Measuring transcutaneous bilirubin: a comparative analysis of three devices on a multiracial population

Raimondi, Francesco; Lama, Sílvia Nassif Del; Landolfo, Francesca; Sellitto, Maria; Borrelli, Antonio; Maffucci, Rosalba; Milite, Paola; Capasso, Letizia

doi:10.1186/1471-2431-12-70

Cited by 50 publications

(36 citation statements)

References 8 publications

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“…This study demonstrated a stronger correlation in the Caucasian group compared to the non‐Caucasian group. These findings are consistent with other studies where the correlation between TcB and SBR in non‐Caucasian or darker‐skinned infants is lower than that of Caucasian or lighter‐skinned infants . The trend in agreement is also consistent with other studies in that TcB devices tend to overestimate the SBR measurements (i.e.…”

Section: Discussionsupporting

confidence: 92%

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Evaluation of the Kejian KJ‐8000 bilirubinometer in an Australian setting

Starowicz

Edwards

Schmidt

et al. 2019

J Paediatrics Child Health

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Aim To evaluate the accuracy of the Kejian 8000 (KJ‐8000) transcutaneous bilirubinometer in infants of differing ethnicity and gestational age. Methods This was a prospective study of infants in the Newborn Care Unit at Gold Coast University Hospital. Transcutaneous bilirubin (TcB) and serum bilirubin (SBR) results were compared using linear regression and a Bland–Altman plot. Predicted indices were calculated to assess the KJ‐8000 as a screening tool using local jaundice management guidelines. Results A total of 416 paired samples were collected from 201 infants. There was a strong correlation between TcB and SBR with a Pearson correlation coefficient of 0.8 (<0.00001). The bias was −5.9 μmol/L (95% confidence interval: −101, 89). The bias was not evenly spread, with the KJ‐8000 tending to underestimate at higher SBR levels. Infants <32 weeks' gestation had a poor correlation of 0.48. Non‐Caucasian infants were more likely to have TcB overestimation, and measurements were less precise. As a screening tool using local guidelines, the KJ‐8000 had a sensitivity, specificity, positive predictive value and negative predictive value of 83, 53, 20 and 96%, respectively, and is predicted to avoid blood tests in 48% of infants screened. Conclusions In this study, the correlation and agreement of TcB measurements using the KJ‐8000 were not as good as has been reported with other more studied devices but may still have value as a screening tool. The poor correlation in preterm infants suggests that use should be restricted to term infants. The overall results of this study are affected by an underrepresentation of term infants, and so, further clinical assessment of this device should be undertaken before it can be recommended for widespread use.

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Section: Discussionsupporting

confidence: 92%

“…positive bias) in non‐Caucasian or darker‐skinned infants (including African American, Thai and Asian sub‐populations) and are less precise than measurements in Caucasian or lighter‐skinned infants where the devices tended to underestimate (i.e. negative bias) …”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Kejian KJ‐8000 bilirubinometer in an Australian setting

Starowicz

Edwards

Schmidt

et al. 2019

J Paediatrics Child Health

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“…Pearson’s correlation coefficient obtained with Bilistick (r = 0.961) was higher than those reported for any transcutaneous POC instrument that ranged from 0.70 to 0.87 [13,14,15,16,17,18,19,20,21]. The Bland-Altman analysis showed a mean difference between hospital laboratory results and Bilistick determinations of 10.3 µmol/l and a 95% confidence interval of –38.0 to –58.7 µmol/l.…”

Section: Discussionmentioning

confidence: 79%

Bilistick: A Low-Cost Point-of-Care System to Measure Total Plasma Bilirubin

et al. 2012

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Background: Severe neonatal hyperbilirubinemia, with consequent encephalopathy, remains a common cause of morbidity and death in many regions of the world. Poor access to clinical laboratory resources and screening programs to measure plasma bilirubin levels is a major contributor to delayed treatment in developing countries, and the cost of existing point-of-care screening instruments precludes their dissemination. Objectives: We are evaluating the accuracy of a low-cost, minimally invasive point-of-care system (Bilistick) requiring a 25-µl blood sample that could be used in low-resource environments to evaluate patients with neonatal jaundice. Methods: We compared plasma bilirubin levels in divided blood samples by clinical laboratories and by Bilistick at two medical centers serving term and near-term newborns from ethnically different populations. Results: 118 neonates with bilirubin levels ranging from 24.8 to 501.0 µmol/l were analyzed. The mean bilirubin concentration (±SD) was 215.6 ± 85.5 µmol/l for Bilistick and 226.1 ± 86.4 µmol/l by laboratory determination. Pearson’s correlation coefficient between all paired results was 0.961, and the Bland-Altman analysis showed a mean difference of 10.3 µmol/l with a 95% interval of agreement of –38.0 to 58.7 µmol/l. Conclusion: Bilistick is a minimally invasive method for measuring total bilirubin concentration over a wide range of values and should provide an affordable and accurate system for pre-discharge and follow-up screening of jaundiced infants, particularly in low-resource environments.

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“…In the past years we developed a skin bilirubin nomogram for the first 96 h of life in a European normal healthy population using BiliCheck™([BC] Respironics, Marietta, GA – USA) and then validated it in a prospective, observational multicenter study [18,22]. BC and JM-103 (Drager Medical Inc, Telford, Pennsylvania) reliability has been evaluated in two recently published papers [23,24]. The purpose of this study was to compare the predictive ability of BiliCheck vs JM-103 in identifying neonates not at risk of significant hyperbilirubinemia, putting the data obtained with the two instruments on our transcutaneous bilirubin nomogram built with the BiliCheck.…”

Section: Introductionmentioning

confidence: 99%

BiliCheck vs JM-103 in identifying neonates not at risk of hyperbilirubinaemia

et al. 2013

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BackgroundTranscutaneous bilirubinometry is widely used to predict hyperbilirubinemia by using several devices. The aim of this study was to compare the predictive ability of BiliCheck vs JM-103 in identifying neonates not at risk of significant hyperbilirubinemia, putting the data obtained with the two instruments on our transcutaneous bilirubin nomogram built with the BiliCheck.MethodsTranscutaneous bilirubin (TcB) measurement was performed when jaundice appeared in newborn babies and/or just before discharge from the hospital. It was performed at the forehead with the two instruments within 5 minutes by two experienced neonatologists, each one blind to the value obtained by the other. Blood samples were drawn to obtain total serum bilirubin (TSB) levels soon after TcB measurements.ResultsA total of 627 paired-sample measurements were obtained from 298 newborn babies. Out of the total population studied, 16 newborn babies (5.4%) showed significant hyperbilirubinemia defined as TSB value >17 mg/dL, or as need for phototherapy treatment according to the AAP guidelines. TcB measurements showed false negative results in the first 60 hours of life using both devices. After the 60th hour of life, TcB measurements using both devices successfully predicted newborn babies not at risk of significant hyperbilirubinemia, being the JM-103 more reliable than BC because of fewer false positive results.ConclusionsOur study shows that both BC and JM-103 can exclude subsequent significant hyperbilirubinemia when the measurements are performed after the 60th hour of life. Nevertheless, the transcutaneous pre-discharge screening should be considered only as the first step, and it has to be followed by a follow-up through the first days after discharge.

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Measuring transcutaneous bilirubin: a comparative analysis of three devices on a multiracial population

Cited by 50 publications

References 8 publications

Evaluation of the Kejian KJ‐8000 bilirubinometer in an Australian setting

Evaluation of the Kejian KJ‐8000 bilirubinometer in an Australian setting

Bilistick: A Low-Cost Point-of-Care System to Measure Total Plasma Bilirubin

BiliCheck vs JM-103 in identifying neonates not at risk of hyperbilirubinaemia

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