{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T15:36:57Z","timestamp":1784043417185,"version":"3.55.0"},"reference-count":56,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T00:00:00Z","timestamp":1734048000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Northern Ireland Connected Health Innovation Centre (NI-CHIC)","award":["RD-0817786"],"award-info":[{"award-number":["RD-0817786"]}]},{"name":"Invest Northern Ireland (Invest NI)","award":["RD-0817786"],"award-info":[{"award-number":["RD-0817786"]}]},{"name":"European Regional Development Fund (ERDF)","award":["RD-0817786"],"award-info":[{"award-number":["RD-0817786"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biosensors"],"abstract":"<jats:p>Lateral flow assays are widely used in point-of-care diagnostics but face challenges in sensitivity and accuracy when detecting low analyte concentrations, such as thyroid-stimulating hormone biomarkers. This study aims to enhance assay performance by leveraging textural features and hybrid artificial intelligence models. A modified Gray-Level Co-occurrence Matrix, termed the Averaged Horizontal Multiple Offsets Gray-Level Co-occurrence Matrix, was utilised to compute the textural features of the biosensor assay images. Significant textural features were selected for further analysis. A deep learning Convolutional Neural Network model was employed to extract features from these textural features. Both traditional machine learning models and hybrid artificial intelligence models, which combine Convolutional Neural Network features with traditional algorithms, were used to categorise these textural features based on the thyroid-stimulating hormone concentration levels. The proposed method achieved accuracy levels exceeding 95%. This pioneering study highlights the utility of textural aspects of assay images for accurate predictive disease modelling, offering promising advancements in diagnostics and management within biomedical research.<\/jats:p>","DOI":"10.3390\/bios14120611","type":"journal-article","created":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T06:53:39Z","timestamp":1734072819000},"page":"611","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Enhancing Sensitivity of Point-of-Care Thyroid Diagnosis via Computational Analysis of Lateral Flow Assay Images Using Novel Textural Features and Hybrid-AI Models"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8338-2726","authenticated-orcid":false,"given":"Towfeeq","family":"Fairooz","sequence":"first","affiliation":[{"name":"School of Engineering, Ulster University, Belfast BT15 1ED, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1711-2714","authenticated-orcid":false,"given":"Sara E.","family":"McNamee","sequence":"additional","affiliation":[{"name":"School of Engineering, Ulster University, Belfast BT15 1ED, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2628-6070","authenticated-orcid":false,"given":"Dewar","family":"Finlay","sequence":"additional","affiliation":[{"name":"School of Engineering, Ulster University, Belfast BT15 1ED, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1465-0592","authenticated-orcid":false,"given":"Kok Yew","family":"Ng","sequence":"additional","affiliation":[{"name":"School of Engineering, Ulster University, Belfast BT15 1ED, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6026-8971","authenticated-orcid":false,"given":"James","family":"McLaughlin","sequence":"additional","affiliation":[{"name":"School of Engineering, Ulster University, Belfast BT15 1ED, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"Global burden of cardiovascular diseases and risk factors, 1990\u20132019: Update from the GBD 2019 study","volume":"76","author":"Roth","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1161\/CIRCULATIONAHA.106.678326","article-title":"Thyroid disease and the heart","volume":"116","author":"Klein","year":"2007","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1001\/jama.2010.1361","article-title":"Subclinical Hypothyroidism and the Risk of Coronary Heart Disease and Mortality","volume":"304","author":"Rodondi","year":"2010","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1038\/nm1051","article-title":"3-Iodothyronamine is an endogenous and rapid-acting derivative of thyroid hormone","volume":"10","author":"Scanlan","year":"2004","journal-title":"Nat. Med."},{"key":"ref_5","first-page":"3040","article-title":"Comparison of measurement of serum TSH by two 3rd generation techniques","volume":"3","author":"Kaur","year":"2014","journal-title":"Int. J. Bioassays"},{"key":"ref_6","unstructured":"(2023, July 06). Thyroid-Stimulating Hormone (TSH) Levels. Available online: https:\/\/my.clevelandclinic.org\/health\/articles\/23524-thyroid-stimulating-hormone-tsh-levels."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.arteri.2014.07.003","article-title":"Effects of thyroid hormones on the heart","volume":"26","year":"2014","journal-title":"Cl\u00edNica Investig. Arterioscler."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1344","DOI":"10.1210\/jc.2010-2693","article-title":"The Thyroid Epidemiology, Audit, and Research Study (TEARS): Morbidity in patients with endogenous subclinical hyperthyroidism","volume":"96","author":"Vadiveloo","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1089\/thy.2007.0411","article-title":"Metabolic effects of thyroid hormones\u2013beyond traditional prospects","volume":"18","author":"Bianco","year":"2008","journal-title":"Thyroid"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1089\/ct.2015;27.174-176","article-title":"Subclinical hyperthyroidism is associated with increased risks of hip fractures, fractures at any site, nonspine fractures, and clinical spine fractures in the largest meta-analysis to date","volume":"27","author":"Leung","year":"2015","journal-title":"Clin. Thyroidol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1161\/CIRCULATIONAHA.112.096024","article-title":"Subclinical thyroid dysfunction and the risk of heart failure events: An individual participant data analysis from 6 prospective cohorts","volume":"126","author":"Gencer","year":"2012","journal-title":"Circulation"},{"key":"ref_12","unstructured":"British Thyroid Foundation (2023, January 20). Thyroid Function Tests. Available online: https:\/\/www.btf-thyroid.org\/thyroid-function-tests."},{"key":"ref_13","first-page":"155","article-title":"Existing and Emerging Technologies for Point-of-Care Testing","volume":"35","author":"Price","year":"2014","journal-title":"Clin. Biochem. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1038\/nature05448","article-title":"Requirements for high impact diagnostics in the developing world","volume":"444","author":"Urdea","year":"2006","journal-title":"Nature"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Habiyambere, V., Nguimfack, B.D., Vojnov, L., Ford, N., Stover, J., Hasek, L., Maggiore, P., Low-Beer, D., Gonz\u00e1lez, M.P., and Edgil, D. (2018). Forecasting the global demand for HIV monitoring and diagnostic tests: A 2016\u20132021 analysis. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0201341"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1146\/annurev.bioeng.10.061807.160524","article-title":"Point-of-Care Diagnostics for Global Health","volume":"10","author":"Yager","year":"2008","journal-title":"Annu. Rev. Biomed. Eng."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Hsieh, H.V., Dantzler, J.L., and Weigl, B.H. (2017). Analytical Tools to Improve Optimization Procedures for Lateral Flow Assays. Diagnostics, 7.","DOI":"10.3390\/diagnostics7020029"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Choi, J.R., Yong, K.W., Choi, J.Y., and Cowie, A.C. (2019). Emerging point-of-care technologies for food safety analysis. Sensors, 19.","DOI":"10.3390\/s19040817"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.bios.2014.07.049","article-title":"\u2018Traffic light\u2019 immunochromatographic test based on multicolor quantum dots for the simultaneous detection of several antibiotics in milk","volume":"63","author":"Taranova","year":"2015","journal-title":"Biosens. Bioelectron."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.bios.2016.12.036","article-title":"Simultaneous quantitation of cytokeratin-19 fragment and carcinoembryonic antigen in human serum via quantum dot-doped nanoparticles","volume":"91","author":"Chen","year":"2017","journal-title":"Biosens. Bioelectron."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1163","DOI":"10.1021\/acs.analchem.6b03536","article-title":"Simultaneous Detection of Dual Nucleic Acids Using a SERS-Based Lateral Flow Assay Biosensor","volume":"89","author":"Wang","year":"2017","journal-title":"Anal. Chem."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.1021\/acs.analchem.8b05154","article-title":"Colorimetric-Fluorescent-Magnetic Nanosphere-Based Multimodal Assay Platform for Salmonella Detection","volume":"91","author":"Hu","year":"2019","journal-title":"Anal. Chem."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3626","DOI":"10.1021\/acs.analchem.0c05354","article-title":"Multifunctional Nano-Sunflowers with Color-Magnetic-Raman Properties for Multimodal Lateral Flow Immunoassay","volume":"93","author":"Liu","year":"2021","journal-title":"Anal. Chem."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.1007\/s00216-006-0549-4","article-title":"A novel enhancement assay for immunochromatographic test strips using gold nanoparticles","volume":"385","author":"Tanaka","year":"2006","journal-title":"Anal. Bioanal. Chem."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1016\/0002-9343(56)90103-6","article-title":"The latex fixation test: I. Application to the serologic diagnosis of rheumatoid arthritis","volume":"21","author":"Singer","year":"1956","journal-title":"Am. J. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e384","DOI":"10.1093\/cid\/ciaa1178","article-title":"Usability and acceptability of home-based self-testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies for population surveillance","volume":"72","author":"Atchison","year":"2021","journal-title":"Clin. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1080\/15321819.2019.1671861","article-title":"Home pregnancy tests in the hands of the intended user","volume":"40","author":"Boxer","year":"2019","journal-title":"J. Immunoass. Immunochem."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.2105\/AJPH.72.9.1034","article-title":"Home pregnancy testing kits: Prevalence of use, false-negative rates, and compliance with instructions","volume":"72","author":"Valanis","year":"1982","journal-title":"Am. J. Public Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"7872","DOI":"10.1021\/acs.analchem.5b01594","article-title":"Paper-based RNA extraction, in situ isothermal amplification, and lateral flow detection for low-cost, rapid diagnosis of influenza A (H1N1) from clinical specimens","volume":"87","author":"Rodriguez","year":"2015","journal-title":"Anal. Chem."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Sheng, E., Lu, Y., Xiao, Y., Li, Z., Wang, H., and Dai, Z. (2021). Simultaneous and ultrasensitive detection of three pesticides using a surface-enhanced Raman scattering-based lateral flow assay test strip. Biosens. Bioelectron., 181.","DOI":"10.1016\/j.bios.2021.113149"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.bios.2016.06.061","article-title":"Lateral flow based immunobiosensors for detection of food contaminants","volume":"86","author":"Raeisossadati","year":"2016","journal-title":"Biosens. Bioelectron."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/S1473-3099(13)70250-0","article-title":"Diagnostic point-of-care tests in resource-limited settings","volume":"14","author":"Drain","year":"2014","journal-title":"Lancet Infect. Dis."},{"key":"ref_33","unstructured":"NHS-UK (2022, January 19). Colour Vision Deficiency (Colour Blindness). Available online: https:\/\/www.nhs.uk\/conditions\/colour-vision-deficiency\/."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"4352","DOI":"10.1039\/c3lc50672j","article-title":"Oligonucleotide-linked gold nanoparticle aggregates for enhanced sensitivity in lateral flow assays","volume":"13","author":"Hu","year":"2013","journal-title":"Lab Chip"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.bios.2015.12.005","article-title":"Sensitive biomolecule detection in lateral flow assay with a portable temperature-humidity control device","volume":"79","author":"Choi","year":"2016","journal-title":"Biosens. Bioelectron."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"4406","DOI":"10.1039\/C4LC00972J","article-title":"Improving sensitivity of gold nanoparticle-based lateral flow assays by using wax-printed pillars as delay barriers of microfluidics","volume":"14","author":"Rivas","year":"2014","journal-title":"Lab Chip"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Sumonphan, E., Auephanwiriyakul, S., and Theera-Umpon, N. (2008, January 5\u20138). Interpretation of nevirapine concentration from immunochromatographic strip test using support vector regression. Proceedings of the 2008 IEEE International Conference on Mechatronics and Automation, Takamatsu, Japan.","DOI":"10.1109\/ICMA.2008.4798830"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1016\/j.ijleo.2009.04.004","article-title":"Research of reflectance photometer based on optical absorption","volume":"121","author":"Huang","year":"2010","journal-title":"Optik"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Lei, H., Wang, K., Ji, X., and Cui, D. (2016). Contactless measurement of magnetic nanoparticles on lateral flow strips using tunneling magnetoresistance (TMR) sensors in differential configuration. Sensors, 16.","DOI":"10.3390\/s16122130"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.bios.2014.08.048","article-title":"A simple and compact smartphone accessory for quantitative chemiluminescence-based lateral flow immunoassay for salivary cortisol detection","volume":"64","author":"Zangheri","year":"2015","journal-title":"Biosens. Bioelectron."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2678","DOI":"10.1039\/c2lc40235a","article-title":"Integrated rapid-diagnostic-test reader platform on a cellphone","volume":"12","author":"Mudanyali","year":"2012","journal-title":"Lab Chip"},{"key":"ref_42","first-page":"1405","article-title":"CMOS image sensor for lateral flow immunoassay readers","volume":"65","author":"Pilavaki","year":"2018","journal-title":"IEEE Trans. Circuits Syst. II Express Briefs"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.trac.2015.10.017","article-title":"Lateral-flow technology: From visual to instrumental","volume":"79","author":"Mak","year":"2016","journal-title":"TrAC Trends Anal. Chem."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Fairooz, T., McNamee, S.E., Finlay, D., Ng, K.Y., and McLaughlin, J. (2023). A novel patches-selection method for the classification of point-of-care biosensing lateral flow assays with cardiac biomarkers. Biosens. Bioelectron., 223.","DOI":"10.1016\/j.bios.2022.115016"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1109\/TSMC.1973.4309314","article-title":"Textural Features for Image Classification","volume":"SMC-3","author":"Haralick","year":"1973","journal-title":"IEEE Trans. Syst. Man Cybern."},{"key":"ref_46","first-page":"177","article-title":"Detection and categorisation of multilevel high-sensitivity cardiovascular biomarkers from lateral flow immunoassay images via recurrent neural networks","volume":"2020","author":"Jing","year":"2020","journal-title":"Bioimaging"},{"key":"ref_47","unstructured":"(2023, December 19). Lumos Diagnostics. Available online: https:\/\/lumosdiagnostics.com\/products."},{"key":"ref_48","first-page":"1","article-title":"Image segmentation by using thresholding techniques for medical images","volume":"6","author":"Senthilkumaran","year":"2016","journal-title":"Comput. Sci. Eng. Int. J."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1016\/j.patrec.2004.09.035","article-title":"Thresholding technique with adaptive window selection for uneven lighting image","volume":"26","author":"Huang","year":"2005","journal-title":"Pattern Recognit. Lett."},{"key":"ref_50","unstructured":"Uppuluri, A. (2023, March 14). GLCM Features4 (MATLAB Central Exchange). Available online: https:\/\/www.mathworks.com\/matlabcentral\/fileexchange\/22354-glcm_features4-m-vectorized-version-of-glcm_features1-m-with-code-changes."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1142\/S0219720005001004","article-title":"Minimum redundancy feature selection from microarray gene expression data","volume":"3","author":"Ding","year":"2005","journal-title":"J. Bioinform. Comput. Biol."},{"key":"ref_52","unstructured":"Gholamy, A., Kreinovich, V., and Kosheleva, O. (2024, October 09). Why 70\/30 or 80\/20 Relation Between Training and Testing Sets: A Pedagogical Explanation. Technical Report: UTEP-CS-18-09, Available online: https:\/\/scholarworks.utep.edu\/cs_techrep\/1209\/."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"2434","DOI":"10.1039\/C7AN00741H","article-title":"Smartphone-based colorimetric detection: Via machine learning","volume":"142","author":"Mutlu","year":"2017","journal-title":"Analyst"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1109\/JTEHM.2021.3130494","article-title":"A Novel Method for Quantitative Analysis of C-Reactive Protein Lateral Flow Immunoassays Images via CMOS Sensor and Recurrent Neural Networks","volume":"9","author":"Jing","year":"2021","journal-title":"IEEE J. Transl. Eng. Health Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1967","DOI":"10.1016\/j.snb.2017.08.220","article-title":"Quantifying colorimetric tests using a smartphone app based on machine learning classifiers","volume":"255","author":"Solmaz","year":"2018","journal-title":"Sens. Actuators B. Chem."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"012008","DOI":"10.1088\/1742-6596\/978\/1\/012008","article-title":"Automated color classification of urine dipstick image in urine examination","volume":"978","author":"Rahmat","year":"2018","journal-title":"J. Phys. Conf. Ser."}],"container-title":["Biosensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6374\/14\/12\/611\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:54:31Z","timestamp":1760115271000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6374\/14\/12\/611"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,13]]},"references-count":56,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["bios14120611"],"URL":"https:\/\/doi.org\/10.3390\/bios14120611","relation":{},"ISSN":["2079-6374"],"issn-type":[{"value":"2079-6374","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,13]]}}}