[caption id="attachment_15108" align="aligncenter" width="460"] Researchers Matthew Mancuso (L) and Vlad Oncescu demo smartCARD on an iPhone.[/caption] Despite predictions that smartphone-based apps will become a primary tool allowing people to manage their own fitness plans or treatment of long-term illnesses, few mobile health apps do anything but keep records or provide advice. The number of people using mobile health-apps or devices will rise to more than 96 million by 2018, compared to about 15 million now, according to a September study from Juniper Research. In healthcare, those apps will include close monitoring of chronic illnesses such as diabetes, saving as much as $35 billion from the cost of on-premise health care, according to the report. The market for fitness apps that use GPS to track running routes or gym workouts will grow far more quickly than the market for more clinical mobile functions, according to Juniper. That may change if more health-related apps are able to give actual evaluations of a person's health, or make recommendations based on the state of a user's health right at that moment – like a smartphone app that can check a user's cholesterol level without a blood test or visit to the doctor's office. Researchers at Cornell University claim to have done exactly that in an app that uses a smartphone camera and paper testing strip to measure cholesterol from a drop of blood, sweat or saliva. The app's name is "Smartphone Cholesterol Application for Rapid Diagnostics" but is shortened to SmartCARD by David Erickson, the Cornell associate professor of mechanical engineering who is lead author on the paper describing the application. The app doesn't give an accurate evaluation of cholesterol level or overall health from a selfie taken with a patient's camera, as one promotional article implies. Instead it uses the kind of test strips that are routine parts of both home and lab-testing procedures, but is able to analyze and quantify the results accurately without bulky, expensive specialty equipment, Erickson said in a statement announcing publication of a study describing the device. SmartCARD is an accessory that clamps over a smartphone's camera and takes pictures with a built-in flash designed to provide a predictable quality of light to allow the software to accurately analyze the color and saturation of cholesterol test trips that provide the biological part of the test. The main advances in the smartCHIP research isn't just the ability to read color on a test trip; it's the ability to rationalize the color calibrations on many different models of smartphone to get a consistent, accurate reading despite the range of hardware available, according to Erickson. In the current version, users would put a drop of blood on a paper test strip that is inserted in the smartCARD reader so the smartphone app can analyze the color values on the strip and offer a conclusion more accurate than is possible for a human comparing the strip by eye with sample results printed on the box. The current version is able to identify only total cholesterol levels, though Erickson and the development team are working on versions that can break out LDL, HDL and triglyceride levels as well. A paper describing the National Science Foundation-funded research behind development of the smartCARD and its results were published Nov. 28 in the journal Lab on a Chip. A related study uses similar techniques to analyze micronutrient levels, to allow health workers in third-world countries to evaluate patients in the field rather than having to send test strips or blood samples to a lab for analysis first. The market for mobile health applications is expected to grow 41.5 percent during the next five years, reaching a total of $10.2 billion by 2018, compared to $1.3 billion during 2012, according to astudy released in January 2013 by Transparency Market Research. A diabetic blood-glucose-testing app called iBGStar is already available from Sanofi Diabetes, for a list price of $74.99. "Mobil health [applications are] increasing at an incredible rate," Erickson said. "It’s the next big thing."   Image: Cornell University Photography/ Jason Koski