Page 708 - 16Neonatal Jaundice_compressed

Neonatal jaundice

Health Technology Appraisal (HTA) A health technology appraisal, as undertaken by NICE, is the process
of determining the clinical and cost-effectiveness of a health
technology. NICE health technology appraisals are designed to
provide patients, health professionals and managers with an
authoritative source of advice on new and existing health
technologies.
Heterogeneity Or lack of homogeneity. The term is used in meta-analyses and
systematic reviews when the results or estimates of effects of
treatment from separate studies seem to be very different – in terms of
the size of treatment effects or even to the extent that some indicate
beneficial and others suggest adverse treatment effects. Such results
may occur as a result of differences between studies in terms of the
patient populations, outcome measures, definition of variables or
duration of follow-up.
Hierarchy of evidence An established hierarchy of study types, based on the degree of
certainty that can be attributed to the conclusions that can be drawn
from a well conducted study. Well-conducted randomised controlled
trials (RCTs) are at the top of this hierarchy. (Several large statistically
significant RCTs which are in agreement represent stronger evidence
than say one small RCT.) Well-conducted studies of patients’ views
and experiences would appear at a lower level in the hierarchy of
evidence.
Homogeneity This means that the results of studies included in a systematic review
or meta analysis are similar and there is no evidence of
heterogeneity. Results are usually regarded as homogeneous when
differences between studies could reasonably be expected to occur
by chance. See also Consistency.
Hyperbilirubinaemia Raised levels of bilirubin in the blood.
Hyperbilirubinaemia, significant An elevation of serum bilirubin to a level requiring treatment (see key
terms 1.1
Hyperglycaemia Raised level of glucose in the bloodstream.
Hyperkalaemia A high serum potassium concentration
Hypernatraemia An electrolyte disturbance in which the sodium concentration in the
plasma is too high
Hyper-reflexia Overactive or over-responsive reflexes.
Hypertonicity (hypertonia) High muscle tension, when used to describe clinical examination
findings.
Hypoglycaemia Lowered levels of glucose in the bloodstream.
Hyponatraemia Lowered levels of is sodium concentration in the bloodstream
Icterometer A tool for estimating the level of jaundice. It consists of strips of
perspex with varying degrees of yellow colour shown in bands.
These are placed against the baby’s skin and the colour closest to the
baby’s skin colour is used to indicates the severity of the jaundice.
Indirect bilirubin See Unconjugated bilirubin
In depth interview A qualitative research technique. It is a face to face conversation
between a researcher and a respondent with the purpose of exploring
issues or topics in detail. Does not use pre-set questions, but is
shaped by a defined set of topics or issues.
Information bias Pertinent to all types of study and can be caused by inadequate
questionnaires (e.g. difficult or biased questions), observer or
interviewer errors (e.g. lack of blinding), response errors (e.g. lack of
blinding if patients are aware of the treatment they receive) and
measurement error (e.g. a faulty machine).

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