Ear biometrics for patient identification in global health: a field study to test the effectiveness of an image stabilization device in improving identification accuracy

Abstract Background In many low and middle-income countries (LMICs), difficulties in patient identification are a major obstacle to the delivery of longitudinal care. In absence of unique identifiers, biometrics have emerged as an attractive solution to the identification problem. We developed an mH...

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Main Authors: Lauren P. Etter, Elizabeth J. Ragan, Rachael Campion, David Martinez, Christopher J. Gill
Format: Article
Language:English
Published: BMC 2019-06-01
Series:BMC Medical Informatics and Decision Making
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12911-019-0833-9
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author Lauren P. Etter
Elizabeth J. Ragan
Rachael Campion
David Martinez
Christopher J. Gill
author_facet Lauren P. Etter
Elizabeth J. Ragan
Rachael Campion
David Martinez
Christopher J. Gill
author_sort Lauren P. Etter
collection DOAJ
description Abstract Background In many low and middle-income countries (LMICs), difficulties in patient identification are a major obstacle to the delivery of longitudinal care. In absence of unique identifiers, biometrics have emerged as an attractive solution to the identification problem. We developed an mHealth App for subject identification using pattern recognition around ear morphology (Project SEARCH (Scanning EARS for Child Health). Early field work with the SEARCH App revealed that image stabilization would be required for optimum performance. Methods To improve image capture, we designed and tested a device (the ‘Donut’), which standardizes distance, angle, rotation and lighting. We then ran an experimental trial with 194 participants to measure the impact of the Donut on identification rates. Images of the participant’s left ear were taken both with and without use of the Donut, then processed by the SEARCH algorithm, measuring the top one and top ten most likely matches. Results With the Donut, the top one identification rate and top ten identification rates were 99.5 and 99.5%, respectively, vs. 38.4 and 24.1%, respectively, without the Donut (P < 0.0001 for each comparison). In sensitivity analyses, crop technique during pre-processing of images had a powerful impact on identification rates, but this too was facilitated through the Donut. Conclusions By standardizing lighting, angle and spatial location of the ear, the Donut achieved near perfect identification rates on a cohort of 194 participants, proving the feasibility and effectiveness of using the ear as a biometric identifier. Trial registration This study did not include a medical intervention or assess a medical outcome, and therefore did not meet the definition of a human subjects research study as defined by FDAAA. We did not register our study under clinicaltrials.gov.
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spelling doaj.art-0c325152cbb24d3aa17b5919e99a86fc2022-12-22T00:59:05ZengBMCBMC Medical Informatics and Decision Making1472-69472019-06-011911910.1186/s12911-019-0833-9Ear biometrics for patient identification in global health: a field study to test the effectiveness of an image stabilization device in improving identification accuracyLauren P. Etter0Elizabeth J. Ragan1Rachael Campion2David Martinez3Christopher J. Gill4College of Engineering, Boston UniversityDepartment of Medicine, Section of Infectious Diseases, Boston Medical CenterCollege of Engineering, Boston UniversityCollege of Engineering, Boston UniversityDepartment of Global Health, Boston University School of Public HealthAbstract Background In many low and middle-income countries (LMICs), difficulties in patient identification are a major obstacle to the delivery of longitudinal care. In absence of unique identifiers, biometrics have emerged as an attractive solution to the identification problem. We developed an mHealth App for subject identification using pattern recognition around ear morphology (Project SEARCH (Scanning EARS for Child Health). Early field work with the SEARCH App revealed that image stabilization would be required for optimum performance. Methods To improve image capture, we designed and tested a device (the ‘Donut’), which standardizes distance, angle, rotation and lighting. We then ran an experimental trial with 194 participants to measure the impact of the Donut on identification rates. Images of the participant’s left ear were taken both with and without use of the Donut, then processed by the SEARCH algorithm, measuring the top one and top ten most likely matches. Results With the Donut, the top one identification rate and top ten identification rates were 99.5 and 99.5%, respectively, vs. 38.4 and 24.1%, respectively, without the Donut (P < 0.0001 for each comparison). In sensitivity analyses, crop technique during pre-processing of images had a powerful impact on identification rates, but this too was facilitated through the Donut. Conclusions By standardizing lighting, angle and spatial location of the ear, the Donut achieved near perfect identification rates on a cohort of 194 participants, proving the feasibility and effectiveness of using the ear as a biometric identifier. Trial registration This study did not include a medical intervention or assess a medical outcome, and therefore did not meet the definition of a human subjects research study as defined by FDAAA. We did not register our study under clinicaltrials.gov.http://link.springer.com/article/10.1186/s12911-019-0833-9Ear biometricsIdentificationPatient identificationGlobal healthPublic healthElectronic medical record
spellingShingle Lauren P. Etter
Elizabeth J. Ragan
Rachael Campion
David Martinez
Christopher J. Gill
Ear biometrics for patient identification in global health: a field study to test the effectiveness of an image stabilization device in improving identification accuracy
BMC Medical Informatics and Decision Making
Ear biometrics
Identification
Patient identification
Global health
Public health
Electronic medical record
title Ear biometrics for patient identification in global health: a field study to test the effectiveness of an image stabilization device in improving identification accuracy
title_full Ear biometrics for patient identification in global health: a field study to test the effectiveness of an image stabilization device in improving identification accuracy
title_fullStr Ear biometrics for patient identification in global health: a field study to test the effectiveness of an image stabilization device in improving identification accuracy
title_full_unstemmed Ear biometrics for patient identification in global health: a field study to test the effectiveness of an image stabilization device in improving identification accuracy
title_short Ear biometrics for patient identification in global health: a field study to test the effectiveness of an image stabilization device in improving identification accuracy
title_sort ear biometrics for patient identification in global health a field study to test the effectiveness of an image stabilization device in improving identification accuracy
topic Ear biometrics
Identification
Patient identification
Global health
Public health
Electronic medical record
url http://link.springer.com/article/10.1186/s12911-019-0833-9
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