Attempt to improve transcutaneous bilirubinometry: a double-blind study of Medick BiliMed versus Respironics BiliCheck.
OBJECTIVE
To compare the accuracy of a new transcutaneous bilirubinometer, BiliMed (Medick SA, Paris, France) with BiliCheck (Respironics, Marietta, GA, USA), a widely available instrument, and with total serum bilirubin measurement.


METHODS
A prospective double-blind study comparing the two devices was carried out. 686 healthy newborns needing measurement of their bilirubin were enrolled over a 4-month period. Serum and transcutaneous bilirubin measurements were taken with both devices within 15 minutes. The order of use of the instruments was randomised.


METHODS
Well-baby nursery ward in a university hospital, tertiary referral centre.


RESULTS
The linear regression analysis showed a better correlation between BiliCheck and serum bilirubin (r = 0.75) than between BiliMed and serum bilirubin (r = 0.45). BiliCheck variability (+/-2 SD of the mean bias from serum bilirubin) was within -87.2 to 63.3 micromol/l, while BiliMed variability was within -97.5 to 121.4 micromol/l. The receiver operating characteristic analysis (for serum bilirubin levels >205.2 micromol/l or >239.4 micromol/l) showed significantly higher areas under the curve for BiliCheck than those for BiliMed (p<0.001).


CONCLUSIONS
Despite the potential practical advantages of BiliMed, its reduced diagnostic accuracy in comparison with BiliCheck does not justify its use in clinical practice.
De Luca
D
D
Divisione di Neonatologia, Departimento di Scienze Pediatriche, Policlinico Universitario "A.Gemelli", L.go Agostino Gemelli 8, 00168 Roma, Italia. dm.deluca@fastwebnet.it
Zecca
E
E
Corsello
M
M
Tiberi
E
E
Semeraro
C
C
Romagnoli
C
C
D001663:Bilirubin / Q000097:blood*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000175:diagnosis; D008027:Light; D008297:Male; D015997:Neonatal Screening; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D015203:Reproducibility of Results; D013057:Spectrum Analysis / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome
D001663:Bilirubin