title: Transcutaneous bilirubin measurement at the time of hospital discharge in a multiethnic newborn population.
abstract: BACKGROUND
  Severe neonatal hyperbilirubinemia continues to occur in healthy newborns. Recent guidelines have supported using transcutaneous devices in estimating bilirubin levels. Previous studies using these devices are limited.
  
  
  METHODS
  Newborns requiring serum bilirubin level measurements before hospital discharge were recruited prospectively. The agreement between a transcutaneous bilirubin (TCB) and total serum bilirubin (TSB) level was assessed. Sensitivity analysis was conducted.
  
  
  RESULTS
  A total of 430 infants were enrolled. Correlation between the values was high (Pearson's correlation coefficient 0.83; Lin's concordance coefficient 0.81 [95% CI 0.77 to 0.84]; P<0.001). The mean (± SD) TSB level was 194±60 μmol/L. The TCB measurement tended to overestimate the value (mean difference 12.7), with wide 95% limits of agreement (-52 μmol/L to 77 μmol/L). Sensitivity and specificity analysis of TCB values allowed estimation of clinically important TSB levels.
  
  
  CONCLUSIONS
  The TCB correlated, but was imprecise in predicting TSB. TCB values can be used at the time of discharge to safely plan care for jaundiced infants if the limits of agreement are considered and clinical judgment is maintained.
authors.affiliation: Department of Paediatrics, St Michael's Hospital;
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Campbell
authors.forename: Karoon C
authors.initials: KC
authors.lastname: Danayan
authors.forename: Valleverdina
authors.initials: V
authors.lastname: McGovern
authors.forename: Sohail
authors.initials: S
authors.lastname: Cheema
authors.forename: Brenda
authors.initials: B
authors.lastname: Stade
authors.forename: Michael
authors.initials: M
authors.lastname: Sgro