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Attempt to improve transcutaneous bilirubinometry: a double-blind study of Medick BiliMed versus Respironics
D De Luca1, E Zecca, M Corsello
1Divisione di Neonatologia, Departimento di Scienze Pediatriche, Policlinico Universitario "A.Gemelli", L.go Agostino Gemelli 8, 00168 Roma, Italia. dm.deluca@fastwebnet.it
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.
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