After a visit to Uganda, a research team leader was inspired to develop a medical laboratory tool for diagnosing adrenal disorders
Saliva and the smartphone do not appear to be a harmonious pair, particularly as elements of a method to remotely perform a medical laboratory test for cortisol. But new research at Intermountain Medical Center in Murray, Utah, suggests they can work together to help physicians remotely conduct cortisol tests.
Intermountain Healthcare is an internationally recognized, nonprofit healthcare system based in Salt Lake City, Utah, with 22 hospitals, more than 185 physician clinics, and 33,000 employees throughout the state of Utah, as well as an affiliated health insurance company, SelectHealth.
Method for Affordable Monitoring of Adrenal Gland Diseases
Pathologists know that cortisol, a steroid hormone produced by the adrenal gland, is a critical indicator of patients’ adrenal gland function and diabetic health.
This diagnostic tool taps new smartphone technology to affordably and easily monitor adrenal gland diseases based on saliva specimens, according to a news release issued by the medical center. It includes an attached device that feeds the results of the test into the smartphone and an app that quantifies and interprets the saliva assay.
This point-of-care test is important for at least two reasons. First, it is another example of how smartphone technology can help patients to self-monitor their health from home. And, it provides an inexpensive approach to cortisol measurement that may help to address the need for inexpensive, accessible diagnostic tests in developing nations.
Device Gives Diabetics and Others Easy Access to Cortisol Levels
This new diagnostic tool screens patients for Cushing’s syndrome, an adrenal gland disease. It can also aid in identifying adrenal insufficiency, monitoring cortisol replacement, and assessing changes in adrenal function, according to the Intermountain news release.
Measuring cortisol, also known as the “stress hormone,” is not so easy to do, researchers noted.
“When cortisol levels are overlooked, too many people suffer and die because of excess or insufficient cortisol,” explained Joel Ehrenkranz, M.D., an endocrinologist and Director of Diabetes and Endocrinology at Intermountain who led this research.
Diabetics must pay close attention to their cortisol levels, which is increased by stress, the researchers emphasized. That’s because elevated cortisol impairs the body’s ability to metabolize glucose, the news release pointed out.
“When blood cortisol levels are too high, insulin will not lower blood sugar,” stated Ehrenkranz. “Elevations in cortisol decrease the effectiveness of insulin and other drugs used in diabetes treatment. Having the ability to easily and inexpensively measure cortisol levels is important in managing diabetes.”
Cortisol Test Works Like a Home Pregnancy Test
The Intermountain researchers’ cortisol measurement tool involves the following:
1) a saliva specimen;
2) a smartphone;
3) a smartphone-attached device that feeds results of the saliva test into the smartphone; and,
4) an app that quantifies and interprets the results of the salivary cortisol assay within five minutes.
“The cortisol assay is similar in design to a home pregnancy test or urine sample drug test and is like having an endocrine specialist in your phone,” explained Ehrenkranz in the Intermountain press release.
Research Motivated by an International Healthcare Encounter
Development of this diagnostic tool was inspired by Ehrenkranz’s experience while on a medical mission to Kampala, Uganda, where he treated a hospitalized woman with Addison’s disease. This disease occurs when adrenal glands do not produce enough hormones, among which is cortisol.
Ehrenkranz ordered a cortisol test on his patient, but was told by Uganda doctors that the cost of this blood test was prohibitive. “After my experience, I knew I needed to develop a test and technology that would fix this problem of testing cortisol levels,” he said, noting that the test had to be inexpensive and easy to do.
On November 18, i-calQ LLC was granted a patent for this technology. Ehrenkranz is the Chief Medical Officer at i-Cal. Based in Salt Lake City, Utah, the company was founded in 2011 to commercialize technology that would support the use of smartphones for point-of-care testing. icalQ says that projects are underway in India and Thailand to incorporate smartphones and i-calQ technology for use in the screening of all newborns. The company says this testing can be performed “in minutes at a cost of less than $1.00, even in the most remote regions of the world.
Smartphone Technology: That’s How Healthcare Diagnostics Rolls
Intermountain is not the only organization making recent contributions to smartphone technology and healthcare diagnostics. Indeed, smartphone technology seems to be on a roll in healthcare.
In June, the Food and Drug Administration approved iHealth Align. Billed as the world’s smallest blood glucose monitor, it tracks blood sugar on a mobile device, according to a report published by Fierce Medical Devices.
iHealth Align works by placing a drop of blood a test strip that is inserted into a tiny plug, which fits into the smartphone. The device displays and stores readings through an accompanying app.
Fierce Medical Devices also published a report on an iPhone heart monitor device. This device, which was developed and patented by Apple, has an embedded ECG sensor that measures heartbeat.
Of course, smartphone technology has a ways to go before replacing the many complicated tests performed today by clinical laboratories. Still, medical diagnostic tools, such as the cortisol test device created by Intermountain researchers, are important to the ever-growing number of elderly people who desire the convenience and affordability home test devices, as well as point-of-care test devices to provide affordable and accessible medical tests in developing nations.
Dark Daily has regularly reported on any number of research and development projects that have matched some type of diagnostic technology with smartphones to provide accurate, fast, low-cost lab tests. Collectively, these research projects indicate to the clinical laboratory profession that there is widespread interest in pairing smartphones with diagnostic devices that can help physicians quickly diagnose diseases and treat patients.
—By Donna Marie Pocius