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Smartphone app a promising screening tool for jaundice in newborns

Jairia Dela Cruz
16 Nov 2017

A technology based on analysis of images taken using a smartphone provides acceptable estimates of total serum bilirubin (TSB) levels in newborn infants, with an accuracy that does not differ from that of transcutaneous bilirubin (TcB) measurement, according to a US study.

Named BiliCam, the smartphone app obtains images of the skin overlying the sternum. This process is initiated by placing a colour calibration card, which helps account for variations in lighting conditions, on the infant’s chest. The resulting image data are then sent to a computer server for analysis.

In the study, researchers compared the BiliCam-estimated bilirubin (BCB) levels with TSB values obtained from 530 neonates aged <7 days old (20.8 percent African American; 26.3 percent Hispanic; 21.2 percent Asian American) and found the correlation overall to be 0.91 (95 percent CI, 0.89 to 0.92). Across races, the correlation was highest in the group of white newborns (0.92) and lowest in the Asian American group (0.88). [Pediatrics 2017;doi:10.1542/peds.2017-0312]

The mean difference between BCB and TSB overall was 0.01 mg/dL. Of note, 91.9 percent of BCB values were within 3 mg/dL of the paired TSB level, while 73.0 percent were within 2 mg/dL.

BiliCam was able to identify newborns with significant hyperbilirubinemia, with 84.6 percent sensitivity and 75.1 percent specificity. The respective sensitivity and specificity for detecting newborns with a TSB level of ≥17.0 mg/dL were 100 and 76.4 percent.

“Our results suggest that BiliCam does not have adequate accuracy to serve as a standalone methodology to assess jaundice in newborns. Rather, as with TcB meters, BiliCam is best suited as a screening device to aid in determining which neonates require a blood draw for a TSB level, with treatment decisions being based on the TSB level,” researchers said.

TcB meters, while a viable option, are particularly expensive. This cost limits their widespread use in outpatient settings, researchers noted.

In comparison, BiliCam requires no extra equipment other than a smartphone and the colour calibration card. The smartphone app, as researchers pointed out, could be used by nurses and other healthcare professionals evaluating newborns both in office settings and during home visits.

Moreover, as a low-cost tool, the technology could facilitate screening for jaundice and effectively identify the few that are at significant risk for extreme hyperbilirubinemia in low- and middle-income countries with limited resources.

“In combination with low-cost phototherapy devices that have now been developed, BiliCam could … be part of a system of care that could significantly reduce the morbidity and mortality related to extreme hyperbilirubinemia in [the aforementioned] areas,” researchers said.

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Most Read Articles
Roshini Claire Anthony, 21 Apr 2016
Twenty-year survival is possible in almost 80 percent of children who had a liver transplant and were given cyclosporine as their primary immunosuppressive regimen, according to a study presented at the annual meeting of the European Association for the Study of the Liver (EASL) International Liver Congress™ (ILC) 2016 in Barcelona, Spain.
16 Jul 2017
Nonalcoholic fatty liver diseases (NAFLD) and serum concentrations of alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyltransferase (GGT) and alkaline phosphatase (ALP) are independent predictors of incident type 2 diabetes, a new prospective study shows.
Elvira Manzano, 22 Apr 2016
Patients infected with hepatitis C virus (HCV) who are in need of a transplant can safely receive a liver from an HCV-positive donor with a healthy liver biopsy, according to an analysis of outcomes spanning over 18 years.
03 Dec 2016
Serum osteoprotegrin levels may eventually be used as a reliable marker for bone loss and osteoporosis risk, at least in women with chronic kidney disease (CKD), a new study reports.