Diagnosing Diseases by Measurement of Electrical Skin Resistance:
A Novel Technique
E. Zimlichman1, A. Kanevsky2, Y. Shoenfeld1
1
Internal Medicine B, Sheba Medical Center, Tel Hashomer, and Tel Aviv University, Israel
2
Medex Screen Ltd, Omer, Israel
Abstract—Diagnostic screening tools based on neuroreflex-
ology have been recently developed. Such techniques are based
on the rationale that measurement of electrical skin resistance
of specific dermal zones reflects pathology in the correspond-
ing internal organs. We have approached this disputable field
with the aim of putting evidence-based medicine techniques
into use in order to evaluate the reliability of this method. Our
first report on such a device (Medex Screen, Omer, Israel)
described the results obtained by blind assessment of patients
in an Internal Medicine department suffering from a hetero-
geneous group of diseases. In 150 patients a good correlation
was found between the clinical diagnosis and the results of the
measurement of skin resistance with a high sensitivity (>70%)
measured for cardiovascular, respiratory, gastrointestinal and
genitourinary diseases. The technique was also found to diag-
nose immunological diseases (autoimmune and allergic disor-
ders) in 108 patients. Another study demonstrated the ability
of the Medex-Test device to detect with high accuracy the
presence of liver disorders and to determine the necro-
inflammatory grade. A fourth study performed on 125 cancer
patients compared Medex-Test with the conventional diagnosis
and found a high sensitivity (>75%) and a high specificity of
(>90%) for lung, breast and prostate cancer. We conclude that
although the exact mechanism is not entirely clear, measuring
electrical skin resistance of dermal zones has the potential to
serve as a diagnostic tool for inner organ pathologies.
Keywords—Electrical resistance, screening, diagnostic tool,
neuroreflexology.
I. INTRODUCTION
The value of routine health examination of asymptomatic
persons has been well established, with the rationale that
early diagnosis and treatment of illness will lead to im-
proved prognosis [1,2]. The identification of proper tests for
preventive medicine is a matter of extensive research based
on a systematic review of evidence of clinical effectiveness
[3].
Recently, a novel diagnostic procedure has been intro-
duced based on the analysis of the data obtained by measur-
ing the skin electrical resistance of pre-determined dermal-
visceral zones (DVZs) on the human body [4-7]. The ra-
tionale behind the system is that internal organs display
corresponding representative zones on the trunk and on the
Hermann Scharfetter, Robert Merva (Eds.): ICEBI 2007, IFMBE Proceedings 17, pp. 172–176, 2007
www.springerlink.com © Springer-Verlag Berlin Heidelberg 2007
limbs, whose physical parameters are related with the pres-
ence of pathological processes. Thus, pathological condition
affecting an internal organ might induce electrophysiologi-
cal changes in the corresponding DVZs.
This method, sponsored by various commercial compa-
nies, is currently used by medical organizations primarily as
a screening test for internal organ pathologies. However, it
is considered as “alternative” medicine, and is yet to be the
subject of scientific research. As medical researchers, we
have approached this disputable field with both skepticism
and concern, but with the aim of putting conventional evi-
dence-based medicine techniques into use in order to evalu-
ate the reliability of this method as a medical tool. During
the last 5 years we have conducted several studies compar-
ing this novel device diagnostic ability with conventional
diagnostic tools. We review here our experience with this
screening test, specifically the Medex device (Medex
Screen Ltd.), for diagnosing internal organ pathologies.
However, we wish to point out that at his stage we have set
our goal only to evaluate this tools diagnostic accuracy,
while not exploring the physiological mechanism beyond
this disputable technique.
II. METHODS
We evaluated a device manufactured by Medex Screen
Ltd. (Omer, Israel). The major components of the device
consists of a special skin resistance measurement device
used to take various measurements of the DVZs on the
human body (expressed as KOhm), which are then proc-
essed by the device software [8]. Once the data is processed,
the Medex device can determine if pathological states are
present in the examined internal organs.
All studies described here were blind, retrospective and
comparative studies. Patients were subjected to a medical
examination by authorized physicians before the Medex
Test was performed. A pre-study case report form for all
subjects was recorded with medical information including
main current disease, co-morbidity illness, current medica-
tions and relevant past medical history.
Technicians performed the Medex Test measurement.
Before testing, the DVZs are cleaned with 70% ethyl alco-
Diagnosing Diseases by Measurement of Electrical Skin Resistance: A Novel Technique 173

ventional diagnosis methods. The statistical analysis esti-

mated agreement between the Medex Test diagnosis and the
results of the conventional diagnostic examinations. A stan-
dard measure of agreement (Cohen-Kappa) between two
binary variables was estimated. In addition, sensitivity and
specificity for the Medex Test diagnosis were calculated
using the conventional diagnosis as the gold standard. P
value for the Cohen-Kappa test <0.01 was considered sig-
nificant.

III. RESULTS
A. Internal Medicine trial
In our first study performed the study population in-
Fig. 1 Several of the 24 Dermal -Visceral Zones cluded 150 patients who were admitted to an internal medi-
cine department for various health problems [4]. Patient's
diagnosis was established according to patient's medical
hol solution to avoid possible effects of sebum or humidity
charts and conventional diagnostic tests that were per-
on the skin. Measurements were carried out by using skin
formed in the department. This was compared, as explained
electrode on 24 pre-determined zones on the hands and feet
above, to the diagnosis established by the Medex test ex-
(Fig. 1). Skin measurement points were established ac-
amination conducted by a second researcher. Table 1 sum-
cording to neuro- reflexology areas on the
marizes the sensitivity, specificity, Cohen-Kappa measure
wrists, arms, ankles and foot. Each measurement was re-
of agreement and P value for each defined category. Corre-
peated twice. First, a baseline measurement was performed;
lation was significant for all categories (P < 0.01) except for
the recorded values were considered to be normative values
blood and lymphatic disease. A high sensitivity (>70%) was
for the individual. Then, trans-cutaneous electrical stimula-
measured for cardiovascular, respiratory, gastrointestinal
tion of other specific skin areas was performed. A second
and genitourinary diseases, with the highest sensitivity
measurement was performed, and any differences were
measured for cardiovascular disease (85.3%). The highest
recorded and analyzed in comparison to the first set of val-
measure of agreement, as represented by the Cohen-Kappa
ues. The measurements were performed with an electrical
factor, was measured for respiratory disease (0.57).
direct current of 20 μA (voltage of 5V). This very low elec-
tric current, is safe and does not display any damage to the
skin during the short time of testing. A software program B. Liver disease
processes the collected information with the help of previ-
The objectives of this study were to determine the effec-
ously built correlative algorithm, and produces an output of
tiveness of this diagnostic test, in diagnosing liver disease
suggested diagnosis.
caused by Hepatitis B, C and non alcoholic fatty liver dis-
The Medex Test Technicians were unaware of the pa-
ease (NAFLD), as well as to determine the degree of liver
tient’s diagnoses. The results of Medex Test assessment
disease progression [5]. A total of 113 patients with liver
have been compared to data from the conventionally ac-
disease and 85 healthy volunteers were evaluated during the
cepted tests and the patients’ charts, in order to determine
study. The most common diagnosis was HCV infection with
the accuracy of the Medex Test device. Software analysis
91 patients, followed by NAFLD with 12 patients and 10
was done at the Medex Screen Company’s headquarters by
with HBV infection. The "Medex Test" detected, with high
a second investigator that was blinded to the medical charts
sensitivity and specificity, the presence of liver disease. The
and physical examination details. The diagnosis determined
sensitivity of the method was 85% and the specificity 94.1%
by the Medex software was printed as a written report. A
(Table 2). There was a statistically significant agreement
third investigator, also blinded to the actual process con-
between the results of the "Medex Test" and the clinical
ducted previously, compared the actual “conventional”
diagnosis K=0.777, p<0.001.High sensitivity was main-
diagnosis and the Medex device output.
tained for different liver diseases and regardless of patients’
Statistical analysis was conducted using the SPSS for
age and sex.
Windows 10.0 program. The Medex Test diagnosis was
statistically compared to the results obtained from the con-

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174 E. Zimlichman, A. Kanevsky, Y. Shoenfeld

Table 1 Sensitivity and specificity of the Medex test method to predict D. Oncological disease
diagnosis, compared to conventional gold standard methods. P value
is given for the Cohen-Kappa test. As cancers are a major health burden and a classic disor-
der in which prompt diagnosis is crucial for definitive cure,
Sensitivity Specificity P we set out to validate the new Medex Screen diagnostic
Diagnosis
(%) (%) value technique in cancer patients in a day hospital setting [7].
Central nervous 18.5 98.3 <0.01 Overall, 125 participants were included in the study. Of
system
Blood/Lymph 6.9 99.1 0.04
these, 28 were patients with prostate cancer, 22 were pa-
Cardiovascular 85.3 52.3 <0.01 tients with lung cancer, 45 were patients with breast cancer
Respiratory 80.6 82.7 <0.01 and 30 were patients with various other neoplastic disorders
Gastrointestinal 81.1 45.0 <0.01 (cervix, endometrial, colon, renal, larynx, pancreas, semi-
Musculoskeletal 48.0 88.4 <0.01
Endocrine 51.0 81.4 <0.01
noma, gastric, urinary bladder and meningioma). Each of
Drug/Alcohol abuse 9.5 99.2 <0.01 the participating patients had only one neoplastic disease.
Genitourinary 72.4 69.7 <0.01 When comparing Medex Screen diagnostic technique with
the conventional method diagnostic technique for the vari-
In the second part of the study, 60 treatment naïve ous neoplastic disorders we found a sensitivity of 76.2%,
chronic HCV patients with a current biopsy underwent a 78.7% and 92.9% and a specificity of 95.0%, 90.7% and
"Medex Test". The "Medex Test" was conducted in average 90.4% for lung, breast and prostate cancer respectively
6.3 months after the biopsy. The necro-inflammatory grade (Table 2). A high measure of agreement was found, as rep-
in the biopsies was on average 2.05 with a median of 2. The resented by a Cohen-Kappa value of 0.67 (p<0.01).
Medex grading of necro-inflammation matched the patho-
logical score in 47 cases (78%). Statistical analysis demon- Table 2 Summary of results of the various studies comparing the
strated that agreement, presented by Kappa, is significant Medex Test method diagnosis to conventional gold standard methods. . P
value
with a Kappa value of K=0.704, p<0.001.
Study Study Disease Sensitivity Specificity P
size (%) (%) value
C. Immune system diseases Zimlichman 150 See Table 1
E. et al.
A third study set out to explore the effi- Lurie Y. et 198 Hepatitis B, 85 94.1 <0.01
cacy of this diagnostic/screening tool spe- al. C, NAFLD
cifically for immune-mediated diseases [6]. Gerosa M. 108 Autoimmune 91.5 58.8 <0.01
et al
Overall, 108 participants were included in Allergy 69.2 42.1 NS
the study. Of these, 38 were patients with Weitzen R. 125 Breast can- 78.7 90.7 <0.01
systemic autoimmune diseases (SAD) (such et al. cer
as systemic lupus erythematosus, Prostate 92.9 90.4 <0.01
cancer
scleroderma, rheumatoid arthritis and pri- Lung cancer 76.2 94.1 <0.01
mary Sjogren syndrome), 40 were patients is given for the Cohen-Kappa test. NAFLD – non alcoholic
with an allergic disorder and 30 participants served as age fatty liver disease.
and sex matched controls. Medex Screen diagnostic tech-
nique displays a very good specificity (93.3%) as well as a
good sensitivity (81.2%) in recognizing pathological disor- IV. DISCUSSION
ders of the immune system (SAD and allergy). The overall
Cohen-Kappa value is 0.65. When analyzing both groups A relatively new application based on measuring electri-
separately, specificity drops in the SAD group (58.8%) and cal properties of dermal zones representing internal organs
sensitivity rises (91.5%) with a smaller Kappa value (0.47), has recently been developed by commercial companies with
while in the allergy disorder group both specificity and aim of diagnosing internal organs pathologies, even at early
sensitivity drop (42.1% and 69.2% respectively) with a non- stages of the disease. This application was the focus of
significant Kappa value of 0.09 (Table 2). These results several trials that have demonstrated its ability to diagnose
show that the technique described was able to better diag- common disorders such as respiratory, cardiovascular and
nose autoimmune disorders than allergic disorders. Fur- gastrointestinal pathologies in an internal medicine depart-
thermore, it was unable to differentiate between autoim- ment setting, autoimmune and allergy disorders, and spe-
mune and allergic disorders, diagnosing them as a single cifically liver disorders and specific oncological disorders
pathology. [4-7].

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Diagnosing Diseases by Measurement of Electrical Skin Resistance: A Novel Technique
Similar attempt to utilize the technique of skin electrical
resistance measurement to diagnose organ pathologies was
described earlier by Szopinski et al [9, 10]. In a double-
blind comparative study the researchers conclude that elec-
trical resistance of skin projection areas corresponding to
diseased organs is increased, relative to that of healthy or-
gan-related skin zones. Overall, sensitivity was 91.8% and
specificity equalled 89.9% in 70 patients with oesophagus,
stomach, duodenum, biliary tract, pancreas, colon, kidneys
and urinary tract pathologies. The difference in resistance
was also found to be proportional to the intensity of the
pathological process.
We found the overall accuracy of the Medex device to
identify pathologies to be surprisingly high. An ideal diag-
nostic test for screening would first and foremost have to be
highly sensitive, so that it will diagnose all diseased per-
sons. Secondly, for the test to be reliable and cost-effective,
it would have to be highly specific, so that persons without
the disease would be negative on this diagnostic test. Con-
sidering these assumptions, many of the diagnostic tests in
use for screening today seem to be far from ideal. Thus, one
of the most widely used screening tests for colorectal can-
cer, the fecal occult blood test (rehydrated), was found to
have a sensitivity of only 50% with a specificity of 94%,
when compared to the gold standard of colonoscopy [11].
Another widely used screening test is the PAP smear for
cervical cancer. A meta-analysis prepared for the U.S.
Agency for Health Care Policy and Research in 1999 esti-
mated the sensitivity of this commonly performed test to be
only 51% but with 98% specificity [12]. Finally, a diagnos-
tic test that has been the subject of much professional debate
with regard to its place in screening for prostate cancer,
prostatic specific antigen, was found to have a sensitivity
range of 18–46% and specificity of 91–98% [13]. When
compared to sensitivity and specificity of most screening
tests, the sensitivity and specificity of the Medex test can
lead to the conclusion that this test is suitable for use as a
diagnostic tool, and perhaps even a screening tool for im-
mune pathologies.
The major weakness of this technique, for us as scien-
tists, is the lack of understanding of its mechanism of action
in pathophysiological terms. Theories concerning neural
pathways that connect through reflex arch specific dermal
points/areas to internal organs have been postulated. Ac-
cording to these theories pathological process within organs
changes the impedance of electrical impulses that convey
from the organ, through the spinal cord, to corresponding
areas on the skin (i.e. visceral-cutaneus reflex). These
changes can be registered on special zones on the trunk and
limbs by simply measuring electrical resistance. This theory
still remains as a speculation with little clear scientific evi-
dence published [14-16].
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175
V. CONCLUSIONS
In summary, we have described here our experience with
a novel technique which is still relatively un-explored by
scientific methods. We feel that the results presented here
merit further research aimed at better understanding the
physiologic mechanism, and further evaluation of this tools
potential as an accepted evidence-based diagnostic and
screening test. However, we wish to point out that at this
point, this method cannot replace formal physical examina-
tion or other well-established diagnostic tests or devices.
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Email: zimliche@post.tau.ac.il

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