title: Comparison of the transcutaneous bilirubinometers BiliCheck and Minolta JM-103 in preterm neonates.
abstract: OBJECTIVE
  To investigate the trueness and uncertainty of two transcutaneous bilirubinometers BiliCheck and Minolta JM-103 in preterm infants; establish cut-off values for the transcutaneous bilirubin (TcB) level, indicating the need for total serum bilirubin (TsB) measurement; and estimate how many blood samples could be saved.
  
  
  METHODS
  In 133 neonates with gestational ages 28(+0) -34(+6) weeks, 239 measurements of TcB by BiliCheck (TcB(B)) and JM-103 (TcB(M)) and of TsB were performed.
  
  
  RESULTS
  Median TsB of the first samples was 160 (range, 53-293) μmol/L, whereas median TcB(B) was 12 μmol/L (8%) lower and TcB(M) 67 μmol/L (40%) lower. TcB(B) underestimated TsB for TsB ≥180μmol/L. All TcB(M) values, except one, underestimated TsB. The underestimation increased with increasing TsB. Multiple regression analysis showed that post-natal age and ethnicity were confounding factors for TcB(M); none were found for TcB(B). The uncertainty was the same for the two instruments. By using cut-off values of 70% of the phototherapy limit for TcB(B) and 35% for TcB(M), the sensitivity of the screening would be 95% and 97%, and 36% and 24% of the blood samples could be saved, respectively.
  
  
  CONCLUSIONS
  TcB determined with JM-103 gave values much lower than those obtained with BiliCheck. The underestimation of TsB increased with increasing concentrations. By using transcutaneous bilirubinometers in preterm neonates, 24-36% of the blood samples could be saved.
authors.affiliation: Department of Paediatrics, Aalborg Hospital, Aarhus University Hospital, Denmark. fe@rn.dk
authors.forename: Finn
authors.initials: F
authors.lastname: Ebbesen
authors.forename: Pernille K
authors.initials: PK
authors.lastname: Vandborg
authors.forename: Torleif
authors.initials: T
authors.lastname: Trydal
mesh_terms: D001663:Bilirubin / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000097:blood / Q000175:diagnosis*; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000097:blood / Q000175:diagnosis*; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D015997:Neonatal Screening / Q000295:instrumentation*; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D001663:Bilirubin