Evaluating the Picterus® Jaundice Pro Application for Neonatal Jaundice Screening by Parents: prospective mixed-methods study (Preprint)
Bibliographic record
Abstract
BACKGROUND: Neonatal jaundice is a very common condition in the first week of life requiring timely recognition of the small subset of neonates at risk of developing severe neonatal hyperbilirubinemia (SNH). Total serum bilirubin, as quantified through blood testing, remains the gold standard for diagnosis, whereas screening based on visual inspection has been proven unreliable in identifying which jaundiced neonates require total serum bilirubin. Picterus Jaundice Pro (JP) is a mobile health app developed for use by health care professionals and parents to screen for imminent SNH. However, parental user experiences with Picterus JP remain largely unexplored. OBJECTIVE: This study aimed to evaluate the usability and user-friendliness of Picterus JP when used and evaluated by parents. METHODS: Between August 2023 and January 2025, we conducted a prospective mixed methods study at 3 maternity care settings: the maternity wards of 2 hospitals in the Netherlands and 1 hospital in Israel. Parents were invited to participate if their infant was near term born (gestational age of ≥35 weeks) and at least 12 hours old but still in the first week of life. Parents used Picterus JP once according to the manufacturer's instructions. Immediately afterward, usability was evaluated using the validated mHealth App Usability Questionnaire, an instrument measured on a 7-point Likert scale ranging from 1 ("strongly disagree") to 7 ("strongly agree"), and open-ended questions. A subset of parents and nurses participated in semistructured interviews and focus groups. RESULTS: In total, 123 parents completed the questionnaire. The median mHealth App Usability Questionnaire score was 6 (IQR 5-7) out of 7. A total of 87.7% (100/114) of the parents indicated that they would use Picterus JP at home. Parents reported that they found the app easy, quick, and convenient, although 55.8% (67/120) reported a failure on the first try. Some parents struggled to find or interpret the instructions, but most of those who tried again (79/105, 75.2%) obtained a bilirubin estimate. Additionally, 12 nurses from 2 participating maternity wards provided their observations on parents' use of Picterus JP in 2 focus groups. Thematic analysis of all combined data identified 3 themes that were considered important for the usability of Picterus JP: intention to use Picterus JP, infant well-being, and instruction and guidance. CONCLUSIONS: Parents rated Picterus JP highly in terms of usability despite encountering difficulties during initial use. Technical improvements and more proactive guidance seem important to support successful parental use. Nonetheless, both parents and nurses were positive about the potential of Picterus JP for home screening for SNH.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.020 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".