Page 334 - 16Neonatal Jaundice_compressed

Neonatal jaundice

Bibliographic details Study type & Patient characteristics Test, Reference Standard, Results Reviewers Comments
Evidence level Threshold for a positive test
median BW 3295 g – range 1972 to 4720 TcB measurement Bland Altman analysis for difference
44 median GA 39 weeks – range 33 to 42 between lab TSB and TcB
median postnatal age: 72 hours – range Diagnostic accuracy of TcB
24 to 264 (various thresholds) estimated by MD = -10.6 micromol/litre (95% CI -80.0 to
Gender: Males = 50% plotting ROC curve. +60.0)
SD = Not reported
Prevalence of TSB >
250 micromol/litre = 55/300 (18.3%) Diagnostic accuracy of TcB (threshold value
> 195 micromol/litre) for detecting TSB >
Exclusion: babies who had previously 250 micromol/litre
received phototherapy
Sensitivity: 50/55 (90.9%)
Specificity: 162/245 (66.1%)
PPV: 50/133 (37.6%)
NPV: 162/167 (97%)

De Luca D; Study Type: Preterm babies with GA between 30– TcB using BiliChek from the Correlation of TcB levels with lab TSB Unselected population
Diagnostic study 36 weeks admitted in the neonatal sub- forehead – mean of 5 levels (Pearson correlation coefficient, Test & Reference test described
Year: 2007 intensive unit of tertiary hospital. measurements taken for data n = 210) adequately
Evidence Level: analysis. Test and reference test carried
Country: Ib n = 340 r = 0.79, P < 0.001 out within one hour
Italy mean BW 2145 ± 518 g Reference standard: Laboratory Blinding – yes but only
TSB levels within 10 minutes of Bland Altman analysis for difference investigator
79 mean GA 33.5 ± 1.9 weeks TcB measurement between mean lab TSB and mean TcB Data not extractable for
mean postnatal age: Not reported % with difference calculating values of TP, FP,
Gender: Males = 48.2% Diagnostic accuracy of TcB > 8.55 micromol/litre = 61.5% (209/340) TN & FN for detecting
estimated by plotting ROC curve MD = -18.8 micromol/litre hyperbilirubinaemia
Exclusion: and results given for best SD = 34.2 micromol/litre
babies receiving phototherapy or thresholds
exchange transfusion, Diagnostic accuracy of TcB (threshold value
asphyxia (Apgar score < 7 at 5 min), > 111 micromol/litre) for detecting TSB >
Rh or major ABO incompatibility, 171 micromol/litre
conjugated bilirubin
> 17.1 micromol/litre, Sensitivity: 100%
congenital malformation, Specificity: 40%
liver disease.
Diagnostic accuracy of TcB (threshold value
> 171 micromol/litre) for detecting TSB >
205 micromol/litre

Sensitivity: 100%
Specificity: 72%

Karon B; Study Type: Babies in a well-infant nursery were Test: Correlation of TcB levels with TSB levels Unselected population
Diagnostic study eligible if a serum bilirubin was ordered TcB reading from the forehead (Pearson correlation coefficient, n = 177) Test & Reference test described
Year: 2008 to assess risk of hyperbilirubinaemia. using BiliChek – mean of 5 adequately
Evidence Level: measurements taken for data Forehead Test and reference test carried
Country: USA III n = 177 analysis Diazo: r² = 0.65 out within one hour

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