Home-based screening for biliary atresia using infant stool colour cards: A large-scale prospective cohort study and cost-effectiveness analysis

Schreiber, Richard A.; Masucci, Lisa; Kaczorowski, Janusz; Collet, Jean‐Paul; Lutley, Pamela; Espinosa, V.; Bryan, Stirling

doi:10.1177/0969141314542115

Cited by 65 publications

(54 citation statements)

References 24 publications

(36 reference statements)

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“…Moreover, the authors concluded that there was a greater than 97% likelihood that screening using stool color cards would result in a gain in life-years and a significant cost savings. Schreiber et al 27 conducted a prospective study in which infant stool color cards were distributed to more than 6000 families in the maternity ward of a Canadian women’s hospital. The authors used a variety of strategies to follow up on the infant stool color, from voluntary return of the cards at 30 days of age to follow-up with family physicians or families by random phone survey.…”

mentioning

confidence: 99%

Newborn Screening for Biliary Atresia

Moss¹,

Caty²,

Davidoff³

et al. 2015

Pediatrics

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Biliary atresia is the most common cause of pediatric end-stage liver disease and the leading indication for pediatric liver transplantation. Affected infants exhibit evidence of biliary obstruction within the first few weeks after birth. Early diagnosis and successful surgical drainage of bile are associated with greater survival with the child’s native liver. Unfortunately, because noncholestatic jaundice is extremely common in early infancy, it is difficult to identify the rare infant with cholestatic jaundice who has biliary atresia. Hence, the need for timely diagnosis of this disease warrants a discussion of the feasibility of screening for biliary atresia to improve outcomes. Herein, newborn screening for biliary atresia in the United States is assessed by using criteria established by the Discretionary Advisory Committee on Heritable Disorders in Newborns and Children. Published analyses indicate that newborn screening for biliary atresia by using serum bilirubin concentrations or stool color cards is potentially life-saving and cost-effective. Further studies are necessary to evaluate the feasibility, effectiveness, and costs of potential screening strategies for early identification of biliary atresia in the United States.

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confidence: 99%

Newborn Screening for Biliary Atresia

Moss¹,

Caty²,

Davidoff³

et al. 2015

Pediatrics

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“…Because the SCC screening program is a feasible, cost-effective, and beneficial strategy for BA detection, 12–14 it has currently been applied regionally or nationally in some countries including Brazil, Japan, Switzerland, Canada, and the Netherlands. 13–18 …”

Section: Introductionmentioning

confidence: 99%

Infant Stool Color Card Screening Helps Reduce the Hospitalization Rate and Mortality of Biliary Atresia

Lee

Chen

Yang³

et al. 2016

Medicine

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Biliary atresia (BA) is a significant liver disease in children. Since 2004, Taiwan has implemented a national screening program that uses an infant stool color card (SCC) for the early detection of BA. The purpose of this study was to examine the outcomes of BA cases before and after the launch of this screening program. The objectives of this study were to evaluate the rates of hospitalization, liver transplantation (LT), and mortality of BA cases before and after the program, and to examine the association between the hospitalization rate and survival outcomes.This was a population-based cohort study. BA cases born during 1997 to 2010 were identified from the Taiwan National Health Insurance Research Database. Sex, birth date, hospitalization date, LT, and death data were collected and analyzed. The hospitalization rate by 2 years of age (Hosp/2yr) was calculated to evaluate its association with the outcomes of LT or death.Among 513 total BA cases, 457 (89%) underwent the Kasai procedure. Of these, the Hosp/2yr was significantly reduced from 6.0 to 6.9/case in the earlier cohort (1997–2004) to 4.9 to 5.3/case in the later cohort (2005–2010). This hospitalization rate reduction was followed by a reduction in mortality from 26.2% to 15.9% after 2006. The Cox proportional hazards model showed a significant increase in the risk for both LT (hazard ratio [HR] = 1.14, 95% confidence interval [CI] = 1.10–1.18) and death (HR = 1.05, 95% CI = 1.01–1.08) for each additional hospitalization. A multivariate logistic regression model found that cases with a Hosp/2yr >6 times had a significantly higher risk for both LT (adjusted odds ratio [aOR] = 4.35, 95% CI = 2.82–6.73) and death (aOR = 1.75, 95% CI = 1.17–2.62).The hospitalization and mortality rates of BA cases in Taiwan were significantly and coincidentally reduced after the launch of the SCC screening program. There was a significant association between the hospitalization rate and final outcomes of LT or death. The SCC screening program can help reduce the hospitalization rate and mortality of BA cases and bring great financial benefit.

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“…The exact percentage of infants with stool color change by 3 weeks of age, however, requires further study. Of importance, compared with the Phase 1 study conducted in BC, we had significantly higher SCC return rates (63% vs 26%) (13), which, we hypothesize, may be related to the engagement of the population in an already established urine home-based screening program.…”

Section: Discussionmentioning

confidence: 95%

Home‐Based Screening for Biliary Atresia Using Infant Stool Color Cards in Canada

Morinville

Ahmed

Ibberson

et al. 2016

J. pediatr. gastroenterol. nutr.

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Home-based screening for biliary atresia using infant stool colour cards: A large-scale prospective cohort study and cost-effectiveness analysis

Abstract: A BA ISCC screening programme targeting families of newborns is feasible in Canada. Passive distribution of ISCC at maternity is potentially effective and highly cost-effective.

Cited by 65 publications

References 24 publications

Newborn Screening for Biliary Atresia

Newborn Screening for Biliary Atresia

Infant Stool Color Card Screening Helps Reduce the Hospitalization Rate and Mortality of Biliary Atresia

Home‐Based Screening for Biliary Atresia Using Infant Stool Color Cards in Canada

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