Smartphone tool plus visual assessment increases jaundice detection in feasibility study of 542 newborns
This feasibility randomized controlled trial enrolled 542 newborns in a resource-limited healthcare setting in Mexico to assess the implementation of Picterus Jaundice Pro, a smartphone-based detection tool, for neonatal jaundice screening. The intervention arm received visual assessment plus the smartphone tool, while the comparator received visual assessment alone. The primary outcomes were feasibility measures including proportion of positive screenings, successful referrals, jaundice management needed, and jaundice management received.
The intervention arm showed higher proportions across all measured feasibility outcomes compared to visual assessment alone. For positive screenings, the proportional difference was 0.299 (95% CI 0.230 to 0.362). For successful referrals to the emergency room (bilirubin ≥14.6 mg/dL [250 μmol/L]), the proportional difference was 0.112 (95% CI 0.058 to 0.166). For jaundice management needed, the proportional difference was 0.045 (95% CI 0.008 to 0.082), and for jaundice management received, it was 0.038 (95% CI 0.003 to 0.072). Absolute numbers for these outcomes were not reported.
Safety and tolerability data were not reported. A key limitation was incomplete referrals occurring in 11% of cases due to logistical barriers and low perceived risk by parents. As a feasibility study, this research assessed implementation practicality rather than clinical efficacy. The findings suggest the smartphone tool may enhance detection and referral processes in this specific setting, but efficacy trials are needed to determine impact on clinical outcomes before considering broader implementation.
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