Measuring TSB with an app may be next

Smartphone applications to estimate bilirubin levels correlate reasonably well with serum bilirubin levels, according to a meta-analysis of 14 studies that examined the efficacy of the apps, using Android or iOS-based phones.

The studies, conducted in various countries, were in a total of 2256 infants, with the number of infants in individual studies ranging from 35 to 530.

Once installed in the smartphone, the apps work by obtaining images from specific body parts with a color calibration card placed on the skin.

The skin images then undergo sophisticated image processing techniques and are compared with a large database of color and bilirubin pairs.

Comparisons of total serum bilirubin (TSB) and app-based bilirubin (ABB) levels found that sensitivities of the app for predicting a TSB of 250 µmol/L (14.6 mg/dL) ranged from 75% to 100%, and specificities ranged from 61% to 100%.

Similarly, for predicting a TSB of 205 µmol/L (12 mg/dL), sensitivity ranged from 83% to 100% and specificity from 61% to 100%.

Investigators noted that although using ABB measurement as a screening tool is noninvasive and easy to learn, among other advantages, it does call for installation of a specific app and requires a certain level of technology literacy.

Thoughts from Dr. Farber

We are almost, but not quite, there. This app will save parents many trips to the doctor, especially when babies also are weighed at home. However, we will need to see how well this works with children of color (although one of the studies reported the app to be better here than with visual assessment).

Reference:

Hegde D, Rath C, Amarasekara S, Saraswati C, Patole S, Rao S. Performance of smartphone application to accurately quantify hyperbilirubinemia in neonates: a systematic review with meta-analysis. Eur J Pediatr. 2023;182(9):3957-3971. doi:10.1007/s00431-02305073-2