Objectives: This study evaluates the efficacy of the icteric index as a pre-screening tool for hyperbilirubinemia in adult patients.
Methods: The use of this index would help optimize the use of clinical laboratory resources.
Results: A retrospective analysis of 3,194 serum samples revealed a strong correlation between icteric index and total bilirubin levels (r=0.972), with an area under the ROC curve of 0.90. An index cut-off value of 1.2 yielded a sensitivity of 100 % and a specificity of 87 %. This performance guarantees the detection of the totality of hyperbilirubinemia cases and the absence of false negatives, albeit with some false positives. This method would avoid around 79 % of unnecessary total bilirubin tests, resulting in estimated annual cost savings of over 1,500 Euros.
Conclusions: In conclusion, the icteric index is an effective, inexpensive, and safe tool for improving the diagnostic performance of laboratory tests without compromising the quality of care.
Keywords: diagnostic performance; hyperbilirubinemia; icteric index; total bilirubin.
© 2026 the author(s), published by De Gruyter, Berlin/Boston.