Development of a mobile phone camera-based transcutaneous bilirubinometer for low-resource settings

• Main Authors: Arefin, M.S (Author), Dobson, D. (Author), Dumont, A.P (Author), Farouk, Z.L (Author), Grossarth, S. (Author), Harrison-Smith, B. (Author), Lawal, N. (Author), Nwaba, A. (Author), Paed, A.M (Author), Patil, C.A (Author), Sun, Y. (Author), Weitkamp, J.-H (Author)
• Format: Article
• Language: English
• Published: Optica Publishing Group (formerly OSA) 2022
• Subjects: Article; bilirubin; bilirubin blood level; blood sampling; calibration; Camera-based; Cameras; Cellular telephones; clinical article; controlled study; country economic status; cross validation; detection algorithm; diagnostic value; Diffuse reflectance; diffuse reflectance spectroscopy; feature extraction; human; illumination; image processing; light intensity; light scattering; limit of agreement; linear regression analysis; Low income countries; Low-resource settings; Middle-income countries; mobile application; Mobile phone cameras; Monte Carlo method; newborn; newborn jaundice; Phone-based; Pilot studies; pilot study; polyethylene; predictive value; process optimization; Reflection; root mean squared error; Spatially resolved; three-dimensional imaging; Transcutaneous
• Online Access: View Fulltext in Publisher

 Newborns in high-income countries are routinely screened for neonatal jaundice using transcutaneous bilirubinometery (TcB). In low-and middle-income countries, TcB is not widely used due to a lack of availability; however, mobile-phone approaches for TcB could help expand screening opportunities. We developed a mobile phone-based approach for TcB and validated the method with a 37 patient multi-ethnic pilot study. We include a custom-designed snap-on adapter that is used to create a spatially resolved diffuse reflectance detection configuration with the illumination provided by the mobile-phone LED flash. Monte-Carlo models of reflectance from neonatal skin were used to guide the design of an adapter for filtered red-green-blue (RGB) mobile-phone camera reflectance measurements. We extracted measures of reflectance from multiple optimized spatial-offset regions-of-interest (ROIs) and a linear model was developed and cross-validated. This resulted in a correlation between total serum bilirubin and mobile-phone TcB estimated bilirubin with a R2= 0.42 and Bland-Altman limits of agreement of +6.4 mg/dL to -7.0 mg/dL. These results indicate that a mobile phone with a modified adapter can be utilized to measure neonatal bilirubin values, thus creating a novel tool for neonatal jaundice screening in low-resource settings. © 2022 OSA - The Optical Society. All rights reserved.