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Zuccotti G, Agnelli P, Labati L, Cordaro E, Braghieri D, Fiorina P, Bertoli S, Berra CCF, Croci M, Malighetti ME, Lo Surdo F, Foppiani A, Bucciarelli L, Xodo M, Battezzati A, De Pasquale S, Calcaterra V
Feasibility of a Noncontact Photoplethysmography–Based Mobile App for Noninvasive Hemoglobin Monitoring: Exploratory Observational Study
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Exploring the feasibility of non-contact PPG-based mobile application for non-invasive hemoglobin monitoring
Gianvincenzo Zuccotti;
Paolo Agnelli;
Lucia Labati;
Erika Cordaro;
Davide Braghieri;
Paolo Fiorina;
Simona Bertoli;
Cesare Celeste Federico Berra;
Marina Croci;
Maria Elena Malighetti;
Fabrizio Lo Surdo;
Andrea Foppiani;
Loredana Bucciarelli;
Marco Xodo;
Alberto Battezzati;
Sergio De Pasquale;
Valeria Calcaterra
ABSTRACT
Background:
Anemia is a widespread global health issue. Hemoglobin (Hb) concentration measurement remains the most common method for anemia screening and diagnosis. In recent years, there has been growing interest in the development of non-invasive point of care technologies that eliminate the need for blood sampling.
Objective:
This study explores the feasibility of using a non-contact, PPG-based mobile application for Hb monitoring.
Methods:
Adult volunteers aged 18 years and older, of both sexes, were consecutively recruited. Data acquisition using remote photoplethysmography (rPPG) was performed by recording participants’ facial images via the front camera of mobile devices for roughly 90 seconds. A complete blood count, including Hb levels, was used as a reference for comparison with the data collected using the comestai application
Results:
A total of 555 individuals (313 F/ 242 M) participated in the study. The app achieved a MAE of 1.46, MAPE of 11.26, with a ME of -0.67 and RMSE of 1.88. The Bland-Altman plot in evaluated the agreement between the app-based and laboratory-based Hb measurements, with the mean difference between the two methods being -0.70 g/dL. The method demonstrated an overall accuracy of 75.0%.
Conclusions:
The comestai.app mobile application offers an innovative approach to wellness monitoring by providing non-invasive Hb estimation using the smartphone’s front-facing camera. Continued development, including algorithmic refinement and larger-scale validation in diverse populations, will be key to enhancing accuracy and broadening its utility. By leveraging the ubiquity of smartphones, comestai.app contributes meaningfully to the democratization of health monitoring and the promotion of proactive self-care. Clinical Trial: ClinicalTrials.gov (ID: NCT06427564)
Citation
Please cite as:
Zuccotti G, Agnelli P, Labati L, Cordaro E, Braghieri D, Fiorina P, Bertoli S, Berra CCF, Croci M, Malighetti ME, Lo Surdo F, Foppiani A, Bucciarelli L, Xodo M, Battezzati A, De Pasquale S, Calcaterra V
Feasibility of a Noncontact Photoplethysmography–Based Mobile App for Noninvasive Hemoglobin Monitoring: Exploratory Observational Study