{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T01:28:36Z","timestamp":1777166916306,"version":"3.51.4"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T00:00:00Z","timestamp":1672790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Serum bilirubin is an established marker of liver disease. Reliable tools for non\u2010invasive assessment of jaundice in cirrhosis patients, at risk of clinical decompensation, are highly desirable. While smartphone\u2010based imaging has been described in neonatal jaundice, it has not been investigated in advanced cirrhosis patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We included 46 hospitalized patients with acute cirrhosis decompensation and jaundice. Scleral images using an Android smartphone were taken to derive \u201cScleral Color Values (SCV),\u201d 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 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\u00a0=\u00a00.90, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001); changes in SCV and serum bilirubin across different time points, were also closely associated (rho\u00a0=\u00a00.77, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). SCV correlated significantly with CLIF Consortium Acute Decompensation score (rho\u00a0=\u00a00.38, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and grade of Acute\u2010on\u2010Chronic Liver Failure (rho\u00a0=\u00a00.42, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.039). SCV was higher in patients who died, however, not significantly (86.1 [IQR 83.0\u201389.7] <jats:italic>vs<\/jats:italic> 82.3 [IQR 78.5\u201383.3], <jats:italic>P<\/jats:italic>\u00a0=\u00a00.22). The associations of SCV with clinical parameters mirrored those of serum bilirubin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Smartphone\u2010based 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\u2010risk of decompensation, post hospital discharge.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.16093","type":"journal-article","created":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T01:04:10Z","timestamp":1672189450000},"page":"330-336","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["A novel smartphone scleral\u2010image based tool for assessing jaundice in decompensated cirrhosis patients"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8111-213X","authenticated-orcid":false,"given":"Konstantin","family":"Kazankov","sequence":"first","affiliation":[{"name":"Liver Failure Group, Institute for Liver and Digestive Health, UCL Medical School Royal Free Hospital  London UK"},{"name":"Department of Hepatology and Gastroenterology Aarhus University Hospital  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miranda","family":"Nixon\u2010Hill","sequence":"additional","affiliation":[{"name":"Department of Medical Physics and Biomedical Engineering University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5092-4821","authenticated-orcid":false,"given":"Rahul","family":"Kumar","sequence":"additional","affiliation":[{"name":"Liver Failure Group, Institute for Liver and Digestive Health, UCL Medical School Royal Free Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Amin","sequence":"additional","affiliation":[{"name":"Liver Failure Group, Institute for Liver and Digestive Health, UCL Medical School Royal Free Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eman","family":"Alabsawy","sequence":"additional","affiliation":[{"name":"Liver Failure Group, Institute for Liver and Digestive Health, UCL Medical School Royal Free Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anmol","family":"Chikhlia","sequence":"additional","affiliation":[{"name":"Liver Failure Group, Institute for Liver and Digestive Health, UCL Medical School Royal Free Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terence S.","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Medical Physics and Biomedical Engineering University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajeshwar P.","family":"Mookerjee","sequence":"additional","affiliation":[{"name":"Liver Failure Group, Institute for Liver and Digestive Health, UCL Medical School Royal Free Hospital  London UK"},{"name":"Department of Hepatology and Gastroenterology Aarhus University Hospital  Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,1,4]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2001.22172"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0011-3840(64)80003-4"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.03.024"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.04.005"},{"key":"e_1_2_5_6_1","article-title":"Evaluation of CirrhoCare\u00ae \u2010 A digital\u2010health solution for home management of patients with cirrhosis","author":"Kazankov K","year":"2022","journal-title":"J. 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