Evidence map›Paper›PMID 36574965›Full record

ArticleJournal of gastroenterology and hepatology2023

A novel smartphone scleral-image based tool for assessing jaundice in decompensated cirrhosis patients.

Konstantin Kazankov, Miranda Nixon-Hill, Rahul Kumar, Ahmed Amin, Eman Alabsawy, Anmol Chikhlia, Terence S Leung, Rajeshwar P Mookerjee

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of gastroenterology and hepatology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.4field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 3 countries.

Konstantin KazankovLiver Failure Group, Institute for Liver and Digestive Health, UCL Medical School, Royal Free Hospital, London, UK.ORCID https://orcid.org/0000-0002-8111-213X
Miranda Nixon-HillDepartment of Medical Physics and Biomedical Engineering, University College London, London, UK.
Rahul KumarLiver Failure Group, Institute for Liver and Digestive Health, UCL Medical School, Royal Free Hospital, London, UK.ORCID https://orcid.org/0000-0002-5092-4821
Ahmed AminLiver Failure Group, Institute for Liver and Digestive Health, UCL Medical School, Royal Free Hospital, London, UK.
Eman AlabsawyLiver Failure Group, Institute for Liver and Digestive Health, UCL Medical School, Royal Free Hospital, London, UK.
Anmol ChikhliaLiver Failure Group, Institute for Liver and Digestive Health, UCL Medical School, Royal Free Hospital, London, UK.
Terence S LeungDepartment of Medical Physics and Biomedical Engineering, University College London, London, UK.
Rajeshwar P MookerjeeLiver Failure Group, Institute for Liver and Digestive Health, UCL Medical School, Royal Free Hospital, London, UK.
The Royal Free Hospital · GBKonan University · JPUniversity College London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimSerum bilirubin is an established marker of liver disease. Reliable tools for non-invasive assessment of jaundice in cirrhosis patients, at risk of clinical decompensation, are highly desirable. While smartphone-based imaging has been described in neonatal jaundice, it has not been investigated in advanced cirrhosis patients.

methodsWe included 46 hospitalized patients with acute cirrhosis decompensation and jaundice. Scleral images using an Android smartphone were taken to derive "Scleral Color Values (SCV)," which were matched with same day serum bilirubin measurements. In 29 patients, repeat SCV and bilirubin measurements were performed over time. We analyzed the relationship of SCV and its dynamics with serum bilirubin, clinical scores, and patient outcomes.

resultsOf 46 patients, 26 (57%) had alcoholic hepatitis as the decompensation precipitant. Seven patients died during admission; a further 12 following hospital discharge. SCV had an excellent linear correlation with serum bilirubin (rho = 0.90, P < 0.001); changes in SCV and serum bilirubin across different time points, were also closely associated (rho = 0.77, P < 0.001). SCV correlated significantly with CLIF Consortium Acute Decompensation score (rho = 0.38, P < 0.001) and grade of Acute-on-Chronic Liver Failure (rho = 0.42, P = 0.039). SCV was higher in patients who died, however, not significantly (86.1 [IQR 83.0-89.7] vs 82.3 [IQR 78.5-83.3], P = 0.22). The associations of SCV with clinical parameters mirrored those of serum bilirubin.

conclusionSmartphone-based assessment of jaundice shows excellent concordance with serum bilirubin and is associated with clinical parameters in acute cirrhosis decompensation. This approach offers promise for remote assessment of cirrhosis patients at-risk of decompensation, post hospital discharge.

Indexed as

JaundiceSmartphoneBilirubinHospitalizationHumansInfant, NewbornLiver CirrhosisPrognosisBilirubinbilirubinimage captureliver diseasephoneremote

Identifiers

PMID36574965
PMCPMC10107452
OpenAlexW4313250872

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.