Title : The effects on accuracy of image-based estimating neonatal jaundice with a smartphone app in the different conditions
Objective: To study the effects on accuracy of automated image-based estimating neonatal bilirubin (AIB) with a smartphone APP in the different conditions. Method: The jaundiced neonates were enrolled from in-patient neonatal ward of The Affiliated Xuzhou Center Hospital of Nanjing University of Chinese Medicine during August 2017 to December 2017. When the blood biochemistry including total serum bilirubin (TSB) need to be tested, the transcutaneous bilirubin (TcB) and AIB on the sternum were meassured stimultaneously, and on the glabella and the visual most yellow area were meassured at the same time in some cases. The gender, gestational age, birth weight, the hours after birth and the detection period of time were recorded. The AIB were meassured by OPPO R11 smartphone, and by Huawei Mate 8 and iPhone 6 at the same time in some cases, with an APP of mobile monitoring neonatal jaundice (BiliScanTM). SPSS 20.0 software was used for date analysis. Date were compared by noninferiority trial, student’s t test, ANOVA, Pearson correlation analysis, Bland-Altman plots consistency analysis or receiver operator characteristic (ROC) curve. Result: A total of 247 sets of data were enrolled from 179 neonates in this study. The mean gestational age were (36.2±2.1) weeks, the mean birth weight were (2871±735) g. The mean difference of the absolute value of AIB-TSB and the absolute value of TcB-TSB was 0.77 mg/dl (10 mg/dl, >15 mg/dl, >20 mg/dl were 0.94, 0.89, 0.84, the sensitivity were 93%, 75%, 50%, the specificity were 85%, 87%, 88%, respectively. Conclusion: The accuracy of AIB was not inferior to the TcB, and significantly superior to visual value. There were good correlation and strong consistency between AIB and TSB. The different hours after birth, gestational age, smartphone and the detection area had little effects on the accuracy of AIB, the correlation and consistency between AIB and TSB. There were greater effects on AIB during the detection period of night. The better detection period of AIB was daytime with bright natural light.