Smart sclera screening of jaundiced newborns in Ghana

We have developed a smartphone app, known as the Sclera-Conjunctival Bilirubin (SCB) app, to screen newborns for hyperbilirubinemia, which is a significant avoidable cause of death and disability affecting 18% of newborns worldwide. By capturing images of the eye and quantifying the yellowness of the sclera, the SCB app can determine if a newborn is at risk of hyperbilirubinemia. We have tested our technique against an established, non-invasive commercial medical device (transcutaneous bilirubinometer: Drager JM105 at ~US$5000) in 78 newborns in Greater Accra Regional Hospital. At less than a tenth of the cost of its commercial counterpart, the smartphone is a much cheaper option and the SCB app has comparable accuracy in detecting newborns with total serum bilirubin > 15 mg/dL, i.e., the SCB app: sensitivity/specificity = 94%/40%  and JM105: sensitivity/specificity = 89%/55%. Based on visual inspection, healthcare workers identified "yellow" newborns with sensitivity/specificity = 94%/20%. In comparison to healthcare workers, the neoSCB app can therefore potentially save 20% of newborns from unnecessary hospital referrals.