Evaluation of CirrhoCare® – a digital health solution for home management of individuals with cirrhosis

Kazankov, Konstantin; Novelli, Simone; Chatterjee, Devnandan; Phillips, Andrew T.; Balaji, Anu; Raja, Maruthi; Foster, Graham R.; Tripathi, Dhiraj; Boddu, Ravan; Kumar, Rajiv; Jalan, Rajiv; Mookerjee, Rajeshwar P.

doi:10.1016/j.jhep.2022.08.034

Cited by 16 publications

(14 citation statements)

References 21 publications

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“…However, not all patients had serial measurements of SCV, and validation of the dynamic associations of SCV and bilirubin in future studies is warranted. Telemedicine and telemonitoring are promising tools in the management of liver disease 5,16,17 . Most patients with cirrhosis have smartphones and are willing to use them in their disease management, 18 and we recently performed a study of remote management in patients with advanced cirrhosis, showing excellent patient engagement as well as fewer and shorter hospital readmissions and less unplanned abdominal fluid drains than in a control group 5 .…”

Section: Discussionmentioning

confidence: 99%

“…Telemedicine and telemonitoring are promising tools in the management of liver disease. 5 , 16 , 17 Most patients with cirrhosis have smartphones and are willing to use them in their disease management, 18 and we recently performed a study of remote management in patients with advanced cirrhosis, showing excellent patient engagement as well as fewer and shorter hospital readmissions and less unplanned abdominal fluid drains than in a control group. 5 Thus, integrating smartphone‐based jaundice assessment into remote‐home monitoring for advanced cirrhosis patients would add value and complement other digital markers of liver complications.…”

Section: Discussionmentioning

confidence: 99%

“… 5 , 16 , 17 Most patients with cirrhosis have smartphones and are willing to use them in their disease management, 18 and we recently performed a study of remote management in patients with advanced cirrhosis, showing excellent patient engagement as well as fewer and shorter hospital readmissions and less unplanned abdominal fluid drains than in a control group. 5 Thus, integrating smartphone‐based jaundice assessment into remote‐home monitoring for advanced cirrhosis patients would add value and complement other digital markers of liver complications. In particular, this approach would help identify patients in the community in need of further investigation and possible hospitalization, and help focus the efforts of healthcare providers on the patients most at need.…”

Section: Discussionmentioning

confidence: 99%

“…However, increasing pressures on an over‐burdened healthcare system may challenge this traditional mode of practice, and this has been further exacerbated by the COVID‐19 pandemic, which necessitated telephone consultations to be instituted 4 . Thus, options to assess a patient remotely are highly desirable, and we recently performed a study of digital home management in patients with advanced cirrhosis, showing good feasibility and utility of a smartphone monitoring approach 5 . Assessment of the patients' bilirubin levels reflecting jaundice as an indication of acute decompensation, without bringing the patient to the hospital, would add a new dimension to remote monitoring for better patient care.…”

Section: Introductionmentioning

confidence: 99%

“… 4 Thus, options to assess a patient remotely are highly desirable, and we recently performed a study of digital home management in patients with advanced cirrhosis, showing good feasibility and utility of a smartphone monitoring approach. 5 Assessment of the patients' bilirubin levels reflecting jaundice as an indication of acute decompensation, without bringing the patient to the hospital, would add a new dimension to remote monitoring for better patient care.…”

Section: Introductionmentioning

confidence: 99%

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

Kazankov

Nixon-Hill

Kumar

et al. 2023

J of Gastro and Hepatol

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Background and Aim: Serum 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. Methods: We 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. Results: 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 = 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 ], P = 0.22). The associations of SCV with clinical parameters mirrored those of serum bilirubin. Conclusion: Smartphone-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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

Kazankov

Nixon-Hill

Kumar

et al. 2023

J of Gastro and Hepatol

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View full text Add to dashboard Cite

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Integrating smart phone applications in the management of cirrhotic patients: A scoping review

Hasan,

Bidargaddi,

Muller

et al. 2023

JGH Open

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Background and AimChronic liver disease and cirrhosis is a significant cause of healthcare utilization and patient morbidity and mortality worldwide. Smartphone applications have high uptake in most communities and therefore have great potential to provide remote support solutions to this patient population. The aim of this scoping review was therefore to provide a comprehensive overview using narrative synthesis on the use of smartphone‐application‐based digital interventions in cirrhotic populations.Materials and MethodsPRISMA guidelines were followed, with two independent researchers identifying 10 relevant studies. Patients studied were predominantly those with decompensated cirrhosis, and hepatic encephalopathy was the most common complication studied.ResultsSmartphones were the most common platform used, but training periods, prior to commencement of the study, were rarely offered. Patient engagement rates with the technology were reported only in three studies, but all reported high (>50%) rates of engagement. Only one study examined the clinical effects of their digital intervention, with a 38% reduction in readmission rate reported.ConclusionOverall, the use of smartphone apps in cirrhosis is in an early phase of development and evaluation but preliminary studies suggest significant potential as an adjunct to routine medical care. Further high‐quality studies of well‐designed digital interventions are needed to advance this promising early experience.

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Emergency Department Utilization and Outcomes Among Adults With Cirrhosis From 2008 to 2022 in the United States

Elhence,

Dodge,

Flemming

et al. 2024

Clinical Gastroenterology and Hepatology

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Evaluation of CirrhoCare® – a digital health solution for home management of individuals with cirrhosis

Cited by 16 publications

References 21 publications

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

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

Integrating smart phone applications in the management of cirrhotic patients: A scoping review

Emergency Department Utilization and Outcomes Among Adults With Cirrhosis From 2008 to 2022 in the United States

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