Improved Transcutaneous Bilirubinometer for Enhanced Measurement Accuracy in Neonatal Hyperbilirubinemia

Background: Conventional transcutaneous bilirubinometers often underestimate total bilirubin (TB) levels at high concentrations, limiting their clinical utility in cases of neonatal hyperbilirubinemia. We aimed to address this shortcoming by developing and testing a novel type of advanced transcutaneous bilirubinometer that may enhance the early identification of severe hyperbilirubinemia, potentially reducing the need for invasive testing and exchange transfusions. Methods: We developed a novel transcutaneous bilirubinometer with adjustable light intensity and detection distances. Transcutaneous bilirubin (TcB) measurements were obtained using both the novel device and a conventional JM-105 bilirubinometer in 66 instances in 62 neonates (≥36 weeks gestation). TB values measured in patient blood samples were used as reference values for calculating correlations and error metrics (i.e., mean squared error [MSE] and mean absolute error [MAE]). Results: The novel device showed strong correlation with TB values across all concentrations (R² = 0.96), including those ≥15 mg/dL (R² = 0.84), outperforming the JM-105 device (R² = 0.60 for TBs ≥15 mg/dL). The novel device also yielded lower MSE (1.53 vs. 2.95) and MAE values (1.00 vs. 1.39) than the JM-105. Conclusions: Our novel transcutaneous bilirubinometer demonstrated improved accuracy at higher bilirubin concentrations compared with a conventional JM-105 device.