The smart phone study: assessing the reliability and accuracy of neonatal jaundice measurement using smart phone application

Srujana Swarna, Sekar Pasupathy, Balaji Chinnasami, Nirmala Manasa D., Balaji Ramraj


Background: Current gold standard for bilirubin estimation in newborns is invasive while transcutaneous bilirubinometer which is a noninvasive option is costly. Smart phone applications can be used as an alternative to measure bilirubin. We did the study to evaluate “Biliscan” medical application for screening of neonatal jaundice.

Methods: During the first seven days, neonates with suspected jaundice were taken blood samples for serum bilirubin. Within two hours photographs were taken using Biliscan app by placing a colour calibration card over the chest. Bilirubin estimate obtained after colour balancing, feature extraction and machine learning regression were compared with blood values.

Results: There is a good correlation (0.6) between Biliscan bilirubin estimation and serum bilirubin levels (p <0.0001) in the present study on 35 neonates. Biliscan thorax values correlated better than abdomen values (0.6 versus 0.551) with serum values. Hence chest is the preferred area for Biliscan measurement.

Conclusions: Biliscan app appears to be a good cheap option to screen for jaundice in newborns noninvasively.


Bilirubin, Biliscan, Hyperbilirubinemia, Neonates, Transcutaneous bilirubinometry

Full Text:



Gourley GR. Breast-feeding, neonatal jaundice and kernicterus. In Seminars in neonatology. WB Saunders; 2002;(7):135-41.

Bhutani VK, Stark AR, Lazzeroni LC, Poland R, Gourley GR, Kazmierczak S, et al. Pre-discharge screening for severe neonatal hyperbilirubinemia identifies infants who need phototherapy. J Paediatr. 2013;162:(3)477-82.

National Collaborating Centre for Women's and Children's Health (UK). Neonatal Jaundice. London: RCOG Press; 2010 May. (NICE Clinical Guidelines, No. 98.) Available at

Biliscan. Biliscan: detect jaundice by phone. Available at

de Greef L, Goel M, Seo MJ, Larson EC, Stout JW, Taylor JA, et al. Bilicam: using mobile phones to monitor newborn jaundice. In: Proceedings of the 2014 ACM International Joint Conference on Pervasive and Ubiquitous Computing. 2014;331-342.

Alpay F, Sarici U, Tosuncuk H, Serdar MA, Inanc N, Gokcay E. The value of first-day bilirubin measurement in predicting the development of significant hyperbilirubinemia in healthy term newborns. Pediatr. 2000;106:16.

Lilien LD, Harris VJ, Ramamurthy RS, Pildes RS. Neonatal osteomyelitis of the calcaneus: complication of heel puncture. J Pediatr. 1976;88(3):478-80.

Maisels MJ. Transcutaneous bilirubinometry. Neo Rev. 2006;7:e217-25.

Mahajan G, Kaushal RK, Sankhyan N, Sharma RL, Nakra M. Transcutaneous bilirubinometer in assessment of neonatal jaundice in northern India. Indian Pediatr. 2005;42(1):41-5.

Poh MZ, Kim K, Goessling AD, Swenson NC, Picard RW. Heartphones: sensor earphones and mobile application for non-obtrusive health monitoring. International Symposium on Wearable Computers; 2009:153-154.

Franko OI, Bray C, Newton PO. Validation of a scoliometer smartphone app to assess scoliosis. J Pediatric Orthopedics. 2012;32(8):e72-5.

Larson E, Goel M, Boriello G, Heltshe S, Rosenfeld M, Patel S. Spiro smart: using a microphone to measure lung function on a mobile phone. ACM UbiComp: 2012:280-9.

Larson EC, Lee T, Liu S, Rosenfeld M, Patel SN. Accurate and privacy preserving cough sensing using a low-cost microphone. 13th International Conference on Ubiquitous Computing (UbiComp), ACM Press. 2011:375.

Chen N, Wang KC, Chu HH. Listen-to-nose: a low-cost system to record nasal symptoms in daily life. 14th ACM International Conference on Ubiquitous Computing (UbiComp); 2012:590-1.

Lee J, Reyes BA, McManus DD, Mathias O, Chon KH. Atrial fibrillation detection using a smart phone. Annual International Conference of the IEEE Engineering in Medicine and Biology Society; 2012:1177-80.

Pamplona VF, Mohan A, Oliveira MM, Raskar R. NETRA: Interactive display for estimating refractive errors and focal range. ACM Transactions on Graphics (SIGGRAPH), 2010;29(4):77.

Taylor JA, Stout JW, de Greef L, Goel M, Patel S, Chung EK, et al. Use of a smartphone app to assess neonatal jaundice. Pediatr. 2017:e20170312.

Rong ZH, Luo F, Ma LY, Chen L, Wu L, Liu W, et al. Evaluation of an automatic image-based screening technique for neonatal hyperbilirubinemia. Zhonghua er ke za zhi Chinese J Pediatr. 2016;54(8):597-600.

Aydın M, Hardalaç F, Ural B, Karap S. Neonatal jaundice detection system. J Med Sys. 2016;40(7):166.

Riskin A, Tamir A, Kugelman A, Hemo M, Bader D. Is visual assessment of jaundice reliable as a screening tool to detect significant neonatal hyperbilirubinemia?. J Pediatr. 2008;152(6):782-7.