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

Demystifying non-invasive approaches for screening jaundice in low resource settings: a review

All national and international pediatric guidelines universally prescribe meticulous bilirubin screening for neonates as a critical measure to mitigate the incidence of acute bilirubin encephalopathy (ABE) and Kernicterus. The prevailing gold standard for jaundice detection in neonates necessitates invasive blood collection, followed by subsequent biochemical testing. While the invasive procedure provides dependable bilirubin measurements and continues to be the sole gold standard diagnostic method for assessing bilirubin concentration. There exists a pressing need to innovate non-invasive screening tools that alleviate the sampling stress endured by newborns, mitigate iatrogenic anemia, and expedite the turnaround time for obtaining results. The exploration of non-invasive modalities for bilirubin measurements is gaining momentum, driven by the overarching goal of minimizing the number of pricks inflicted upon neonates, thereby rendering screening a swift, efficient, comfortable, and dependable process. This comprehensive review article delves extensively into the array of non-invasive approaches and digital solutions that have been proposed, implemented, and utilized for neonatal bilirubin screening, with a particular emphasis on their application in low-resource settings. Within this context, the review sheds light on the existing methodologies and their practical applications, with a specific focus on transcutaneous bilirubin meters. Moreover, it underscores the prevailing open challenges in this domain and outlines potential directions for future research endeavors. Notably, the review underscores the imperative need for robust educational programs targeted at both families and healthcare personnel to expedite the process of seeking timely care for neonatal jaundice. Additionally, it underscores the necessity for the development of enhanced screening and diagnostic tools that can offer greater accuracy in clinical practice.

Non-invasive detection of total bilirubin based on multi-wavelength PPG signal

BACKGROUND AND OBJECTIVE

Abnormal bilirubin metabolism can result in various liver function disorders. Current clinical practice for bilirubin level detection involves invasive blood collection from patients, which is time-consuming, painful, and poses infection risks. Thus, there is a pressing need for non-invasive bilirubin detection methods. This study aims to develop a non-invasive total serum bilirubin(TSB) detection method in humans based on multi-wavelength photoplethysmography (PPG) signals.

METHODS

The experimental instrument includes a light source and a spectrometer. PPG signals are collected from the subjects' fingers, and the samples are selected based on the PPG deviation degree screening method. The absorption spectrum of blood is extracted from the PPG signal using dynamic spectroscopy. Finally, locally developed software calculates the total bilirubin value. The instrument is modeled and validated according to the clinical-biochemical test values.

RESULTS

The results of the prediction set (correlation coefficient is 0.91, RSMEP is 2.32 umol/L, average absolute error percentage is 9.3%) show that our method has a strong correlation with the detection results of clinical-biochemical analysis instruments. The Bland-Altman test showed that the device deviated from the data detected by biochemical methods in the clinic with a mean deviation of about 0.12 umol/L and a 95% confidence interval between -2.95 umol/L and 2.7 umol/L.

CONCLUSIONS

This study's non-invasive bilirubin detection method has high accuracy, which can meet the needs of continuous non-invasive total bilirubin detection in clinical practice.