Page 266 - 16Neonatal Jaundice_compressed

Neonatal jaundice

Bibliographic details Study type & Patient characteristics Test, Reference Standard, Results Reviewers Comments
Evidence level Threshold for a positive test
Cases: Babies with maximum TSB early jaundice cases. age more than 7 days at the time of highest adequately
levels = 428 micromol/litre within the TSB levels, Reference test a standard test
first 30 days after birth (n = 67) Predictive accuracy compared by average number of TSB tests per patient, Blinding – Not reported
Controls: Random sample of babies the c-statistic (equal to area under length of hospitalisation stay
from the cohort with maximum TSB ROC curve) and treatment with phototherapy
levels = 428 micromol/litre (n = 208)
Study 2: Accuracy of Modified risk index score (with
Mean BW: Not reported Test 1 exclusion of family HISTORY OF jaundice)
Mean GA: Not reported Partial clinical risk index derived in predicting significant hyperbilirubinaemia
Gender: Not reported from Risk index in Study 1 by (with 95% CI)
Ethnicity: Not reported deleting factors family history of
jaundice, breastfeeding, bruising 1997–1998 cohort
Study 2: and by substituting scalp injury in c-statistic 0.83 (95% CI 0.77 to 0.89)
All infants with BW = 2000 g and medical records with
GA = 36 weeks born alive at 11 cephalohaematoma. 1995–96 cohort
hospitals of a health maintenance c-statistic 0.84 (95% CI 0.79 to 0.89)
organisation during a four year period, Test 2
and who had TSB measured at TSB levels measured at < 48 hours Study 2:
< 48 hours of age (n = 5706) and classified into 4 age-specific Prevalence of hyperbilirubinaemia
percentile groups
Mean BW: Not reported < 40 centile, 230/5,706 (4.7%)
th
Mean GA: Not reported th th
Gender: Not reported 40 to < 75 centile,
th
th
Ethnicity: Not reported 75 to < 95 centile, Risk of developing TSB levels >
th 342 micromol/litre based on TSB percentile
group
Exclusion criteria: > 95 centile).
Babies developing TSB levels
> 342 micromol/litre at < 48 hours The data was then transformed into < 40th centile = 0.5
hour-specific z scores 40 to < 75th centile = 0.7
th
75th to < 95th centile = 3.3
Reference standard
Significant Hyperbilirubinaemia ≥ 95th centile = 13.8
defined as maximum TSB
levels = 342 micromol/litre Accuracy of tests in predicting
hyperbilirubinaemia (TSB
levels = 342 micromol/litre

Partial risk index score
c-statistic 0.69

TSB centile group
c-statistic 0.79

TSB z score
c-statistic 0.83

TSB z score + Partial risk index score
c-statistic 0.86

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