Page 286 - 16Neonatal Jaundice_compressed

Neonatal jaundice

Bibliographic details Study type & Patient characteristics Test, Reference Standard, Results Reviewers Comments
Evidence level Threshold for a positive test
Gender: Males = 50% SD = Not reported

Prevalence of TSB > Diagnostic accuracy of TcB (threshold value
250 micromol/litre = 55/300 (18.3%) > 195 micromol/litre) for detecting TSB >
250 micromol/litre
Exclusion: babies who had previously
received phototherapy Sensitivity: 50/55 (90.9%)
Specificity: 162/245 (66.1%)
PPV: 50/133 (37.6%)
NPV: 162/167 (97%)

Briscoe L; Study Type: Babies > 34 weeks who were having TcB reading using Minolta JM-102 Correlation of JM-102 with lab TSB levels Unselected population
Diagnostic study blood taken for any reason, mostly at the forehead (Pearson correlation coefficient, n = 303) Test & Reference test described
Year: 2002 done for clinical jaundice. (mean of 3 readings used for in detail
Evidence Level: II analysis) r = 0.76, P < 0.0001 Test and reference test carried
Country: n = 303 out within one hour
UK median BW 3267 g - range 1800– Reference standard: Laboratory Diagnostic accuracy of JM-102 for detecting Blinding – not specified
5008 TSB levels measured concurrently TSB > 249 micromol/litre (n = 303) Data not extractable for
46 median GA 39 weeks - range 34–42 calculating values of TP, FP,
median age at presentation: 3 – range For diagnostic accuracy: Area under ROC = 0.89 TN & FN
0 to 13 days Area under ROC curve calculated
Gender: Not reported for detecting TSB Predictive accuracy of JM-102 value 19.9
> 249 micromol/litre (highest accuracy from ROC curve)
Ethnicity
White: 94.7% Sensitivity: 86% (81–89%)
Specificity: 78% (73–83%)
PPV: Not reported
Prevalence of TSB > NPV: Not reported
300 micromol/litre = 3.3% (10/303)

Exclusion: babies who had previously In this study a reading of > 18 reflectance
units was taken as an indicator for serum
received phototherapy bilirubin, resulting in a reduction of 34% in
the number of blood samples taken.

Bhutani VK; Study Type: All babies born from 01 January 1990 Incremental hospital systems Incidence of adverse outcomes for term and Non-comparative observational
Observational study to 31 December 2000 who were approach in the management of near-term infants in the well-baby nursery study
Year: 2006 discharged from the well-baby neonatal hyperbilirubinaemia Hospital-based intensive phototherapy Time periods of different
Evidence Level: III nursery of a tertiary hospital as term studied with different clinical Phase 1: 3.6% clinical approaches
Country: USA and near-term healthy babies. approaches at different phases: Phase 2: 4.5% overlapping. Confounding
Phase 1: Phase 3: 5.4% variables not adjusted
47 n = 31 059 selective pre-discharge TSB Phase 4: 2.5%
mean BW: 3318 ± 457 g mean GA: measurements (1990–1992) Phase 5: 1.3%
Phase 2:
38.7 ± 1.3 weeks universal TSB measurement at the Exchange transfusion
Gender: Males = Not reported time of metabolic screening with an (in risk)
authority given to nurses (after in- Phase 1: 1:2137
Ethnicity: service workshops and training) to Phase 2: 1:1322
White = 43.5% obtain bilirubin estimation at their Phase 3: 1:1637

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