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. 2017 Sep;140(3):e20170312.
doi: 10.1542/peds.2017-0312.

Use of a Smartphone App to Assess Neonatal Jaundice

James A Taylor  1 , James W Stout  2 , Lilian de Greef  2 , Mayank Goel  2   3 , Shwetak Patel  2 , Esther K Chung  4   5 , Aruna Koduri  6 , Shawn McMahon  7 , Jane Dickerson  8 , Elizabeth A Simpson  9 , Eric C Larson  10
Affiliations

Use of a Smartphone App to Assess Neonatal Jaundice

James A Taylor et al. Pediatrics. 2017 Sep.

Abstract

Background: The assessment of jaundice in outpatient neonates is problematic. Visual assessment is inaccurate, and more exact methodologies are cumbersome and/or expensive. Our goal in this study was to assess the accuracy of a technology based on the analysis of digital images of newborns obtained using a smartphone application called BiliCam.

Methods: Paired BiliCam images and total serum bilirubin (TSB) levels were obtained in a diverse sample of newborns (<7 days old) at 7 sites across the United States. By using specialized software, data on color values in the images ("features") were extracted. Machine learning and regression analysis techniques were used to identify features for inclusion in models to predict an estimated bilirubin level for each newborn. The correlation between estimated bilirubin levels and TSB levels was calculated. In addition, the sensitivity and specificity of the estimated bilirubin levels in identifying newborns with high TSB levels were calculated by using 2 recommended decision rules for jaundice screening.

Results: Estimated bilirubin levels were calculated and compared with TSB levels in a diverse sample of 530 newborns (20.8% African American, 26.3% Hispanic, and 21.2% Asian American). The overall correlation was 0.91, and correlations among white, African American, Hispanic, and Asian American newborns were 0.92, 0.90, 0.91, and 0.88, respectively. The sensitivities of BiliCam in identifying newborns with high TSB levels were 84.6% and 100%, respectively, by using 2 decision rules; specificities were 75.1% and 76.4%, respectively.

Conclusions: BiliCam provided accurate estimates of TSB values, demonstrating that an inexpensive technology that uses commodity smartphones could be used to effectively screen newborns for jaundice.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: Drs Taylor, Stout, and Patel are cofounders of BiliCam, LLC, a company developing the technology described in this study for commercial use; the other authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
The relationship between paired TSB and BCB values in 530 newborns. The linear regression line is shown, along with individual points.
FIGURE 2
FIGURE 2
A Bland-Altman plot of paired BCB and TSB values. The mean of TSB and BCB values (in mg/dL) is displayed along the x-axis, and the difference of BCB-TSB (mg/dL) is displayed on the y-axis. Horizontal lines denote the mean difference between BCB and TSB values and limits (95% confidence interval) of agreement.
See this image and copyright information in PMC

Comment in

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