The value of Bilicheck as a screening tool for neonatal jaundice in term and near-term babies

Abstract

Aims: To determine the accuracy of Bilicheck in assessing serum bilirubin. To evaluate the effectiveness of Bilicheck as a screening device in a population of jaundiced term and near-term babies.

Methods: Prospective evaluation of paired Bilicheck measurements and serum bilirubin in 300 babies.

Results: There was a strong correlation between Bilicheck and serum bilirubin. The mean difference between Bilicheck and serum bilirubin was -10.7 micromol/l, but the 95% limits of agreement were wide at -80 micromol/l to +60 micromol/l. Bilicheck identified significant jaundice (serum bilirubin above 250 micromol/l) with a sensitivity (95% confidence interval) of 91% (88% to 94%) and specificity of 66% (60% to 71%). The area under the receiver operator characteristic curve was 0.85. There were five false negatives, all of whom had a serum bilirubin below 300 micromol/l. If Bilicheck had been used as a screening device, there would have been a 55% decrease in blood samples taken in these babies.

Conclusion: Bilicheck cannot be used to measure serum bilirubin in term and near-term babies with jaundice, but is an effective screening method, which can be used to safely reduce the number of blood tests in these babies.