Neonatal jaundice screening with variable screening thresholds using a smartphone and a transcutaneous...

Area of Science:

• Neonatal Medicine
• Medical Technology
• Public Health

Background:

• Newborn jaundice, indicated by elevated total serum bilirubin (TSB), requires timely screening.
• Current NICE guidelines recommend a TSB threshold of >250 μmol/L for babies over 24 hours old.
• Screening accuracy in neonates younger than 24 hours, especially with lower thresholds, requires further investigation.

Purpose of the Study:

• To evaluate the neoSCB app's efficacy in screening neonatal jaundice at lower thresholds (<250 μmol/L).
• To compare the neoSCB app's performance against the Drager JM105 transcutaneous bilirubinometer in newborns under 24 hours.
• To assess the potential application of these devices for early jaundice screening.

Main Methods:

• Prospective study involving smartphone app (neoSCB) and transcutaneous bilirubinometer (Drager JM105) measurements.
• Comparison of device readings against confirmatory blood tests (TSB).
• Analysis of sensitivity and specificity at varying TSB screening thresholds (100-250 μmol/L).

Main Results:

• Both the neoSCB app and JM105 demonstrated sensitivities above 0.85 for TSB thresholds between 100 and 250 μmol/L.
• Specificities for both devices exceeded 0.70 within the same threshold range.
• These findings indicate comparable performance between the app and the established device.

Conclusions:

• The neoSCB app shows promise as a tool for screening neonatal jaundice in infants younger than 24 hours.
• The Drager JM105 also maintains acceptable accuracy at lower thresholds for this age group.
• Both methods could potentially aid in earlier detection and management of neonatal jaundice.