A Novel Image-Based Algorithm to Support Future Remote Assessment of Chewing Function

Background: Chewing difficulty is associated with poorer physical and mental health. Objective measurement of chewing function is currently limited to methods that require specialist lab equipment (for example lab-based manipulation or comminution tests). A remote method for estimating chewing-related metrics would support the development of accessible and scalable means of detecting and monitoring chewing-related health issues. Method: This paper details initial work on developing a novel smartphone-based, image-analysis algorithm to estimate particle-size metrics from photographs of masticated raw carrot deposited in a Petri dish. A two-stage image-processing pipeline was developed, comprising geometric calibration and particle segmentation, enabling estimation of particle-size metrics from smartphone photographs. The algorithm was implemented both as a Python script and as a graphical user interface (GUI), the latter allowing semi-automated per-image adjustment of calibration and segmentation parameters with visual feedback. The script and graphical user interface (GUI) are publicly available: osf.io/kgx9f Results: Performance was evaluated on artificially generated test images to benchmark the algorithm against ground-truth data with known sizes, while also assessing data-collection processes, usability and key challenges. On the more realistic synthetic-particle images, which include overlapping particles of varying size, the algorithm produced a cumulative area error of 20.6% and a mean per-particle relative error of 21.1% (median 14.8%; mean absolute error 1.02 mm²), with the largest errors occurring for the smallest and most overlapped particles. These synthetic-particle figures reflect performance on successfully matched particles; end-to-end performance including undetected particles would be lower. On simpler geometric-shape images, total-area relative error was lower, at 3.10% for the large-shape set, 3.00% for the small-shape set, and 3.12% across all shapes. Conclusion: The algorithm demonstrates quantifiable analytical performance in estimating chewing-related particle-size metrics from smartphone images, supporting its potential use as a foundation for future remote measurement of chewing function. However, the method is not yet clinically validated. In its current form, the method achieves its best performance through a semi-automated, GUI-based workflow, which introduces a subjective element but provides a practical way to handle heterogeneous image conditions and inform future automation.