Journal Article2024Cited by 1

Development and performance evaluation of a Bengali-adapted mHealth app for early detection of impaired visual acuity

Monzurul Haque, Marzia Zaman, Ashraful Islam, Farhana Sarker, Nahid Ferdausi, Khondaker A. Mamun

Heliyon

Elsevier BV, Vol. 10, Issue 23, pp. e40853, ISBN: 2405-8440

DOI: 10.1016/j.heliyon.2024.e40853Open AccessURL

Abstract

This paper presents a comprehensive study on the development and performance evaluation of " Dristi ," a mobile health (mHealth) app designed to facilitate eye screening for impaired visual acuity (VA) in Bangladesh. Recognizing the critical importance of vision and the challenges posed by visual impairments, particularly in low-resource settings, this study explores an innovative solution to enhance eye care accessibility. The app, developed for Android devices, integrates features such as VA testing using adapted Bengali letters, color blindness tests, and eye health education, aiming to make eye care more user-friendly and accessible. Inspired by the Snellen chart, the app employs a simplified method for VA assessment, suitable for the constraints of mobile devices. The study involved a cross-sectional comparative design, conducted between June and September 2022, to clinically validate the app's feature of testing distant vision and near vision. Participants were recruited from one government eye hospital, one semi-private eye hospital, one high school, and a private clinic in Bangladesh, encompassing a diverse demographic. The validation study revealed promising results in terms of the app's accuracy, sensitivity, and specificity in both distant and near vision testing, although some variability was observed across different data sources. The study also identified a significant number of participants with diabetes and hypertension, common comorbidities affecting eye health. Overall, " Dristi " demonstrates potential as a valuable tool in the early detection and management of visual impairments in Bangladesh. Its development marks a significant step towards utilizing mHealth solutions to overcome healthcare barriers and improve eye care services in low-resource settings. Future directions include expanding the app's features, enhancing its integration with healthcare systems, and extending its reach to other similar contexts.

Keywords

  • mobile health apps
  • visual acuity
  • early detection
  • visual impairment
  • eye care
  • resource-limited settings
  • Bangladesh
  • Bengali language
  • mobile health

CCDS Authors

Ashraful Islam, PhD
Ashraful Islam

Ashraful Islam, PhD

  • Center Director, CCDS
  • Director, HCI Wing

Published at

CHI, UIST, UbiComp, IJCNN, ICIP, HCII, ICDMW, BLP, Pattern Recognition, IEEE Internet of Things Journal, JMIR, JMIR Human Factors, JMIR Formative Research, IEEE Access, Smart Agricultural Technology, Diabetes Research and Clinical Practice, PLOS ONE

Farhana Sarker, PhD
Farhana Sarker, PhD

Farhana Sarker, PhD

  • Director, WiSE Wing

  • Associate Professor

    Department of Computer Science and Engineering

    Independent University, Bangladesh (IUB)

Published at

ICDMW, IEEE Access

References

  1. 1.Mary L. McHugh. (2013). The Chi-square test of independence. Biochemia Medica, 23(2), 143–149[10.11613/bm.2013.018]
  2. 2.Ian L. Bailey, Jan E. Lovie-Kitchin. (2013). Visual acuity testing. From the laboratory to the clinic. Vision Research, 90, 2–9[10.1016/j.visres.2013.05.004]
  3. 3.RajeevKumar Malhotra, A Indrayan. (2010). A simple nomogram for sample size for estimating sensitivity and specificity of medical tests. Indian Journal of Ophthalmology, 58(6), 519[10.4103/0301-4738.71699]
  4. 4.Muhammad Nazrul Islam, Md. Mahboob Karim, Toki Tahmid Inan, A. K. M. Najmul Islam. (2020). Investigating usability of mobile health applications in Bangladesh. BMC Medical Informatics and Decision Making, 20(1), 19[10.1186/s12911-020-1033-3]
  5. 5.Stephenie Tiew, Christina Lim, Tharsica Sivagnanasithiyar. (2020). Using an excel spreadsheet to convert Snellen visual acuity to LogMAR visual acuity. Eye, 34(11), 2148–2149[10.1038/s41433-020-0783-6]
  6. 6.Hillary Rono, Andrew Bastawrous, David Macleod, Ronald Mamboleo, Cosmas Bunywera, Emmanuel Wanjala, Stephen Gichuhi, Matthew J Burton. (2021). Effectiveness of an mHealth system on access to eye health services in Kenya: a cluster-randomised controlled trial. The Lancet Digital Health, 3(7), e414–e424[10.1016/s2589-7500(21)00083-2]
  7. 7.Ipsita Sutradhar, Priyanka Gayen, Mehedi Hasan, Rajat Das Gupta, Tapash Roy, Malabika Sarker. (2019). Eye diseases: the neglected health condition among urban slum population of Dhaka, Bangladesh. BMC Ophthalmology, 19(1), 38[10.1186/s12886-019-1043-z]
  8. 8.Fiona J Rowe, Lauren Hepworth, Claire Howard, Alison Bruce, Victoria Smerdon, Terry Payne, Phil Jimmieson, Girvan Burnside. (2020). Vision Screening Assessment (VISA) tool: diagnostic accuracy validation of a novel screening tool in detecting visual impairment among stroke survivors. BMJ Open, 10(6), e033639[10.1136/bmjopen-2019-033639]
  9. 9.Lingge Suo, Xianghan Ke, Di Zhang, Xuejiao Qin, Xuhao Chen, Ying Hong, Wanwei Dai, Defu Wu, Chun Zhang, Dongsong Zhang. (2021). Use of Mobile Apps for Visual Acuity Assessment: Systematic Review and Meta-analysis. JMIR mhealth and uhealth, 10(2), e26275[10.2196/26275]
  10. 10.Gang Luo, Chen-Yuan Lee, Prerana Shivshanker, Wenbo Cheng, Jamie Wang, Sophia Marusic, Aparna Raghuram, Yan Jiang, Rui Liu. (2022). Preliminary Evaluation of a Smartphone App for Refractive Error Measurement. Translational Vision Science & Technology, 11(2), 40[10.1167/tvst.11.2.40]
  11. 11.Shawkat Ara Shakoor, Mustafizur Rahman, A H M Enayet Hossain, Mohammad Moniruzzaman, Mahfuzur Rahman Bhuiyan, Ferdous Hakim, M Mostafa Zaman. (2022). Prevalence of blindness and its determinants in Bangladeshi adult population: results from a national cross-sectional survey. BMJ Open, 12(4), e052247[10.1136/bmjopen-2021-052247]
  12. 12.Bryce de Venecia, Yasmin Bradfield, Ralph Møller Trane, Alicia Bareiro, Miguel Scalamogna. (2018). Validation of Peek Acuity application in pediatric screening programs in Paraguay. International Journal of Ophthalmology, 11(8), 1384–1389[10.18240/ijo.2018.08.21]
  13. 13.Sue Stevens. (2007). Test distance vision using a Snellen chart. DOAJ (DOAJ: Directory of Open Access Journals)[link]
  14. 14.Noémie Stoll, Elsa Di Foggia, Claude Speeg-Schatz, Hélène Meunier, Adam Rimele, Pascal Ancé, Pierre-Henri Moreau, Arnaud Sauer. (2022). Development and validation of a new method for visual acuity assesment on tablet in pediatric population: eMOVA test. BMC Ophthalmology, 22(1), 180[10.1186/s12886-022-02360-8]
  15. 15.Hillary Rono, Andrew Bastawrous, David Macleod, Cosmas Bunywera, Ronald Mamboleo, Emmanuel Wanjala, Matthew Burton. (2019). Smartphone-Guided Algorithms for Use by Community Volunteers to Screen and Refer People With Eye Problems in Trans Nzoia County, Kenya: Development and Validation Study. JMIR mhealth and uhealth, 8(6), e16345[10.2196/16345]
  16. 16.Yu-Hung Lai, Horng-Jiun Wu, Shun-Jen Chang. (2021). A reassessment and comparison of the Landolt C and tumbling E charts in managing amblyopia. Scientific Reports, 11(1), 18277[10.1038/s41598-021-97875-3]
  17. 17.Soolienah Rhiu, Hye Jin Lee, Yong Sook Goo, Kyoungrok Cho, Jae-hyung Kim. (2015). Visual Acuity Testing Using a Random Method Visual Acuity Application. Telemedicine Journal and e-Health, 22(3), 232–237[10.1089/tmj.2015.0073]
  18. 18.Nishat Nasrin, Muhammad Asaduzzaman, Dilruba Sharmin, Nigar Sultana Tithi, Syed Md Nazmul Hudda. (2020). A survey-based study on awareness of eye diseases among population of Bangladesh. Asian Journal of Medical and Biological Research, 5(4), 292–296[10.3329/ajmbr.v5i4.45267]
  19. 19.Moinul H. Chowdhury, Rony Chowdhury Ripan, A.K.M. Nazmul Islam, Rubaiyat Alim Hridhee, Farhana Sarker, Sheikh Mohammed Shariful Islam, Khondaker A. Mamun. (2023). Digital health inclusion towards achieving universal health coverage for Bangladesh utilizing general practitioner model. Health Policy and Technology, 14(4), 100731[10.1016/j.hlpt.2023.100731]
  20. 20.A R Siti Nor Aishah, A Mutalib, H Asma, A A Baig, N N Naing, S E Hashim, M A Hau. (2020). Development and validation of a new vision screening test algorithm for public use mobile application- A pilot study.. PubMed, 75(6), 685–690
  21. 21.Ashraful Islam, Eshtiak Ahmed, Md Rakibul Islam. (2023). Early Stage Design of a mHealth Intervention for Managing Gestational Diabetes Mellitus in Bangladeshi Women. Communications in computer and information science, 380–388[10.1007/978-3-031-49212-9_47]
  22. 22.Abu Musa Sakib, Sanzar Adnan Alam, Ashraful Islam. (2024). User-Centered Design and Validation of mHealth App for Providing Vital Assistance and Emergency Healthcare Support in Bangladesh. International Congress on Human-Computer Interaction, Optimization and Robotic Applications (ICHORA), 1–6[10.1109/hora61326.2024.10550719]
  23. 23.Jack T. Holladay. (2004). Visual acuity measurements. Journal of Cataract & Refractive Surgery, 30(2), 287–290[10.1016/j.jcrs.2004.01.014]

Cited By

  1. 1.Lavnik Poddar, Varun Sai Koruprolu, Mohammed Naim Shaikh, Monika Aggarwal. (2025). Digital Stethoscopes for Telemedicine in Rural India: Designing for Usability and Practical Adoption. Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 69(1), 1411–1417[10.1177/10711813251364797]
← All publications