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New mobile app helps screen stool for liver disease in newborns
In a pilot study, PoopMD, a mobile health application, was accurate in reading the color of a newborn’s stool for early signs of biliary atresia, a rare form of liver disease, according to newly published findings.
“The use of mobile applications provides an additional opportunity to educate parents of newborns regarding the clinical significance of acholic stools and the value in early detection for cholestatic liver diseases such as [biliary atresia],” the researchers wrote. “Over the last few years, health-related mobile app development and use has increased significantly due to recognition of the potential for both far-reaching societal impacts as well as financial gains in this field.”
Researchers from Johns Hopkins University, including Douglas B. Mogul, MD, MPH, a pediatric gastroenterologist, collaborated with HCB Health in Austin, Texas, who used HTML5/CSS3 code and iOS and Android platforms to create the application. The application (app) is free for Apple and Android users and was first launched in 2014 with an aim to read, interpret and record the color of a newborn’s stool for possible symptoms of biliary atresia (BA). Parents using the app can rely on it to help detect the symptomatic pale yellow to chalky grey stools that mean urgent medical assessment is needed, according to a press release.
Douglas B. Mogul
To study the accuracy of the app, the researchers sought medical opinion from expert pediatricians who looked at 34 photographs of pale-colored stool, according to the release. Afterwards, one expert and three laypeople were asked to use the app on different devices to look at and analyze the same pictures under different lighting conditions and using various smartphone models.
“These individuals were essentially asked to take a picture of the stool photograph and determine if the app identifies the photo as normal or pale, but in normal use, a parent just takes pictures of the contents of a diaper,” Mogul said in the release.
The experts were able to differentiate between the normal and pale-looking stools, indicating it was accurate in determining abnormal ones. Overall, all of the experts agreed that 27 stools were normal and 7 were acholic. The sensitivity of PoopMD under initial conditions was 100% with no false negatives, whereas the specificity of PoopMD under initial conditions was 89%, with 3 images being falsely labeled as indeterminate and no images being falsely labeled as acholic, according to the research.
To use the app, parents or caregivers download it and take a picture of the newborn’s stool and are able to look at any the part of the picture for a stool color that may be of concern.
“The app then immediately identifies whether the stool color matches those associated with gastrointestinal illnesses or problems with the liver, including BA,” according to the release.
In addition, the app can store results for future and comparative reference, parents can email a photo to a pediatrician directly from the app and also reminds parents to check their newborn’s stool color every two weeks, according to the release.
Mogul stated in the release that the application is a great way to get younger parents and caregivers involved with interactive medical advice.
“Four out of five adults in the U.S. ages 18 [to] 35 — the age of young parents — have a smartphone, and that’s independent of income level, so the app gives us a great opportunity to distribute interactive content that helps young parents pay attention to educational advice,” Mogul said in the release. – by Melinda Stevens
Disclosures: The researchers report no relevant financial disclosures.