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 Early testing found that the application has greater accuracy than
visual exams performed by doctors, according to research presented
September 16 at the International Joint Conference on Pervasive and
Ubiquitous Computing (UbiComp 2014) in Seattle, Washington.
Dr. James Taylor, a pediatrician at the University of Seattle who is
helping to develop the technology, told Reuters Health by email that
when it’s ready for release, the BiliCam's performance might compare
to that of a much more expensive jaundice diagnostic device, the
transcutaneous bilirubinometer.
“We think that BiliCam will be useful by relieving anxiety of
parents about jaundice,” Dr. Taylor said. It will also provide an
inexpensive, reliable tool to help doctors determine when newborns
with jaundice need urgent treatment, he added.
His team believes the BiliCam will reduce healthcare costs by
earlier identification of babies who need treatment, when it’s
easier and cheaper to deliver it.
The BiliCam is named after bilirubin, a yellowish pigment produced
by the normal breakdown of red blood cells. Bilirubin passes through
the liver on its way out of the body. When levels of bilirubin in
the blood are high (a condition known as hyperbilirubinemia), it
might mean there’s a problem with the liver. When levels become
extremely high, patients develop jaundice, with yellowing of the
skin or the whites of the eyes.
The BiliCam could allow parents to monitor their newborns' health at
home simply by taking pictures of the baby with their phone camera’s
flash turned on. The parent or clinician first places a “color
calibrator,” a sheet the size of a business card printed with eight
blocks of different colors, on the baby's chest. The software
processes the images, adjusts color and white balance, accounts for
different lighting conditions and skin tones, and then gives a
report.
Tests with data from 100 newborns show that the BiliCam closely
matches the accuracy of blood tests for babies’ bilirubin levels,
which are currently the gold-standard method for diagnosing
jaundice.
The BiliCam’s accuracy was better than visual exams, the researchers
say. Past research shows that doctors using the visual method may
also tend to underestimate the degree of jaundice, which may be of
particular concern, the researchers say.
The BiliCam's performance may also put it in the same league as the
transcutaneous bilirubinometer, which correlates well with the blood
test, said Lilian de Greef, a doctoral student in computer science
and engineering at the University of Washington who is involved in
developing the technology.
An at-home test like the BiliCam may be important for parents, given
the high rate of jaundice in newborns.
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“Because the majority of all newborns have some level of jaundice,
or yellowing of the skin, and because jaundice doesn't tend to peak
until babies are at home with their families (out of the nursery) at
day of life 3 or 4, having access to this app will provide a chance
for families to access data without a trip to the clinic, hospital,
or birthing center," Dr. Wendy Sue Swanson said.
"This really puts the power of diagnostics into the patient and
family's hands and that's earnest opportunity for improved health
care driven by patients," said Swanson, a pediatrician and executive
director of Digital Health at Seattle Children's Hospital, who is
familiar with BiliCam but is not involved in developing the
application.
The BiliCam is not quite ready to roll out, however. The researchers
are tackling issues like how to display the results of the test and
how to tweak the color calibration card to make it more accurate and
user friendly.
“Currently, everything we developed was mostly to collect data and
process them for our evaluation. There's still lots of work to be
done on how to present everything for users like parents,” de Greef
said.
When they think it is ready, the researchers plan a phased release,
first to clinicians and then to parents.
“We think that parents will use BiliCam like they use thermometers
now. Instead of just knowing that their baby looks jaundiced they
will have an estimate of the bilirubin level that can be (reported)
to the baby’s healthcare provider,” Taylor said.
The BiliCam research was funded in part by Coulter Foundation and a
National Science Foundation Graduate Research Fellowship.
A full copy of the paper presented at the meeting is available from
the Association for Computing Machinery, at http://bit.ly/1shPIML.
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