Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 49 6 2020 06 08 1079 1086 Xiaoyue DONG Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China Xiaofan SUN Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China Zhangbin YU Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China Shuping HAN Women’s Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China 2019 11 04 2019 12 21 Background: Newborn infants who are risk for severe hyperbilirubinemia and cared at home should be monitored for progression of jaundice. We aimed to verify if a smart phone application (BiliScan Inc), which uses automated imaging for bilirubin (AIB), can be used to estimate total serum bilirubin (TSB) levels at home. Methods: A convenience sample of 1038 “healthy” infants in China were prospectively enrolled to a single-center study in 2016. Correlations between AIB and TcB measurements were correlated to TB measurements. Bias and imprecision of AIB measurements were determined using Bland-Altman analysis. The diagnostic value of AIB was compared by the area-under-curve (AUC) values of receiver operator characteristic (ROC) curves. Results: The best correlation and AUC for AIB were at the sternum, both with values of 0.76. We truncated performances to 369 TB values >5 and <15 mg/dL, and sternal AIB showed the best correlation to TB (r =0.5, P<0.0001). The AUC for this range was 0.54. However, from a subset of 200 AIB values >13.5 mg/dL (n=369 babies), the sensitivity and negative predictive value (NPV) were 100% with a specificity of 50%. Furthermore, Bland-Altman analyses showed a bias and imprecision of AIB and TcB when TB was >13.5 and <15 mg/dL. Conclusion: The use of AIB may be a potentially useful screening device for neonatal jaundice. Its performance requires additional improvements for accurate measurements across wider ranges of TB levels. https://ijph.tums.ac.ir/index.php/ijph/article/view/18849 https://ijph.tums.ac.ir/index.php/ijph/article/download/18849/6820