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{{Paper
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|title=None
|pdfUrl=https://ceur-ws.org/Vol-2105/10000461.pdf
|volume=Vol-2105
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==None==
https://ceur-ws.org/Vol-2105/10000461.pdf
Mobile Application to Determine the Severity of
Salmonellosis Disease
Tetyana Zhylenko 1[0000-0002-9717-3033], Iryna Shuda1[0000-0003-0184-8057],
Oksana Chemych1[0000-0003-1332-2175], Mykola Chemych 1[0000-0002-7085-5448] and
Anton Kudryavtsev1[0000-0003-1705-4235]
1 Sumy State University, Rymskogo-Korsakova. 2, 40007 Sumy, Ukraine
t.zhylenko@phe.sumdu.edu.ua
Abstract. The paper deals with studying the use of mobile devices for diagnos-
ing in medicine, working out the element of medical students’ electronic teach-
ing and applying the mobile app in learning infectious diseases, namely, salmo-
nellosis. The amount of people infected with this disease have been increasing
year by year. The complexity of curing the moderate and serious diseases de-
pends on the timeliness of determining the patient’s condition. The authors have
statistically researched how four indices of clinical blood test that affect the
course of disease are significant. Three mean values of each of the four indices
of clinical blood test were shown, which correspond to the three levels of sever-
ity of the disease. The application for mobile devices that enables the urgent
and accurate determination of the salmonellosis disease severity without extra
time and financial expenditures has been worked out. It can be used by students
in the academic process, by doctors while rendering the first aid to patients, as
well as for the independent disease course control by a patient himself / herself.
Keywords: Mobile App, Salmonellosis, Concordance Correlation Coefficient,
Sign Test, Android, Kotlin.
1 Introduction
Today there are more than 325 thousand mHealth apps in the sphere of medicine.
Most of them are free of charge. Research2Guidance prognosticates that the most
prospective tendency of mHealth in the nearest 5 years will be elaboration of apps for
distant monitoring and consulting [1]. In Ukraine the new edition of the technical
regulation that is worked out according to the EU Medical Device Directive has been
mandatory since July 1, 2015.
We have analyzed the modern state of incidence of salmonellosis, an intestinal in-
fection, in the world. People all over the world suffer from this disease. About 94
million cases of salmonellosis are detected annually [2]. In the European countries
where the incidence amounts to 23,4 cases per 100 thousand people the disease has a
considerable influence on the population health [3]. The main task of curing the dis-
ease is early determination of its severity degree. This topic is studied by scientists all
over the world [1-3], the patient’s condition and products that cause the disease are
analyzed, the formulae for clinical blood test are suggested, the statistical analysis of
data about the disease at a particular period is conducted, but no source contains the
reference to an app or calculator that is used by students or practitioners to urgently
determine the degree of the disease severity. Such an app is especially topical while
the ambulance service and rendering the first aid by family physicians are involved in
the medical reform which starts on January 1, 2018. For the first time we have created
the app for the Android which will help to quickly determine intoxication indices and
disease severity without a personal computer and at any place. The app is basically
aimed at the automatization of calculating intoxication indices to shorten time and
determine the patient’s condition more accurately. The basic requirements for the
application are the possibility to put in data, to calculate intoxication indices and to
determine the patient’s condition, the modern design of the app, the convenient use.
2 The Basis for Mobile App Creation
Creating the mobile app has relied on the integrated development environment (IDE)
for the platform Android – Android Studio. This program is free of charge, it is li-
censed by Apache 2.0. Android Studio is based on IntelliJ IDEA Community Edition
that is supported by the company JetBrains. The applications for the operation system
Android can be made in many programming languages [4-6]. The most popular lan-
guage to develop on the platform Android is Java now [5]. But while creating the
application we have used the programming language Kotlin [6]. The use of the pro-
gramming language has been determined by the fact that it is the most modern and the
easiest one to write programs. Kotlin can be compiled in two variations: bytecode
JVM and JavaScript. All the Java-frameworks and libraries can be also used. Kotlin
may be converted into Java and just the other way round. This programming language
is null-safe. The important advantages of Android Studio are the represented collec-
tion of typical interface elements and the visual editor for their combination that pro-
vides the convenient preview of the targeted application, code highlighting, analysis
and detection of errors, integration with the control system.
3 Statistic Preparation of Data to Create the App
It should be noted that the salmonellosis disease falls into three degrees of the clinical
course. The criteria for the degree of salmonellosis severity comprise the height of
fever and its duration, stool frequency and volume and duration of diarrhea.
The mild severity degree is characterized with low grade fever, watery stool up to
5 times a day, duration of diarrhea for 1-3 days. The temperature of 38-39° С for 4
days and the stool up to 10 times a day for about a week indicate the moderate degree
of severity. The evident intoxication, the temperature that rises to 39° С and higher
for five or even more days and profuse stool more than 10 times with the duration for
more than a week are characteristic of the serious degree of severity.In order that the
severity of the gastrointestinal salmonellosis should be accurately diagnosed, we have
used for the first time the integrative indicators of endogenous intoxication the deter-
mination of which does not involve extra expenditures, apart from the conventional
analyses – clinical blood test [7]. It has been found out what indices reflect the degree
of disease severity most objectively. For this purpose, the concordance correlation
criterion has been applied: we have dealt with the most widespread variants to deter-
mine the sequence of the importance of indices investigated in case records to evalu-
ate the hypotheses of different levels of importance of four indices: the index of shift
of leucocytes (ISL), the leucocytic intoxication index (LII), hematological index of
intoxication (HII), the index of intoxication (II). Their analysis has presupposed the
ranking number for every index.We have used the concordance correlation coefficient
for the case of tied ranks (the same values of ranks in evaluation of the same hypothe-
sis).
1 m
1 li
W S / ( m2 (n3 n) mTi ), Ti (ti 3 ti ),
12 i 1 12 i 1
where S - the sum of ranks, m - the number of hypotheses, n - the number of indices,
Ti – the number of connections (types of the repeated elements) in evaluations of the
ith hypothesis, ti – the number of elements in the lth connection for the ith hypothesis
(the number of repeated elements). Then we have set the task to find out what indices
influence the accurate diagnosis. As a result of the research, it has been identified on
the basis of expert rating that the most significant qualitative properties are ISL and
LII [7].
4 Key Moments in Creating the Application
Then, based on the results obtained, a mobile application was created to quickly de-
termine the severity of the disease for salmonellosis, which can be found by reference
http://play.google.com/store/apps/details?ld=com.kam123.ua
The application for the operating system Android is a set of classes and forms.
Every form is an object of the class Activity, the interconnection between them is
realized by the object of the class Intent.The first form is for data input by the user.
The main designated purpose of the first form is getting the necessary information
from the user. The user puts in the data about the clinical blood test that are necessary
to determine the severity of salmonellosis disease. The second one reflects the general
theoretical data about each intoxication index. The third form demonstrates the results
of calculations and the information about the obtained degree of disease severity. The
object of the class Intent is employed to change the form. The additional elements
EditText are essential for data input, and the button “Calculate” initiates the call of
another form and puts down the results of calculations into static variables in the class
Result. After that the results are available in the form in which the answer is output.
The variables that have the static modifier are global variables. When the class objects
are initialized the copies of a static variable are not made. All the samples of the class
make common use of one static variable. It is not necessary to create an object of the
class to get access to the static variable. The event processor is not obligatory to simu-
late pressing the button. The attribute OnClick specially elaborated for Android has
been used. It is the modern approach to programming on Android that makes the
elaboration easier and shortens the number of lines in the code. The class Formula has
been created for calculations. It stores static functions which compute intoxication
indices and determine the disease severity. It allows to apply formulae from any part
of the program.
The calculations are made in the following way:
val LII_v = Formula.LII(M, Y, St, Se, Pl, Ly, Mo, E)
val HPI_v = Formula.HII(LII_v, Cesr, Cl)
val ISL_v = Formula.ISL (E, B, St + Se, Mo, Ly)
val II_v = Formula.II(LII_v, Lc, ESR)
val res = Formula.result(LII_v, HPI_v, ISL_v, PI_v, T, K)
The results are written into global variables of the class Result. Then the form with
the results opens by means of the method startActivity:val intent = Intent(this, Re-
sultActivity::class.java)startActivity(intent). Then we turn to variables of the class
Result which are output on the form Result Activity. To start working with the appli-
cation one should put in correct data and press the button “Calculate”. After pressing
the button “Calculate” the check is carried out whether all the columns are filled in. If
one of the columns is not filled in, the warning will appear, and they will be filled in
with zeros. After all the data are put in the program computes the result.
Appendix
For the first time the mathematical model of calculating the degree of gastrointestinal
salmonellosis severity has been elaborated. The application for the urgent and accu-
rate determination of the disease severity degree has been created that can be used by
medical students in studying, by medical staff for making a diagnosis and rendering
the emergency care, infection disease doctors at different stages of patients’ treatment
and, finally, in the independent disease course control by a patient himself / herself.
The severity of salmonellosis disease is determined quickly and without economic
expenditures, besides objective indicators are additionally regarded.
References
1. Research2guidance, https://research2guidance.com/325000-mobile-health-apps-available-
in-2017/, last accessed 2018/03/12
2. Majowicz S., Musto J., Scallan E. et al.: International Collaboration on Enteric Disease
‘Burden of Illness’ Studies. ClinInfectDis 50(6), 882–889 (2010).
3. EU summary report on zoonoses, zoonoticagents and food-borne outbreaks 2014. EFSA
Journal 13(12), 4-5 (2015).
4. Start Android, http://start of android.com/, last accessed 2018/03/12
5. Gerbert Shildt. Java 8. Polnoe rukovodstvo, 9-eizdanie =Java 8. The Complete Reference,
9thEdition, Vilyams, Moscow (2015).
6. Kotlin Programming Language, https://kotlinlang.org/, last accessed 2018/03/12
7. Chemych, O., Zhylenko, T., Shuda, I., Chemych, M., Moroz, L.: Mathematical Model of
the Severity of Gastrointestinal form of Salmonelollosis. J.Clin.Exp.Med.Res. 5(4), 1066-
1076 (2017).