title: Reproducability of non-invasive bilirubin measurements.
abstract: OBJECTIVE
  To determine the level of agreement between transcutaneous bilirubin (TcB) measurements when sequentially measured by one and two users.
  
  
  METHODS
  A method comparison study design was used to compare two sequential TcB measurements (JM103, Drager Medical Inc., Telford, PA) obtained by the same user and then by two different users. Users were blinded to each others' results. Differences (bias) and limits of agreement (±2 precision or SD) between sequential measurements with the TcB by a single user and two users were calculated and graphed using the Bland-Altman method. Acceptable levels for bias and precision were set a priori at bias ≤±1.5 mg/dL and/or precision ≤±3.0 mg/dL.
  
  
  RESULTS
  A total of 34 newborn infants were studied, with total serum bilirubin (TSB) levels ranging from 2.7 to 8.1 mg/dL, averaging (±SD) 5.5 ± 1.8 mg/dL. Differences (bias) and the level of agreement (precision; SD) for two sequential noninvasive TcB measurements obtained by a single user and two different users (-0.2 ± 0.7 and -0.4 ± 0.7, respectively) were within the acceptable ranges.
  
  
  CONCLUSIONS
  We found good agreement between TcB measurements obtained sequentially by a single user and by two different users of the device, as well as between laboratory TSB values in low-risk newborn infants with normal bilirubin levels. These findings support the use of a noninvasive bilirubin meter to screen for hyperbilirubinemia, which could reduce the amount of blood obtained invasively from newborns.
authors: Mary G. Mazur, BSN, RN, is a Staff Nurse, Providence Hospital, Alternative Birth Care Unit, 16001 W 9 Mile Road, Southfield, MI 48175. She can be reached via e-mail at mayrmazur@gmail.com Judith Mihalko-Mueller, RN, Helen Callans, BS, RN, Deetra Klesh, BSN, RN, Heather Sell, MSN, RN, and Diane Bendig, ASN, RN, are Staff Nurses, Providence Hospital, Alternative Birth Care Unit, 16001 W 9 Mile Road, Southfield, MI 48175.
authors: Mary G
authors: MG
authors: Mazur
authors: Judith
authors: J
authors: Mihalko-Mueller
authors: Helen
authors: H
authors: Callans
authors: Deetra
authors: D
authors: Klesh
authors: Heather
authors: H
authors: Sell
authors: Diane
authors: D
authors: Bendig
mesh_terms: D001663:Bilirubin / Q000032:analysis*; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000175:diagnosis* / Q000378:metabolism; D007231:Infant, Newborn; D007567:Jaundice, Neonatal; D015997:Neonatal Screening / Q000295:instrumentation / Q000379:methods*; D015203:Reproducibility of Results
chemical_list: D001663:Bilirubin