Attempt to improve transcutaneous bilirubinometry: a double-blind study of Medick BiliMed versus Respironics BiliCheck

Arch Dis Child Fetal Neonatal Ed. 2008 Mar;93(2):F135-9. doi: 10.1136/adc.2007.121053. Epub 2007 Nov 15.

Abstract

Objectives: 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.

Design: 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.

Setting: 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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Bilirubin / blood*
  • Double-Blind Method
  • Female
  • Humans
  • Infant, Newborn
  • Jaundice, Neonatal / diagnosis
  • Light
  • Male
  • Neonatal Screening
  • Predictive Value of Tests
  • Pregnancy
  • Prospective Studies
  • Reproducibility of Results
  • Spectrum Analysis / instrumentation
  • Spectrum Analysis / methods
  • Treatment Outcome

Substances

  • Bilirubin