Accuracy of the Bilicare? transcutaneous bilirubinometer as the predischarge screening tool for significant hyperbilirubinemia in healthy term and late preterm neonates

Background: The Bilicare? is a new device that measures transcutaneous bilirubin (TcB) level at the ear pinna. There are only few studies which have evaluated its accuracy in clinical practice. Objective: This study aims to determine the accuracy of Bilicare? as a predischarge screening tool in late preterm and term neonates and to define the optimal cutoff point for determining the need to measure total serum bilirubin (TSB). Methods: The 35 weeks? gestation or more and healthy neonates who underwent predischarge TSB measurement were enrolled. Bilicare? TcB was measured within 30?minutes of blood sampling. Paired TcB and TSB data were analyzed. Results: We collected 214 paired samples. Mean age (SD) at TcB measurement was 57.17 (7.47) hours. Mean TSB (SD) was 9.79 (2.83) mg/dL. TcB showed a significant correlation with TSB (r?=?0.84, r(2)?=?0.7). The mean difference (SD) between TcB and TSB was 0.7 (0.21) mg/dL (95%CI 0.49?0.91). TcB tended to overestimate TSB level at the TSB values of <12?mg/dL but underestimate at the higher TSB level. The accuracy of using TcB values to detect neonates who required phototherapy was 92.5%. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 78.3, 94.2, 62.1, and 97.3%, respectively. If TcB +3?mg/dL was applied as a cutoff point, the sensitivity, specificity, PPV, and NPV were 100, 53.9, 20.7, and 100%, respectively. Conclusions: Bilicare? TcB and TSB measurements were well correlated. The TcB level +3?mg/dL could detect all neonates who had significant hyperbilirubinemia requiring phototherapy during their birth hospitalization.