Artificial Intelligence in Diagnostics: Enhancing Urine Test Accuracy Using a Mobile Phone-Based Reading System

Ann Lab Med. 2025 Mar 1;45(2):178-184. doi: 10.3343/alm.2024.0304. Epub 2024 Dec 16.

Abstract

Background: Urinalysis, an essential diagnostic tool, faces challenges in terms of standardization and accuracy. The use of artificial intelligence (AI) with mobile technology can potentially solve these challenges. Therefore, we investigated the effectiveness and accuracy of an AI-based program in automatically interpreting urine test strips using mobile phone cameras, an approach that may revolutionize point-of-care testing.

Methods: We developed novel urine test strips and an AI algorithm for image capture. Sample images from the Chungnam National University Sejong Hospital were collected to train a k-nearest neighbor classification algorithm to read the strips. A mobile application was developed for image capturing and processing. We assessed the accuracy, sensitivity, specificity, and ROC area under the curve for 10 parameters.

Results: In total, 2,612 urine test strip images were collected. The AI algorithm demonstrated 98.7% accuracy in detecting urinary nitrite and 97.3% accuracy in detecting urinary glucose. The sensitivity and specificity were high for most parameters. However, this system could not reliably determine the specific gravity. The optimal time for capturing the test strip results was 75 secs after dipping.

Conclusions: The AI-based program accurately interpreted urine test strips using smartphone cameras, offering an accessible and efficient method for urinalysis. This system can be used for immediate analysis and remote testing. Further research is warranted to refine test parameters such as specific gravity to enhance accuracy and reliability.

Keywords: Artificial intelligence; Mobile application; Smartphone; Urinalysis.

MeSH terms

  • Algorithms*
  • Area Under Curve
  • Artificial Intelligence*
  • Cell Phone*
  • Glycosuria / diagnosis
  • Glycosuria / urine
  • Humans
  • Image Processing, Computer-Assisted
  • Mobile Applications
  • Nitrites / urine
  • Point-of-Care Testing
  • ROC Curve
  • Reagent Strips
  • Sensitivity and Specificity
  • Smartphone
  • Urinalysis* / instrumentation
  • Urinalysis* / methods

Substances

  • Nitrites
  • Reagent Strips