You can do this for peanuts or you can do this for other kinds of allergens,” Dr. Ozcan said.
Other attachments measure the presence of E. coli in food, blood cell counts, and blood sugar levels. Cell phones are less expensive than a large lab and can be used in the field with immediate results.
“This platform is a very reliable means for looking at micro and nano scale things,” Dr. Ozcan explained.
So don’t be surprised if one day your doctor pulls out his cellphone to diagnose you.
It’s not on the market yet, but once it is available researchers believe it will be particularly beneficial to doctors and patients in developing countries who don’t have access to advanced laboratories. 

BACKGROUND: It’s estimated over 90 percent of American adults use a cell phone. And cell phones today are growing in complexity and sophistication by the month; one study found 56 percent of Americans have a smart phone. As the cell phones become more complex and farther reaching, as the estimated number of cell phone users worldwide hits 6 billion, the promise of using them for healthcare is growing. There are a variety of health apps for your phone that can help you with everything from managing diabetes to getting motivated to go to the gym. (Source: www.pewresearch.org/fact-tank/2013/06/06/cell-phone-ownership-hits-91-of-adults/
IPHONE HOME EAR EXAMINATION: A home ear examination can help parents detect many ear problems; such as ear infections, excessive earwax, or an object in the ear canal. Wilbur Lam, MD, PhD, from Emory University and Georgia Institute of Technology created a smartphone-enabled otoscope for remote diagnosis of pediatric ear infections.  The Remotoscope is a clip-on attachment and software app that turns an iPhone into a digital otoscope. (SOURCE: www.actsi.org/news/2012/Documents/Lam%20Interview_ccm_final.pdf)  
NEW TECHNOLOGY: Dr. Aydogan Ozcan, at UCLA has developed a way for your phone to act like a very inexpensive microscope. He developed a device which uses your cell phone’s camera to test a variety of different things; including allergens, your urine, and even if you have diabetes. He hopes his device will be able to change healthcare in the United States by making it more efficient, but also worldwide by providing developing countries with an economical way of testing patients. (Source: Dr. Aydogan Ozcan)

Mark Wheeler
Senior Media Relations Rep
UCLA Health Sciences Media Relations
(310) 794-2265

Aydogan Ozcan, PhD, Associate Professor of Electrical Engineering and BioEngineering, UCLA, talks about how cell phones could be medicine’s next big thing.

When you started developing all of these things that basically fit into an iPhone, what was your vision?  
Dr. Ozcan: So, to set the stage, we have close to 7 billion cell phone subscribers today. And more than 70 percent of these cells phones are actually being used in developing part of the world. And in addition to this, if you look at the state of the art cell phones, it’s really pretty amazing. It acts like a super computer; it has graphics processing units to it; it has very advanced cameras at the back of it, and it has connectivity meaning that you can actually measure stuff using the same cell phone that we are talking with and share them wherever the cell phones work.  So in that regard, the cell phone has become really like a Swiss Army knife tool that you can do various different measurements that normally would be done in a laboratory, except now, with attachments that are compact, cost effective, light weight, and integrated to the cell phones.  So, that’s essentially bringing us a fantastic platform whether you want to do imaging of cells, bacteria, or viruses.
So, you’re just using normal cell phones?
Dr. Ozcan: Today’s smart phones are really very advanced. We try to create new imaging designs, new sensing designs that are attached to the cell phone to make it work like a microscope or a computational imager where the bulky optical components that you normally find in a microscope are replaced by computer algorithms.  It’s a very inexpensive method to create a microscope that can see, for instance, individual cells that are smaller than 1/10th of our human hair in terms of diameter. So in that regard, using computational algorithms to replace bulky optical components, you can imagine your cell phone working like a very advanced microscope for looking at various different specimen in field conditions using compact cost effective and light weight interfaces
Do you think it will replace even labs in our country?
Dr. Ozcan: This kind of an infrastructure would have huge impact for developing countries.  But I believe also it is going to help our own healthcare delivery system in advanced countries, even in the United States, to get more efficient and more cost effective. So a small nurse office or a point of care office, we’re talking about maybe a single doctor there or a couple of nurses could function like a more powerful hospital.
How accurate are your tests? Take, for example the kidney test; is it just as accurate as going to the hospital? 
Dr. Ozcan: So for this specific example of urine albumin concentration measurements, we are quite specific. Our concentration level of detection is on the order of five to ten micrograms per milliliter, which is essentially below at least 3 times the clinically accepted range for essentially a chronic condition.  In that regard, these are quite sensitive.  They may not be as sensitive as a bulky, major instrument that you would find in a hospital, but they’re sensitive enough for clinical ranges.  And of course, there are various different tests that you need to do in a lab, in general, so it’s a matter of time that these kinds of tests are built and modified to run on mobile health devices including cell phones, iPads or tablet PCs of any kind.
So how does your kidney test work? You have a device that you stick in a swab?
Dr. Ozcan: For the example of the urine test for albumin concentration measurements, essentially you deal with urine from the patient and you look at the fluorescent light that is generated by the urine, in attraction with a substrate with a certain test tube, and the amount of fluorescence that you get from that disposable curette, will give you essentially an indirect measure of the albumin concentration.  As I’ve given you the example of around 5 to 10 micrograms of albumin per milliliter of urine could be sensed using these attachments.
How does the eye test tell you about food allergies? Is each one covered, like let’s say I have a peanut allergy, then that one would be programed for peanuts?
Dr. Ozcan: Very similar to the albumin detection for allergen detection, you’re also looking at disposable tubes where for instance, peanut detection, there would be a container which the food extract will be placed and based on a specific reaction, the color of that tube will change or the light that is transmitted through that tube is going to change in response to peanut concentration.  The more peanuts you have in the food extract, the more color change. So we quantify the color change per tube, in this specific example, to also calibrate what the concentration of the food extract was in terms of grams per milliliter. You can do this for peanuts or you can do this for other kinds of allergens.  All you need to do is change the substrate and the chemistry that you insert into your optical reader at the back of your cell phone. 

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