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• W2125473313 abstract "To the Editor:The study question of Robertson et al 1Robertson AF Karp VVB Brodersen R Comparison of the bilirubin concentration and the bilirubin/albumin ratio with the bilirubin-binding ability in neonatal serum.J Pediatr. 1998; 132: 343-344Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar “Is the bilirubin/albumin ratio correlated more closely than the bilirubin concentration to the bilirubin-binding ability of newborn serum?” contains a fatal flaw. The bilirubin concentration, bilirubin/albumin ratio, and the “reserve” albumin binding capacity (RAC), the authors’ measure of serum bilirubin binding with which the first 2 variables are to be correlated, are all mathematically related through the law of mass action.Correlation, unfortunately, cannot be applied to mathematically related variables.2Zar JH Biostatistical analysis.in: Prentice Hall, Englewood Cliffs (NJ)1974: 199Google ScholarThe authors measure RAC with the deputy ligand MADDS that binds weakly at the bilirubin-albumin binding site. 3Broderson R Determination of the vacant amount of high-affinity bilirubin binding site on serum albumin.Acta Pharmacol Toxicol. 1978; 42: 153-158Crossref PubMed Scopus (27) Google Scholar If m is the fraction of bilirubin bound to albumin at MADDS binding sites and n is the number of MADDS binding sites per albumin molecule, the RAC, bilirubin, and albumin are related by: RAC = n·Albumin – m·Bilirubin.This equation can be rearranged to give both the bilirubin and bilirubin/ albumin ratio as functions of the RAC:Bilirubin will correlate randomly with RAC unless n·albumin and m are constant. Because neither was constant, as expected, the bilirubin versus RAC correlation coefficient was small and positive. The bilirubin/albumin ratio would be expected to correlate negatively with RAC, but the robustness would likely be poor because of the intersample variability in albumin, m, and n. The authors, indeed, found a negative small correlation coefficient. It is very important that clinicians do not misinterpret the poor correlation between the variables in this study as evidence that the bilirubin/albumin ratio offers no more information than the bilirubin itself regarding bilirubin binding when they are evaluating jaundiced newborns. To the Editor:The study question of Robertson et al 1Robertson AF Karp VVB Brodersen R Comparison of the bilirubin concentration and the bilirubin/albumin ratio with the bilirubin-binding ability in neonatal serum.J Pediatr. 1998; 132: 343-344Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar “Is the bilirubin/albumin ratio correlated more closely than the bilirubin concentration to the bilirubin-binding ability of newborn serum?” contains a fatal flaw. The bilirubin concentration, bilirubin/albumin ratio, and the “reserve” albumin binding capacity (RAC), the authors’ measure of serum bilirubin binding with which the first 2 variables are to be correlated, are all mathematically related through the law of mass action.Correlation, unfortunately, cannot be applied to mathematically related variables.2Zar JH Biostatistical analysis.in: Prentice Hall, Englewood Cliffs (NJ)1974: 199Google ScholarThe authors measure RAC with the deputy ligand MADDS that binds weakly at the bilirubin-albumin binding site. 3Broderson R Determination of the vacant amount of high-affinity bilirubin binding site on serum albumin.Acta Pharmacol Toxicol. 1978; 42: 153-158Crossref PubMed Scopus (27) Google Scholar If m is the fraction of bilirubin bound to albumin at MADDS binding sites and n is the number of MADDS binding sites per albumin molecule, the RAC, bilirubin, and albumin are related by: RAC = n·Albumin – m·Bilirubin.This equation can be rearranged to give both the bilirubin and bilirubin/ albumin ratio as functions of the RAC:Bilirubin will correlate randomly with RAC unless n·albumin and m are constant. Because neither was constant, as expected, the bilirubin versus RAC correlation coefficient was small and positive. The bilirubin/albumin ratio would be expected to correlate negatively with RAC, but the robustness would likely be poor because of the intersample variability in albumin, m, and n. The authors, indeed, found a negative small correlation coefficient. It is very important that clinicians do not misinterpret the poor correlation between the variables in this study as evidence that the bilirubin/albumin ratio offers no more information than the bilirubin itself regarding bilirubin binding when they are evaluating jaundiced newborns. The study question of Robertson et al 1Robertson AF Karp VVB Brodersen R Comparison of the bilirubin concentration and the bilirubin/albumin ratio with the bilirubin-binding ability in neonatal serum.J Pediatr. 1998; 132: 343-344Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar “Is the bilirubin/albumin ratio correlated more closely than the bilirubin concentration to the bilirubin-binding ability of newborn serum?” contains a fatal flaw. The bilirubin concentration, bilirubin/albumin ratio, and the “reserve” albumin binding capacity (RAC), the authors’ measure of serum bilirubin binding with which the first 2 variables are to be correlated, are all mathematically related through the law of mass action. Correlation, unfortunately, cannot be applied to mathematically related variables.2Zar JH Biostatistical analysis.in: Prentice Hall, Englewood Cliffs (NJ)1974: 199Google Scholar The authors measure RAC with the deputy ligand MADDS that binds weakly at the bilirubin-albumin binding site. 3Broderson R Determination of the vacant amount of high-affinity bilirubin binding site on serum albumin.Acta Pharmacol Toxicol. 1978; 42: 153-158Crossref PubMed Scopus (27) Google Scholar If m is the fraction of bilirubin bound to albumin at MADDS binding sites and n is the number of MADDS binding sites per albumin molecule, the RAC, bilirubin, and albumin are related by: RAC = n·Albumin – m·Bilirubin. This equation can be rearranged to give both the bilirubin and bilirubin/ albumin ratio as functions of the RAC: Bilirubin will correlate randomly with RAC unless n·albumin and m are constant. Because neither was constant, as expected, the bilirubin versus RAC correlation coefficient was small and positive. The bilirubin/albumin ratio would be expected to correlate negatively with RAC, but the robustness would likely be poor because of the intersample variability in albumin, m, and n. The authors, indeed, found a negative small correlation coefficient. It is very important that clinicians do not misinterpret the poor correlation between the variables in this study as evidence that the bilirubin/albumin ratio offers no more information than the bilirubin itself regarding bilirubin binding when they are evaluating jaundiced newborns." @default.
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