Adapting an artificial intelligence sexually transmitted diseases symptom checker tool for Mpox detection: the HeHealth experience.

Artificial Intelligence (AI) applications have shown promise in the management of pandemics. In response to the global Monkeypox (Mpox) outbreak, the HeHealth.ai team leveraged an existing tool to screen for sexually transmitted diseases (STD) to develop a digital screening test for symptomatic Mpox using AI. Before the global Mpox outbreak, the team developed a smartphone app (HeHealth) where app users can use a smartphone to photograph their own penises to screen for symptomatic STD. The AI model initially used 5000 cases and a modified convolutional neural network to output prediction scores across visually diagnosable penis pathologies including syphilis, herpes simplex virus, and human papillomavirus. A total of about 22,000 users had downloaded the HeHealth app, and ~21,000 images were analysed using HeHealth AI technology. We then used formative research, stakeholder engagement, rapid consolidation images, a validation study, and implementation of the tool. A total of 1000 Mpox-related images had been used to train the Mpox symptom checker tool. Based on an internal validation, our digital symptom checker tool showed specificity of 87% and sensitivity of 90% for symptomatic Mpox. Several hurdles identified included issues of data privacy and security for app users, initial lack of data to train the AI tool, and the potential generalisability of input data. We offer several suggestions to help others get started on similar projects in emergency situations, including engaging a wide range of stakeholders, having a multidisciplinary team, prioritising pragmatism, as well as the concept that 'big data' in fact is made up of 'small data'.