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Abstract. Transcutaneous bilirubin (TcB) has been reported to have a high correlation with serum bilirubin. The objectives of this study were: 1) to compare the accuracy of two transcutaneous bilirubinometer (Minolto AirShields Jaundice Meter, JM103 (JM) and SpectRx, Bilicheck (BC) in estimating total serum bilirubin (TSB) levels; and 2) to assess the predictive ability of transcutaneous bilirubin in relation to specific selected TSB levels. A total of 154 measurements of TcB, using JM and BC, and TSB were recruited from 134 term and near-term infants. Postnatal ages ranged from 19 to 160 hours (x = 64.7, SD = 25.6). TSB levels ranged from 4.5 to 17.5 mg/dl (x = 10.4, SD = 2.5). The correlation coefficients between TcB (JM and BC) and TSB measurements were significant and similar (r 0.80 and 0.82, respectively). The errors of distribution were, for TSB and TcB-JM, the mean difference of 0.7 mg/dl [SD 1.6 mg/dl and 95% confidence interval of the mean (CI) 0.4 and 1.0]; and, for TSB and TcB-BC, the mean difference of -0.6 mg/dl (SD 1.5 mg/dl and 95% CI -0.4 and -0.8). TcB-JM had a tendency to underestimate TSB levels, and TcB-BC had a tendency to overestimate TSB levels. The sensitivity of BC was higher, but specificity was lower, than JM in corresponding to different TSB levels, except at a TSB level of 15 mg/dl when both instruments yielded 100% sensitivity. The accuracy of JM in predicting TSB was higher than BC at all TSB levels. Operating the JM was simple and uncomplicated. It would be suitable for clinical use when a number of personnel perform the measurement.
INTRODUCTION
Neonatal jaundice is one of the most common problems encountered in newborn infants, and infants with significant hyperbilirubinemia are at risk of developing kernicterus. To prevent this devastating condition, practice parameters for management [American Academy of Pediatrics (AAP), 1994] and nomograms to predict the severity of hyperbilirubinemia (Bhutani et al, 1999; Sarici et al, 2004) have been recommended. Total serum bilirubin (TSB) is usually determined in clinical practice to identify significant hyperbilirubinemia. The decision to obtain a blood sample for TSB relies on the subjective judgement by visual inspection of the yellowness of the skin. Transcutaneous bilirubin (TcB) measurement is more objective than visual estimation,...