Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Institute of Health Economics. Transcutaneous bilirubinometry for the screening of neonatal hyperbilirubinemia ≥35 weeks' gestation. Edmonton: Institute of Health Economics (IHE). 2013 Authors' conclusions Early hospital discharge policies have resulted in increased hospital readmission rates of healthy term or late preterm neonates for phototherapy and in a resurgence of kernicterus—a serious neurological damage. Timely identification of neonates at high risk for severe neonatal hyperbilirubinemia is encouraged as a preventive strategy.
TcB, a rapid, non-invasive, point-of-care test for predicting neonatal hyperbilirubinemia, has undergone clinical investigation in different countries and clinical settings for its reliability and accuracy. Performance of TcB in predicting hyperbilirubinemia, as measured by BiliCheck or JM-103 devices, has been examined in term or late-preterm neonates from various ethnic origins.
Research findings suggested that TcB is a safe procedure. TcB cannot replace TSB but can be considered a valid screening tool to determine the need for a confirmatory TSB test. A TcB cut-off of ≥75th percentile at 48 to 72 hours of age (pre-discharge) is a good predictor of TSB of ≥95th percentile. TcB appears to be a promising technology and may be a useful addition to clinical assessment in the screening of neonatal jaundice.
Evidence from five studies (one conducted in Canada) suggested that the implementation of a TcB screening program was associated with a reduction in the number of TSB tests but without an increase in the incidence of significant neonatal hyperbilirubinemia.
Several aspects should be taken into consideration when planning to implement a universal TcB screening program, including the availability and cost of TcB devices, the need to develop a local TcB nomogram, the selection of appropriate TcB cutoff values (a balance between 100% sensitivity with low specificity and maximal screening accuracy), the appropriate quality assurance, training, and education of personnel, and the impact on the demand for community resources. Indexing Status Subject indexing assigned by CRD MeSH Diagnostic Techniques, Obstetrical and Gynecological; Humans; Hyperbilirubinemia, Neonatal; Infant, Newborn Language Published English Country of organisation Canada English summary An English language summary is available. Address for correspondence #1200, 10405 Jasper Avenue, Edmonton, AB T5J 3N4, Canada. Tel: +1 780 448 4881, Fax: +1 780 448 0018 Email: info@ihe.ca AccessionNumber 32013000856 Date abstract record published 02/12/2013 |