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Diagnosis
Clinical examination could not accurately predict neonatal jaundice

https://doi.org/10.1136/ebm.5.6.187

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    (2000) Arch Pediatr Adolesc Med 154, 391. Moyer VA, Ahn C, Sneed S.. Accuracy of clinical judgment in neonatal jaundice.. Apr;. :. –4.
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 QUESTION: How accurate are clinicians in assessing neonatal jaundice?

    Design

    Blinded comparison of clinicians' visual observations with serum bilirubin test results.

    Setting

    Well newborn nursery of a hospital in Houston, Texas, USA.

    Patients

    122 healthy full term infants (mean age 2 d, 54% boys).

    Description of tests and diagnostic standard

    The infants were observed by 2 clinicians independently (paediatric resident, nurse practitioner, or attending physician) under fluorescent lighting near a window. The clinicians assessed jaundice as being absent, slight, or obvious for prespecified body zones starting at the head and progressing down the body. The record of each clinical assessment was placed in a sealed envelope before the serum bilirubin test was done.

    Main outcome measures

    Agreement between the 2 observers and correlation with serum bilirubin concentrations. The cut point for clinically significant …

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    Footnotes

    • Source of funding: no external funding.

    • For correspondence: Dr V A Moyer, Department of Pediatrics, University of Texas–Houston Health Science Center, 5656 Kelley Street, Houston, TX 77026, USA. Fax +1 713 636 5844.