Faculty Collaboration Database

Performance of bilirubin determinations in US laboratories--revisited. Clin Chem 2004 Jan;50(1):190-4

Date

11/25/2003

Pubmed ID

14633931

DOI

10.1373/clinchem.2003.019216

Scopus ID

2-s2.0-1642533460 (requires institutional sign-in at Scopus site)   40 Citations

Abstract

BACKGROUND: The diagnosis and management of hyperbilirubinemia in the newborn requires accurate and precise bilirubin determinations. We evaluated the current status of bilirubin measurements in US laboratories by examining data submitted by laboratories participating in the College of American Pathologists (CAP) Neonatal Bilirubin (NB) and Chemistry (C) Surveys.

METHODS: We analyzed specimens from the CAP NB and C Surveys by the reference method for total bilirubin in three laboratories. The reference method bilirubin values were compared with bilirubin values reported by Survey participants.

RESULTS: The imprecision (CV) for all instruments combined (CAP-All Instruments) ranged from 4.7% to 5.6% at the bilirubin concentrations tested. The CVs of the four most commonly used instruments were smaller, ranging from 1.9% to 4.5%. Differences between bilirubin values by the reference method and mean values from the four most common instruments ranged from -21.6% to 10.9%. When the same specimens from the NB Surveys were used in the C Surveys, the Vitros values were strikingly different from those of the NB Surveys. The use of different methods in the NB and C Surveys coupled with the presence of a nonhuman protein base and ditaurobilirubin (DTB) in the Survey specimens accounted for the discrepant results.

CONCLUSIONS: The evaluation of accuracy is impossible from the CAP Surveys because the specimens consist of bovine serum containing a mixture of unconjugated bilirubin and DTB. For the evaluation of accuracy, we recommend that Survey specimens consist of human serum enriched with unconjugated bilirubin.

Author List

Lo SF, Doumas BT, Ashwood ER

Author

Stanley F. Lo PhD Professor in the Pathology and Laboratory Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Bilirubin
Blood Chemical Analysis
Blood Specimen Collection
Humans
Hyperbilirubinemia
Infant, Newborn
Quality Control
Reference Standards
United States