Neonatal Hyperbilirubinemia: Sensitivity and Specificity

Introduction: aka neonatal jaundice. Use the Bhutani nomogram ( http://www.bilitool.org ) to evaluate the risk of progression to kernicterus and requirement for phototherapy.

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Prevalence

Population / Calculator	Prevalence	Comments / Study / Link
Term newborns	60%	Clinical jaundice Clin Pediatr (Phila). 2003 Mar;42(2):153-8. PMID: 12659389
Term newborns	10%	Hyperbilirubinemia requiring phototherapy Clin Pediatr (Phila). 2003 Mar;42(2):153-8. PMID: 12659389
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The sensitivity and specificity of findings for Neonatal Hyperbilirubinemia are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Sensitive Findings
Finding	Result	Sensitivity	Specificity
[ + ] Jaundice at the Abdomen	+ 0 -	97%	19%
between the nipple line and the umbilicus, for TBili >=12.0mg/dl. Mean age = 2 days. Study: Arch Pediatr Adolesc Med. 2000 Apr;154(4):391-4. PMID: 10768679

Poorly Diagnostic Findings
Finding	Result	Sensitivity	Specificity
[ + ] Jaundice	+ 0 -	81%	71%
"clinical jaundice" by neonatologists, at ~70 hours of life. For TBili > 12mg/dl Study: Clin Pediatr (Phila). 2003 Mar;42(2):153-8. PMID: 12659389