Smartphone potential to monitor liver disease patients at home

Liver disease patients could soon be able to use their smartphones to help monitor symptoms, British researchers say.

A new study from UCL and the Royal Free Hospital, UK, found that the camera on a smartphone can detect changes in skin tone and eye colour accurately, which could help them to track their symptoms at home easily and in a more cost-effective way.

Published in PLOS Digital Health, the research is the first to assess and compare how smartphone images of the forehead, white of the eye and lower eyelid could be used to predict the bilirubin level of patients with advanced cirrhosis.

The research team developed a smartphone app to detect the severity of jaundice with a high degree of accuracy. They used a smartphone to take photographs of the forehead, white of the eye and lower eyelid of 66 cirrhosis patients and after calibrating the images for lighting conditions, used them to train an algorithm that could predict bilirubin level based on the degree of yellowness in the image.

When these predictions were checked against blood test data, which is the current way of testing bilirubin levels, they found the images of the white of the eye had the strongest correlation.

Study co-author Professor Raj Mookerjee, of UCL Medicine, said: “One of the reasons that liver disease is so challenging is that patients can deteriorate very quickly. It’s an unfortunate fact that if a patient arrives at the clinic much more jaundiced than they were previously, the chances are that they have already progressed their disease considerably.

“The approach that we’ve assessed in this study could allow us to monitor patients from their own homes much more frequently than is currently possible and, hopefully, detect worsening of clinical signs and symptoms before things become critical.”

One of the challenges the study sought to overcome is the degree of yellowness in patients with cirrhosis.

“You can look at a patient and tell if they have jaundice right away,” said Professor Mookerjee. “But it’s not a question of if the skin looks yellow or not, it’s about how much more yellow it looks, which gives you an indication of how badly the liver function has deteriorated.

“The smartphone app gives us this degree of accuracy. It’s a remarkable feat of engineering and shows the power of clinicians and engineers collaborating to solve urgent healthcare problems.”

The research team are now hoping to undertake a larger trial to validate the safety and accuracy of the approach.

Nixon-Hill M, Mookerjee RP, Leung TS. Assessment of bilirubin levels in patients with cirrhosis via forehead, sclera and lower eyelid smartphone images. PLOS Digital Health 6 October 2023



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