Abstract
Background
This study aimed to determine the accuracy of a point-of-care Bilistick method for measuring total serum bilirubin (TSB) and its turn-around-time (TAT) against hospital laboratory methods.
Methods
This prospective study was carried out on 561 term-gestation jaundiced neonates in two Malaysian hospitals. Venous blood sample was collected from each neonate for contemporary measurement of TSB by hospital laboratories and Bilistick. TAT was the time interval between specimen collection and TSB result reported by each method.
Results
The mean laboratory-measured TSB was 194.85 (±2.844) µmol/L and Bilistick TSB was 169.37 (±2.706) µmol/L. Pearson’s correlation coefficient was: r = 0.901 (p < 0.001). The mean difference of [laboratory TSB− Bilistick TBS] was 26.48 (±29.41) µmol/L. The Bland–Altman plots show that the 95% limits of agreement (−31.1577, 84.11772) contain 94.7% (=531/561) of the difference in TSB readings. Bilistick has a 99% accuracy and 100% sensitivity to predict laboratory TSB levels of ≥80 µmol/L and ≥360 µmol/L at lower Bilistick TSB levels of ≥55 and ≥315 µmol/L, respectively. TAT of Bilistick TSB (2.0 min) was significantly shorter than TAT (105 min) of laboratory TSB (p < 0.001).
Conclusions
Bilistick has shorter TAT. The accuracy and sensitivity of Bilistick TSB for predicting laboratory TSB is high at lower cutoff levels.
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Acknowledgements
We thank the Director General of the Ministry of Health of Malaysia for giving us the permission to publish these findings, and the following doctors in Ampang Hospital and Selayang Hospital for helping us to recruit some of the patients: Li Lian Boey, Tow Swan Chiam, Koon Hau Chong, Chin Yee Chuah, Kevin Chin Zhi En, Chyi Chyi Khoo, Laavania Ganesapiran, Soon Yap Lee, Maizatul Akmar Musa, Bee Hong Tan, Eng Teck Tan, Tze Hau Yeoh, Umar Mohd Rais, Priya Lakshmy Balasubramanium, Hana Guee, and Nethiya Vengataraman. This project was funded by a research grant from the Universiti Tunku Abdul Rahman of Malaysia (Project number: IPSR/RMC/UTARRF/2016-C2/B01).
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N.Y.B.: conceptualized and planed the study, analyzed the data, and prepared the manuscript. Y.F.C.: participated in planning the study, analyzed the data, and reviewed the manuscript. Y.X.L.: recruited patients in Selayang Hospital, keyed in the data, and reviewed the manuscript. Z.Y.T.: recruited patients in the Ampang Hospital, keyed in the data, and reviewed the manuscript. L.C.H.: recruited patients in the Ampang Hospital, helped keyed in some of the data, and reviewed the manuscript. S.C.C. and Z.A.L..: participated in planning the study, supervised the recruitment of patients in the Selayang Hospital, are responsible for the validity of the data, and reviewed the manuscript.
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This project was funded by a research grant from the Universiti Tunku Abdul Rahman of Malaysia (Project number: IPSR/RMC/UTARRF/2016-C2/B01).
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Boo, NY., Chang, YF., Leong, YX. et al. The point-of-care Bilistick method has very short turn-around-time and high accuracy at lower cutoff levels to predict laboratory-measured TSB. Pediatr Res 86, 216–220 (2019). https://doi.org/10.1038/s41390-019-0304-0
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DOI: https://doi.org/10.1038/s41390-019-0304-0
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