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

Department of Paediatrics, Neonatology Division, University Hospital "A Gemelli", Catholic University of the Sacred Heart, Rome, Italy

Correspondence to:
Dr D De Luca, Divisione di Neonatologia, Departimento di Scienze Pediatriche, Policlinico Universitario "A.Gemelli", L.go Agostino Gemelli 8, 00168 Roma, Italia; dm.deluca{at}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 µmol/l, while BiliMed variability was within –97.5 to 121.4 µmol/l. The receiver operating characteristic analysis (for serum bilirubin levels >205.2 µmol/l or >239.4 µmol/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.