Attempt to improve transcutaneous bilirubinometry: a double blinded study Medick BiliMed versus Respironics BiliCheck

Abstract

Objectives: To compare the accuracy of a new transcutaneous bilirubinometer (BiliMed® Medick SA, Paris, France) with BiliCheckTM (Respironics, Marietta, GA- USA), a widely available instrument, and with total serum bilirubin measurement.

Design: We conducted a prospective double blinded study comparing two devices. 686 healthy newborns needing their bilirubin measured 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 randomized.

Setting: Well-baby nursery ward in a University Hospital, tertiary referral centre.

Results: The linear regression analysis showed a better correlation between BiliCheckTM and serum bilirubin (r = 0.75) than between BiliMed® and serum bilirubin (r = 0.45). BiliCheckTM variability (± 2 S.D. of the mean bias from serum bilirubin) was within -5.1/+3.7 mg/dl, while BiliMed® variability was within -5.7/+7.1 mg/dl. The ROC analysis (for serum bilirubin levels > 12 mg/dl or > 14 mg/dl) showed significantly higher areas under the curve for BiliCheckTM than those for BiliMed® ( p < 0.0001).

Conclusions: Despite the potential practical advantages of BiliMed® , the reduced diagnostic accuracy in comparison to BiliCheckTM does not justify its use in clinical practice.