Page 302 - 16Neonatal Jaundice_compressed

Neonatal jaundice

Bibliographic details Study type & Patient characteristics Test, Reference Standard, Results Reviewers Comments
Evidence level Threshold for a positive test

Madlon-Kay DJ; Study Type: Babies with age > 2 days in a normal 1) Clinical estimation of degree of Prevalence of hyperbilirubinaemia Study population selected by
Diagnostic study newborn nursery.in a teaching hospital jaundice and cephalo-caudal (TSB = 205 micromol/litre convenience sampling
Year: 1997 progression by nurses and 11/89 (12.3%) Test & Reference test described
Evidence Level: (n = 171 physicians by blanching the skin. in detail
Country: USA II mean GA 39 weeks) (36 nurses, 20 family physicians Correlation of estimated TSB levels with lab Test and reference test carried
mean BW: Not reported and 4 paediatricians) TSB values after adjusting for various out within one hour, but
57 Gender: Not reported confounding factors like level of training, reference test (laboratory TSB)
2) Clinical assessment of jaundice race, etc (Pearson correlation coefficient) not conducted in all babies
Maternal ethnicity by the parents after receiving (89/171)
white = 50% written and verbal instructions Nurse estimate of TSB Blinding – yes
black = 24% about the process r = 0.52, P < 0.001 Data not extractable for
Asian = 13% (147 parents with 81% having calculating exact values of TP,
Hispanic = 9% English as the primary language Nurse assessment of cephalo-caudal FP, TN & FN
Other = 4% and 46% having completed high progress
school) r = 0.48. P < 0.05
Exclusion: babies who received
phototherapy, and whose parents were 3) Ingram Icterometer readings Physician estimate of TSB
unable to read and understand the from nose (n = 132 readings) r = 0.55, P < 0.05
instruction form
Reference standard: Laboratory Physician assessment of cephalo-caudal
TSB levels within 1 hr progress
r = 0.35. p > 0.05
Correlation between the estimated
and the observed TSB values Parent assessment of cephalo-caudal
determined before and after progress
adjusting for various factors r = 0.71, P < 0.01

Icterometer
r = 0.57, P = 0.002

Szabo P; Study Type: Healthy preterm babies 34–37 weeks 1) Clinical assessment by nurses Comparison 1: Unselected population
Diagnostic study with BW > 2000 g and no older than and primary investigator using Test & Reference test described
Year: 2004 6 days in maternity ward and Kramer criterion Correlation of estimated TSB levels with lab in detail
Evidence Level: intermediate care neonatal unit. TSB (Pearson correlation coefficient, Test and reference test carried
Country: II 2) TcB using Minolta JM-102 at n = 107 observations) out within one hour
Switzerland n = 69, the sternum By nurses Blinding – not specified
median GA: 35.7 weeks – range 34 to (mean of two readings used for 2 Data not extractable for
55 36.9 weeks analysis) R = 0.22, P < 0.01 calculating values for TP, FP,
median BW 2530 g – range 2050 to By primary investigator TN & FN
2
3630 g 3) TcB using BiliChek at the R = 0.20, P < 0.01
Gender: Not reported forehead and sternum
(mean of 5 readings used for Diagnostic accuracy for detecting TSB
Ethnicity analysis) > 190 micromol/litre (Area under ROC
white = 87% curve, N = Not reported)

224