Smartphone App for Screening Jaundiced Neonates gives Promising Results for Point-of-Care Assessment

Service Engineering

Collaborative research carried out by experts from University College London and hospital practioners from a number of healthcare institutions and hospitals in Accra and Nkawkaw, Ghana, has worked to validate a sclera-scanning application for the screening of neonatal jaundice.

Although neonatal jaundice is a common finding and is a physiological phenomena that results simply from the adaptation to extra-uterine life, in some infants, neonatal jaundice is an indicator of serious underlying pathology, and if left untreated, can cause permanent neurological complications. This is particularly true in low-resource settings where screening tools may be limited. Globally, severe neonatal jaundice causes 114,000 deaths in newborns, and 178,000 disability-causing changes, despite the ease with which it can be screened for and managed in settings where resources are available.

“Smartphone App for Screening Jaundiced Neonates gives Promising Results for Point-of-Care Assessment“

336 infants were screened using the app, which utilises a smartphone camera to quantify the ‘yellowness’ or the sclera, a key clinical characteristic in jaundice. The aim is to improve sensitivity compared to the human eye, and find a diagnostic threshold that is much lower than the visibly yellow sclera, meaning interventions can be carried out sooner and improve health outcome in unwell babies.

"This app has the potential to prevent death and disability worldwide in many different settings. It will reduce unnecessary hospital visits and potentially empower community health workers and parents to care for newborn babies safely."

- Dr Judith Meek, Senior Author and Consultant Neonatologist at UCLH NHS Foundation Trust, London

Of the 336 infants assessed using the app, 79 were severely jaundiced according to more comprehensive blood tests for total serum bilirubinaemia typically carried out once neonatal hyperbilirubinaemia is suspected. When compared to traditional screening methodology carried out with the use of a transcutaneous bilirubinometer, a non-invasive device that measures the yellow pigmentation of the neonatal skin, which identified 76/79 unwell babies, while the NeoSCB, (Neonatal Scleral-Conjunctival Bilirubin) app identified 74/79. Infants who were considered positive on screening then were assessed using blood tests to inform management.

So why is a new device needed when effective, commercially available devices exist? The portable nature of smartphones makes them ideal for low-resource settings, and their cost is much lower than the devices currently used in clinical settings. Transcutaneous bilirubinometers cost approximately £4000 per device, while a smartphone costs less than 10% of this. Furthermore, the portable nature of the smartphone makes it useful in settings where home-births and more rural healthcare centres make it necessary to bring diagnostic and treatment materials to the patient, and reduce unnecessary and difficult hospital visits.

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