Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a Cochrane Clinical Answer that focuses on the above important clinical question.
Confidence in the evidence is moderate or low to moderate where GRADE has been performed and the intervention may be more effective/beneficial than the comparison for key outcomes.
Population: Newborn infants with nonhemolytic unconjugated hyperbilirubinemia
Intervention: Phototherapy plus reflective curtains ᵃ
Comparison: Phototherapy alone ᵃ
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
Decline in serum bilirubin (subgroup: at 4–8 hours) | Favors intervention | Moderate |
Decline in serum bilirubin (subgroup: at 24 hours) | See note ᵇ | Very Low |
Decline in serum bilirubin (subgroup: first measurement) | Favors intervention | Very Low |
Duration of phototherapy (in hours) | See note ᶜ | Very Low |
Duration of hospital stay (in hours) | Favors intervention | Moderate |
Exchange transfusion | See note ᵈ | GRADE assessment not performed for this outcome |
Adverse events | See note ᵉ | GRADE assessment not performed for this outcome |
Acute life‐threatening events, parental and medical staff satisfaction with treatment, breastfeeding on discharge | - | None of the reviewed studies assessed these outcomes |
Note The Cochrane review which underpins this Cochrane Clinical Answer (CCA) noted that the difference between participants' age at recruitment, severity of jaundice, the different types of reflective material used, and the timing of outcome measurements account for the heterogeneity found among the reviewed studies. ᵃ This evidence table summarizes the findings for the comparison of phototherapy plus reflective curtains versus phototherapy alone, which is the main comparison as stated in the Cochrane review Summary of Findings table. See the full CCA for information on other comparisons (reflective curtains versus intensified phototherapy). ᵇ Nine RCTs (893 infants). All analyses favored phototherapy plus reflective curtains. However, no pooled estimate was reported due to heterogeneity. The analyses in three RCTs did not reach statistical significance and several analyses were underpowered. ᶜ Four RCTs (466 infants) reported that duration of phototherapy (measured in hours) was shorter with phototherapy plus reflective curtains than with phototherapy alone, and a fifth RCT found that the median duration of phototherapy was reduced in infants receiving phototherapy plus reflective curtains. No pooled estimate was reported due to heterogeneity. ᵈ Two RCTs reported no exchange transfusion in either group. ᵉ Adverse events were sparsely reported in eight RCTs. See the CCA for more details.
This evidence table is related to the following section/s:
Cochrane Clinical Answers
Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care and have been added to relevant sections of the main Best Practice text.
- How does fiberoptic phototherapy compare with conventional phototherapy for neonates with jaundice?
- How does phototherapy with light-emitting diodes (LEDs) compare with alternative light sources for neonates with unconjugated hyperbilirubinemia?
- How does prophylactic phototherapy compare with standard phototherapy for preterm or low birth weight infants?
- What are the effects of adding reflective curtains to phototherapy units for newborn infants with unconjugated hyperbilirubinemia?
- What are the benefits and harms of immunoglobulin for neonates with alloimmune hemolytic disease/jaundice?
- What are the effects of adding clofibrate to phototherapy for neonates with unconjugated hyperbilirubinemia?
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