December 2020. Volume 16. Number 4

The difficult path of bile duct atresia screening

 
 
 
 
 
 
 
 
 
 
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AVC | Critically appraised articles

Harpavat S, García-Prats JA, Anaya C, Brandt M, Lupo PJ, Finegold MJ, et al. Diagnostic yield of newborn screening for biliary atresia using direct or conjugated bilirrubin measurements. JAMA. 2020; 323: 1141-50.

Reviewers: Llerena Santa Cruz E1, Pérez-Moneo Agapito B2.
11Pediatra CAP La Torrassa. Hospital Parc Tauli. Sabadell. Barcelona. España.
2Servicio de Pediatría. Hospital Universitario Infanta Leonor. Universidad Complutense. Madrid. España.
Correspondence: Enrique Llerena Santa Cruz. Email: kikellerena@gmail.com
Reception date: 03/09/2020
Acceptance date: 25/09/2020
Publication date: 07/10/2020

Abstract

Authors’ conclusions: newborn screening with direct or conjugated bilirrubin measurements detected all known infants with biliary atresia in the study population, although the 95% confidence interval around the sensitivity was wide and the study desing did not ensure complete ascertainment of false-negative results. Research is needed in larger population to obtain more precise estimates of diagnostic yield and to better understand the clinical outcomes and cost-effectiveness of this screening approach.

Reviewers’ commentary: the screening strategy proposed by the present study based on the measurement of direct bilirubin in two phases, reduces the days until a Kasai portoenterostomy can be perform in biliary atresia, however its implementation seems not feasible since it requires a complex infrastructure.

How to cite this article

Llerena Santa Cruz E, Pérez-Moneo Agapito B. El difícil camino del cribado de la atresia de vías biliares. Evid Pediatr. 2020;16:43.

AVC | Critically appraised articles

Harpavat S, García-Prats JA, Anaya C, Brandt M, Lupo PJ, Finegold MJ, et al. Diagnostic yield of newborn screening for biliary atresia using direct or conjugated bilirrubin measurements. JAMA. 2020; 323: 1141-50.

Reviewers: Llerena Santa Cruz E1, Pérez-Moneo Agapito B2.
11Pediatra CAP La Torrassa. Hospital Parc Tauli. Sabadell. Barcelona. España.
2Servicio de Pediatría. Hospital Universitario Infanta Leonor. Universidad Complutense. Madrid. España.
Correspondence: Enrique Llerena Santa Cruz. Email: kikellerena@gmail.com
Reception date: 03/09/2020
Acceptance date: 25/09/2020
Publication date: 07/10/2020

How to cite this article

Llerena Santa Cruz E, Pérez-Moneo Agapito B. El difícil camino del cribado de la atresia de vías biliares. Evid Pediatr. 2020;16:43.


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