Field validation of deep learning based Point-of-Care device for early detection of oral malignant and potentially malignant disorders

Praveen Birur N, Bofan Song, Sumsum P. Sunny, Keerthi G, Pramila Mendonca, Nirza Mukhia, Shaobai Li, Sanjana Patrick, Shubha G, Subhashini A.R, Tsusennaro Imchen, Shirley T. Leivon, Trupti Kolur, Vivek Shetty, Vidya Bhushan R, Daksha Vaibhavi, Surya Rajeev, Sneha Pednekar, Ankita Dutta Banik, Rohan Michael RameshVijay Pillai, Kathryn O.S, Petra Wilder Smith, Alben Sigamani, Amritha Suresh, Rongguang Liang, Moni A. Kuriakose

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Early detection of oral cancer in low-resource settings necessitates a Point-of-Care screening tool that empowers Frontline-Health-Workers (FHW). This study was conducted to validate the accuracy of Convolutional-Neural-Network (CNN) enabled m(mobile)-Health device deployed with FHWs for delineation of suspicious oral lesions (malignant/potentially-malignant disorders). The effectiveness of the device was tested in tertiary-care hospitals and low-resource settings in India. The subjects were screened independently, either by FHWs alone or along with specialists. All the subjects were also remotely evaluated by oral cancer specialist/s. The program screened 5025 subjects (Images: 32,128) with 95% (n = 4728) having telediagnosis. Among the 16% (n = 752) assessed by onsite specialists, 20% (n = 102) underwent biopsy. Simple and complex CNN were integrated into the mobile phone and cloud respectively. The onsite specialist diagnosis showed a high sensitivity (94%), when compared to histology, while telediagnosis showed high accuracy in comparison with onsite specialists (sensitivity: 95%; specificity: 84%). FHWs, however, when compared with telediagnosis, identified suspicious lesions with less sensitivity (60%). Phone integrated, CNN (MobileNet) accurately delineated lesions (n = 1416; sensitivity: 82%) and Cloud-based CNN (VGG19) had higher accuracy (sensitivity: 87%) with tele-diagnosis as reference standard. The results of the study suggest that an automated mHealth-enabled, dual-image system is a useful triaging tool and empowers FHWs for oral cancer screening in low-resource settings.

Original languageEnglish (US)
Article number14283
JournalScientific reports
Issue number1
StatePublished - Dec 2022

ASJC Scopus subject areas

  • General


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