INVESTIGATING THE ACCURACY OF AN UPGRADED TRANSCUTANEOUS BILIRUBIN SCREENING TOOL BY SITE OF TESTING
Bibliographic record
Abstract
BACKGROUND: Severe neonatal hyperbilirubinemia continues to occur in healthy term infants. The incidence has decreased as a result of guidelines by the Canadian Pediatric Society (CPS) and American Academy of Pediatrics (AAP), requiring all healthy newborns to receive either a transcutaneous bilirubin (TCB) or total serum bilirubin (TSB) at discharge. Several studies have investigated the effectiveness of TCB tools. However, discrepancies still exist on the agreement between TCB and TSB by site and treatment. OBJECTIVES: The aim of this study was to determine the accuracy and agreement of TCB and TSB by site and treatment using the JM-105. DESIGN/METHODS: A multi-site prospective clinical trial of term infants requiring TSB measurements. Pearson’s correlation coefficient was used to determine the accuracy between TSB and TCB measurements by site and treatment. Bland-Altman Plots of the agreement between TSB and TCB values by site and treatment were generated. RESULTS: Paired TSB and TCB measurements from the forehead and sternum were collected from 75 term infants between 36-44 weeks gestational age. Bland-Altman Plots by site demonstrated the mean difference between TSB and TCB on the forehead to be -1.72 μmol/L ± 24.64 μmol/L (-66.7 μmol/L to 49.00 μmol/L) and sternum to be 1.2 μmol/L ± 37.99 μmol/L (-82.00. μmol/L to 136.33 μmol/L). The mean TSB level was 131.43 μmol/L ± 54.88 μmol/L (31 μmol/L – 285 μmol/L), mean TCB level on the forehead was 132.40 μmol/L ±57.029 μmol/L,(19 μmol/L-284.5 μmol/L) and mean TCB level on the sternum was 121.32 μmol/L ±58.27 μmol/L, (13.5 μmol/L-261.6 μmol/L). Paired t-tests revealed no significant mean differences between TCB and TSB measurements by site and treatment. The correlation between the TSB and TCB values from the forehead (Pearson’s correlation r =0.877, p<0.01) were higher than the correlation between TSB and TCB values from the sternum (r= 0.646, p<0.01). The correlation between TSB and TCB values on the forehead (r=0.879, p<0.01) and sternum (r=0.747, p<0.01) were higher prior to phototherapy. The mean difference between TSB and TCB after phototherapy on the forehead was 25.77 μmol/L ± 48.36 μmol/L and sternum was 95.69 μmol/L ± 73.72 μmol/L. CONCLUSION: The JM-105 is an accurate TCB screening tool for physicians to use in healthy newborns by site. After the initiation of phototherapy the forehead may be a more appropriate site of measure with an overestimate of bilirubin levels. Additional research is required to obtain a greater understanding of the impact of phototherapy and site on TCB screening tools.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.040 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".