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ABSTRACT: Background
Since most infants are usually discharged before age 48-72 hours, peak bilirubin levels will almost always occur after discharge. Parents may be the first to observe the onset of jaundice after discharge, but visual assessment is unreliable. The jaundice colour card (JCard) is a low-cost icterometer designed for the assessment of neonatal jaundice. The objective of this study was to evaluate parental use of JCard to detect jaundice in neonates.Methods
We conducted a multicentre, prospective, observational cohort study in nine sites across China. A total of 1161 newborns ≥35 weeks of gestation were enrolled in the study. Measurements of total serum bilirubin (TSB) levels were based on clinical indications. The JCard measurements by parents and paediatricians were compared with the TSB.Results
JCard values of parents and paediatricians were correlated with TSB (r=0.754 and 0.788, respectively). The parents' and paediatricians' JCard values 9 had sensitivities of 95.2% vs 97.6% and specificities of 84.5% vs 71.7% for identifying neonates with TSB ≥153.9 µmol/L. The parents' and paediatricians' JCard values 15 had sensitivities of 79.9% vs 89.0% and specificities of 66.7% vs 64.9% for identifying neonates with TSB ≥256.5 µmol/L. Areas under the receiver operating characteristic curves of parents for identifying TSB ≥119.7, ≥153.9, ≥205.2, and ≥256.5 µmol/L were 0.967, 0.960, 0.915, and 0.813, respectively, and those of paediatricians were 0.966, 0.961, 0.926 and 0.840, respectively. The intraclass correlation coefficient was 0.933 between parents and paediatricians.Conclusion
The JCard can be used to classify different levels of bilirubin, but it is less accurate with high bilirubin levels. The JCard diagnostic performance of parents was slightly lower than that of paediatricians.
SUBMITTER: Xue G
PROVIDER: S-EPMC10314627 | biostudies-literature | 2023 Jun
REPOSITORIES: biostudies-literature
Xue Guochang G Zhang Huali H Ding Xuexing X Xiong Fu F Liu Yanhong Y Peng Hui H Wang Changlin C Zhao Yi Y Yan Huili H Ren Mingxing M Ma Chaoying C Lu Hanming H Li Yanli Y Meng Ruifeng R Xie Lingjun L Chen Na N Cheng Xiufang X Wang Jiaojiao J Xin Xiaohong X Wang Ruifen R Jiang Qi Q Zhang Yong Y Liang Guijuan G Li Yuanzheng Y Kang Jianing J Zhang Huimin H Zhang Yinying Y Yuan Yuan Y Li Yawen Y Su Yinglin Y Liu Junping J Duan Shengjie S Liu Qingsheng Q Wei Jing J
BMJ paediatrics open 20230601 1
<h4>Background</h4>Since most infants are usually discharged before age 48-72 hours, peak bilirubin levels will almost always occur after discharge. Parents may be the first to observe the onset of jaundice after discharge, but visual assessment is unreliable. The jaundice colour card (JCard) is a low-cost icterometer designed for the assessment of neonatal jaundice. The objective of this study was to evaluate parental use of JCard to detect jaundice in neonates.<h4>Methods</h4>We conducted a mu ...[more]