Saturation of stool color in HSV color model is a promising objective parameter for screening biliary atresia

Shen, Zhen; Zheng, Shan; Dong, Rui; Chen, Gong

doi:10.1016/j.jpedsurg.2016.09.044

Cited by 15 publications

(14 citation statements)

References 9 publications

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“…In another study, the saturation in HSV (H-hue; S-saturation; V-value) was shown to be an important parameter for the recognition of acholic stools with a sensitivity of 100% but a specificity of 85% which is not ideal, especially for stools of dark green color (that might reflect a high concentration of bile pigment). 15 Recently, Hoshino et al 16 integrated a stool color evaluation system, developed for mobile devices with pattern recognition and a machine learning process, into a new mobile App (Baby Poop). Baby Poop App was able to correctly identify five BA stools with 100% accuracy in a sample of 40 pictures, although all images analyzed were taken from a pre-existing collection of pictures and, consequently, some variables related to the photo shoot, such as the brightness of exposure, could not be tested.…”

Section: Discussionmentioning

confidence: 99%

“…12 Due to advances in technology and the increased access to smartphones, in recent years the number of available health "Apps" has exploded, and mobile applications have gained a concrete role in healthcare systems. 13 Since 2015, some mobile phone applications have been developed which aim to recognize acholic stools, [14][15][16] but further data are needed to confirm their clinical applicability in a larger cohort and the impact of the Apps on the early diagnosis of BA.…”

Section: Introductionmentioning

confidence: 99%

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A novel mobile phone application for infant stool color recognition: An easy and effective tool to identify acholic stools in newborns

et al. 2020

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Objectives Early diagnosis of biliary atresia is essential to improve long-term outcomes. Newborn screening with an infant stool color card allows early recognition of biliary atresia patients. Our aim was to develop and validate a mobile phone application (PopòApp) able to identify acholic stools. Methods An intuitive app was developed for iOS and Android smartphones. A learning machine process was used to generate an algorithm for stools color recognition based on the seven colors of the infant stool color card, which were considered as the gold standard. Consecutive images of stools were taken by the PopòApp, directly into the diapers of children aged ≤6 months. The PopòApp classified the photographs as “normal”, “acholic” or “uncertain”. To validate the PopòApp, four doctors independently classified all images, and only those for which all doctors agreed were included. The sensitivity, specificity, positive/negative predictive values, and accuracy of the PopòApp were evaluated. Results Of 165 images collected, 160 were included in the study. All acholic stools were recognized by the PopòApp. The PopòApp sensitivity was 100% (95% CI:93.9%–100%) with no false negatives, regardless of the brand of phone. The specificity was 99.0% (95% CI:94.6%–99.9%). The accurancy of the PopòApp was 99.4% (95% CI:96.6%–99.9%), with a positive predictive value of 98.4% (95% CI:89.8%–99.8%). Conclusion The current study proved, in a large cohort, that the PopòApp is an accurate and easy tool for recognition of acholic stools. The mobile App may represent an effective strategy for the early referral of children with acholic stools, and potentially could improve the outcomes of biliary atresia.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A novel mobile phone application for infant stool color recognition: An easy and effective tool to identify acholic stools in newborns

et al. 2020

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“…Stool colour is affected by daily diet and by the secretion of digestive fluids, such as bile, and has also been reported to be associated with the occurrence of bile duct disease and colon cancer 34,43 . There were significant differences in the L*a*b* colour space evaluation results using the colourimeter among the observational colour responses, suggesting a discriminative ability to detect differences in stool colour using the faecal assessment tool.…”

Section: Discussionmentioning

confidence: 99%

“…The Bristol Stool Form Scale (BSFS) is a well-known tool for classifying faecal form 28–30 . Stool colour cards have also been used to screen for biliary atresia in infants 21,31–34 and for gastrointestinal bleeding in adults. However, no tools are available that allow convenient observation and evaluation of faecal volume and odour, and no tools have been reported that allow for comprehensive observation and evaluation of faecal condition.…”

Section: Introductionmentioning

confidence: 99%

Validity of an observational assessment tool for multifaceted evaluation of faecal condition

Ohno

Murakami

Tanisawa

et al. 2019

Sci Rep

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Faecal volume, form, colour, and odour are associated with various diseases, dietary habits, and the gut microbiome. Multifaceted assessment of faecal condition will be needed for future research and practice. Faecal observation has advantages, as it is non-invasive, frequent, and easy. We have developed and validated an illustrative card tool for comprehensively faecal assessment. In 38 healthy adults, observations of volume, form, colour, and odour of faeces using the tool were compared to the objective characteristics of the actual faeces determined using a weighing scale, moisture meter, hardness meter, colourimeter, and odour measuring device. A significant positive correlation (ρ = 0.778) was observed between the number of faecal model (2 cm × 10 cm) units and the actual weight. The Bristol Stool Form Scale showed a significant positive correlation with the moisture content (ρ = 0.717) and negative correlations with faecal hardness (ρ = −0.843) and adhesiveness (ρ = −0.761). The L*a*b* colour space values of the stool differed significantly among observational judgments using the colour card tool. No significant correlation was observed between the observation of odour and the measured odour index. In conclusion, the faecal volume, form, and colour can be estimated by observation using the multifaceted assessment card tool.

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“…The application, in Japanese only, had 100% sensitivity and specificity for the detection of BA based on a test sample of 40 stool pictures including five BA stools. A similar application is being developed in Shanghai [57].…”

Section: Ba Screening Using a Stool Colour Smartphone Appmentioning

confidence: 99%

Biliary Atresia in 2021: Epidemiology, Screening and Public Policy

Schreiber

Harpavat

Hulscher

et al. 2022

JCM

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Biliary atresia (BA) is a rare newborn liver disease with significant morbidity and mortality, especially if not recognized and treated early in life. It is the most common cause of liver-related death in children and the leading indication for liver transplantation in the pediatric population. Timely intervention with a Kasai portoenterostomy (KPE) can significantly improve prognosis. Delayed disease recognition, late patient referral, and untimely surgery remains a worldwide problem. This article will focus on biliary atresia from a global public health perspective, including disease epidemiology, current national screening programs, and their impact on outcome, as well as new and novel BA screening initiatives. Policy challenges for the implementation of BA screening programs will also be discussed, highlighting examples from the North American, European, and Asian experience.

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Saturation of stool color in HSV color model is a promising objective parameter for screening biliary atresia

Cited by 15 publications

References 9 publications

A novel mobile phone application for infant stool color recognition: An easy and effective tool to identify acholic stools in newborns

A novel mobile phone application for infant stool color recognition: An easy and effective tool to identify acholic stools in newborns

Validity of an observational assessment tool for multifaceted evaluation of faecal condition

Biliary Atresia in 2021: Epidemiology, Screening and Public Policy

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