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BiliCheck transcutaneous bilirubinometer: a screening tool for neonatal jaundice in the Chinese population
EYW Ho, SYR Lee, CB Chow, JWY Chung
Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Laichikok, Hong Kong
OBJECTIVE. To verify the usefulness of the BiliCheck
transcutaneous bilirubin meter as a screening device for neonatal
jaundice in a Chinese population compared with the Minolta bilirubin
meter.
DESIGN. A prospective correlation study that compared
transcutaneous bilirubin measurements with serum bilirubin levels.
SETTING. Obstetric ward and a neonatal unit of a
regional hospital in Hong Kong.
PATIENTS. Neonates with gestation above 32 weeks
with neonatal jaundice who were admitted between April 2001 and
February 2002.
MAIN OUTCOME MEASURES. Transcutaneous measurements
of serum bilirubin obtained from the forehead and the sternum with
two instruments: BiliCheck and Minolta Airshields JM 102.
RESULTS. A total of 77 term and six near-term babies
(gestation, 32-37 weeks) were recruited. The mean age at the time
of data collection was 3.96 days (range, 2-9 days). The correlations
between serum bilirubin and transcutaneous bilirubin measurements
of the two devices at the two sites were high, with a coefficient
of 0.718 (95% confidence interval, 0.610-0.800; n=100) for forehead
measurements, and 0.814 (95% confidence interval, 0.740-0.870; n=99)
for sternum using the Minolta Airshields JM 102; and a coefficient
of 0.757 (95% confidence interval, 0.657-0.827; n=98) for forehead
measurements, and 0.794 (95% confidence interval, 0.700-0.862; n=92)
for sternum using the BiliCheck. For BiliCheck, a cut-off point
of 250 micromol/L at the forehead and 260 micromol/L at the sternum
had a specificity of 61.9% and 70.0%, respectively with a sensitivity
of 100% for the detection of serum bilirubin concentrations of 250
micromol/L or higher. This level is commonly used as the level for
initiation of treatment such as phototherapy.
CONCLUSION. BiliCheck is a useful screening tool
for neonatal jaundice in the Chinese population and is comparable
with the Minolta Airshields JM 102.
Hong Kong Med J 2006;12:99-102
Key words: Bilirubin/blood; Comparative study; Infant, newborn; Jaundice, neonatal; Neonatal screening
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