Page 298 - 16Neonatal Jaundice_compressed

Neonatal jaundice

Bibliographic details Study type & Patient characteristics Test, Reference Standard, Results Reviewers Comments
Evidence level Threshold for a positive test
Sensitivity: 97.1% (67/69)
Specificity: 19.0% (33/174)
PPV: 32.2% (67/208)
NPV: 94.3% (33/35)

Madlon-Kay DJ; Study Type: Newborn babies delivered in a hospital 1) Clinical assessment by nurses TSB levels (micromol/litre) Unselected population
Diagnostic study with follow-up visit at home by Home with their usual method (e.g All babies (n = 164) Test & Reference test described
Year: 2001 Health Nurses. blanching skin, judging degree of Mean (sd) 125 (80) in detail
Evidence Level: yellowness with caudal Range: 12 to 345 Test and reference test carried
Country: USA II (n = 164, progression, looking for jaundice at out within one hour
mean GA: Not reported sclera, gums, nose) Babies assessed to be jaundiced by nurses Blinding – not specified
59 mean BW: Not reported (n = 82) Data not extractable for
mean age at assessment 6.4 ± 2.5 days) 2) Caudal progression of jaundice Mean (sd): 180 (68.4) calculating exact values of TP,
alone as assessed by nurses FP, TN & FN
Gender: Not reported Babies assessed not to be jaundiced by

Ethnicity (nurse determination) 3) Ingram Icterometer reading from nurses (n = 82) Funding: Ramsey Foundation
white = 60% nose Mean (sd): 72 (46)

Threshold for diagnostic accuracy –
black = 18% reading > 2.5 Comparison 1:
Asian = 6%
Hispanic = 7%
Other = 9% Reference standard: Laboratory Correlation of estimated TSB levels with lab
TSB (Pearson correlation coefficient, n = 82
TSB levels within 1 hr
where sampling done)
Exclusion: babies who were in intensive
care nursery or received phototherapy, r = 0.61, P < 0.01
Also babies whose mothers lived more
than 10 miles from hospital or were not
proficient in English Comparison 2:

Correlation of estimated TSB levels with lab
Babies examined by 12 home health TSB (Pearson correlation coefficient, n = 82
nurses.
where sampling done)
r = 0.47, P < 0.01

Accuracy of test (caudal progression to
nipple line) in detecting TSB
> 205 micromol/litre (N = Not reported)
Sensitivity: 76%
Specificity: 60%

Comparison 3:

Correlation of estimated TSB levels with lab
TSB (Pearson correlation coefficient, n = 82
where sampling done)
r = 0.48, P < 0.01

Accuracy of test in detecting TSB

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