Abstract
As a screening device for hyperbilirubinemia, we compared the Minolta Janudice Meter (M) with the 30 year old Ingram icterometer (Ic). The M is a fiberoptic reflectometer marketed as a device to identify infants whose degree of jaundice indicates the need for chemical serum bilirubin estimation. The inexpensive Ic (appros. $10) consists of a strip of transparent plexiglass on which are painted 5 yellow stripes of precise and graded hue. In use, the color of the baby's skin is matched with the stripes and a jaundice score assigned. 120 serum bilirubin values were obtained by A.C.A. Dupont Analyzer because of visible jaundice in a population of term, healthy Caucasian newborns. Under controlled, artificial light, first the Ic then the M was used on each baby. Defining hyperbilirubinemia as > 12.9 mg/dl the sensitivity and specifity of each device was determined. For 120 trials the Ic had a sens. of .86 and a spec. of .75. The M had a sens. of .95 and spec. of .77. 2 of 3 false negatives with the Ic occurred in the first 4 measurements, a time when familiarity with the insturment was being obtained. The last 116 measurements produced a sens. of .95, spec. of .74 for the Ic and a sens. of .95, spec. of .77 for the M. Although serial individual assessment was consistent, interobserver variation was significant. With the Ic as with the M, we would suggest that individuals establish their own action levels prior to reliable usage. We conclude that in spite of the availability of more complex and expensive instruments, for the individual clinician, the Ic continues to serve as a sensitive, cost effective screening device for hyperbilirubinemia.
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