"Significant hyperbilirubinemia is an important public health problem in the Philippines. Total bilirubin determination performed at the 24th hour of life can adequately predict development of significant hyperbilirubinemia at the 72nd hour of life. A 24 h bilirubin level of ≥ 7.5 mg/dL can be used as a cut-off value to identify Filipino infants at risk of developing significant hyperbilirubinemia. The Bilistick 2.0 device is a reliable tool to determine total bilirubin among Filipino infants. Establishment of a pre-discharge bilirubin screening program utilizing the 24 h bilirubin level plus risk factors (inadequate breastmilk intake, blood incompatibility, late preterm, bruising) is recommended to identify at risk Filipino infants."

While invasive blood tests remain the diagnostic gold standard, their clinical efficacy depends on strict analytical accuracy and international traceability. The development of affordable point-of-care devices like BiliSpec and Bilistick represents a crucial advancement, offering accessible and reliable screening for resource-limited regions while expanding the diagnostic focus to include bilirubin photoisomers and oxidation products.

"Bilistick is a minimally invasive method for measuring total bilirubin concentration over a wide range of values and should provide an affordable and accurate system for pre-discharge and follow-up screening of jaundiced infants, particularly in low-resource environments."

"The Bilistick® System (BM-BS 1.0 - FW version 2.0.1) underestimates TSB, whereas TCB [measured with the JM-105 bilirubinometer] overestimates TSB in jaundiced Indonesian infants. Further improvement of Bilistick®'s diagnostic accuracy with less false-negative readings is essential to increase its use."

The BEAT jaundice @home study concludes that the Bilistick (version 2.0) lacks the diagnostic accuracy and reliability required for home-based neonatal screening. Due to an unacceptably wide margin of error, a high rate of technical failures, and poor user convenience among midwives, the device is currently unsuitable as a standalone tool for identifying infants in need of phototherapy.

"Bilistick 2.0 showed strong diagnostic agreement with reference laboratory bilirubin testing. With training and basic laboratory coordination, it may support safe, rapid bilirubin management in resource-limited neonatal care."

"These findings support Bilistick POC as an easily utilized, consistent, and portable testing device to measure TSB compared to a hospital-based analyzer."

"Despite the advantages that handheld POC devices offer, these findings suggest that the imprecision for measurement of neonatal bilirubin needs improvement to tailor neonatal jaundice management."

"Bilistick as a PoC device is not accurate to estimate TB within the clinically acceptable difference (plus or minus 2 mg/dl) of TB estimation by spectrophotometry and needs further improvement to make it more accurate."

"Bilistick has shorter TAT. The accuracy and sensitivity of Bilistick TSB for predicting laboratory TSB is high at lower cutoff levels."

"Both methods are reliable for measuring TSB before, during, and after phototherapy in preterm infants. TcB tends to overestimate while Bilistick underestimates TSB."

"BS is a reliable system to detect neonatal jaundice over a wide range of bilirubin levels. Since Bilistick is a point-of-care test, its use may provide appropriate and timely identification of jaundiced newborns requiring treatment."

"This evaluation showed that the BS, in its current formulation, does not provide reliable results for measuring SBR in a tropical, low-resource setting but has acceptable usability features."

"The Bilistick System is an accurate alternative to transcutaneous (TcB) determination for early diagnosis and proper management of the neonatal jaundice."