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Appendix H: Evidence tables
How useful are the following tests in predicting neonatal hyperbilirubinaemia?
Prediction of hyperbilirubinaemia (diagnostic accuracy)
Bibliographic details Study type & Patient characteristics Test, Reference Standard, Results Reviewers Comments
Evidence level Threshold for a positive test
Knupfer M; Study Type: Healthy babies with GA > 34 weeks Test: Mean UCB (micromol/litre) Unselected population
Diagnostic study cared for in a maternity ward of a Umbilical cord blood bilirubin Test and Reference described
Year: 2005 University hospital. The study (UCB) measured within 2 hours of Group 1: 32.4 ± 9.2 adequately
Evidence Level: II population divided into 3 groups: storage in amber Group 2: 31.7 ± 9.1 Reference test a standard one
Country: Germany Group 1: Term appropriate for Blinding – Not reported
gestational age Threshold values Group 3: 30.9 ± 6.7
30 n = 1100 < 20 micromol/litre
mean GA 39.6 ± 1.1 weeks mean 20–30 micromol/litre Comparison of prevalence of
30–40 micromol/litre hyperbilirubinaemia in Group 1, 2 and 3 (in
BW 3562 ± 418 g > 40 micromol/litre %)
Gender: Not reported
Ethnicity: Not reported Reference standard: With TSB > 250 micromol/litre
TcB from forehead every morning 10.6 vs 9.8 vs 25.6
Group 2: Term small for for 4 days and laboratory TSB
gestational age performed if TcB index > 16. With TSB > 300 micromol/litre
n = 163 3.0 vs 3.1 vs 6.4
mean GA 39.4 ± 1.2 weeks Diagnostic accuracy also calculated
for predicting TSB levels requiring Treated with phototherapy
mean BW 2683 ± 274 g phototherapy 3.4 vs 10.4 vs 47.7
Gender: Not reported
Ethnicity: Not reported Diagnostic accuracy of UCB (threshold >
30 micromol/litre) in predicting TSB >
Group 3: Preterm 300 micromol/litre
n = 78 Group 1:
mean GA 35.3 ± 0.8 weeks Prevalence: 33/1100 (3.0%)
Sensitivity: 32/33 (97%)
mean BW 2578 ± 437 g Specificity: 442/1067 (41.4%)
Gender: Not reported PPV: 32/657 (4.9%)
Ethnicity: Not reported NPV: 442/443 (99.8%)
Exclusion: Group 2:
th
discharge before 4 postnatal day, Prevalence: 5/163 (3.1%)
significant illness followed by special Sensitivity: 5/5 (100%)
therapy such as antibiotics, CPAP or Specificity: 70/158 (44.3%)
artificial ventilation PPV: 5/93 (5.4%)
NPV: 70/70 (100%)
Group 3:
Prevalence: 5/78 (6.4%)
Sensitivity: 5/5 (100%)
Specificity: 32/73 (43.8%)
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