Evidence map›Paper›PMID 26678312›Full record

ArticleBMC pediatrics2015

Evaluation of a simple intervention to reduce exchange transfusion rates among inborn and outborn neonates in Myanmar, comparing pre- and post-intervention rates.

G Arnolda, A A Thein, D Trevisanuto, N Aung, H M Nwe, A A Thin, N S S Aye, T Defechereux, D Kumara, L Moccia

Open access · goldAbstract readEvaluation StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC pediatrics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
4.6field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
  7. Article
  8. Observational
  9. Irradiance levels of phototherapy devices: a national study in Dutch neonatal intensive care units.Journal of perinatology : official journal of the California Perinatal Association · 2017
    Article
  10. Observational
  11. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 4 countries.

G ArnoldaThrive Networks, Oakland, CA, USA. gaston.arnolda@gmail.com.
A A TheinDepartment of Neonatology, University of Medicine (1), Yangon, Myanmar. babydocaathein@gmail.com.
D TrevisanutoAmici della Neonatologia Trentina, Trento, Italy. trevo@pediatria.unipd.it.
N AungSenior Consultant Neonatologist, Central Women's Hospital, Mandalay, Myanmar. nilarmintun@gmail.com.
H M NweAssociate Professor, Department of Paediatrics, University of Medicine (1), Yangon, Myanmar. drhmnwe@gmail.com.
A A ThinSenior Consultant Neonatologist, Mandalay Children's Hospital (300), Mandalay, Myanmar. drayeayethin63@gmail.com.
N S S AyeSenior Consultant Neonatologist, Central Women's Hospital, Yangon, Myanmar. nssaye@gmail.com.
T DefechereuxDepartment of Surgery, Liege University Hospital, Liege, Belgium. thierry@defechereu-md.com.
D KumaraThrive Networks, Oakland, CA, USA. danica.kumara@thrivenetworks.org.
L MocciaThrive Networks, Oakland, CA, USA. luciano.moccia@thrivenetworks.org.
Provincia Autonoma di Trento · ITThrive · USUniversity Of Medicine 1 Yangon · MMYangon Central Women's Hospital · MMMandalay University · MMUniversity of Liège · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn Myanmar, approximately half of all neonatal hospital admissions are for hyperbilirubinaemia, and tertiary facilities report high rates of Exchange Transfusion (ET). The aim of this study was to evaluate the effectiveness of the pilot program in reducing ET, separately of inborn and outborn neonates.

methodsThe study was conducted in the Neonatal Care Units of four national tertiary hospitals: two exclusively treating inborn neonates, and two solely for outborn neonates. Prior to intervention, no high intensity phototherapy was available in these units. Intervention in late November 2011 comprised, for each hospital, provision of two high intensity LED phototherapy machines, a photo radiometer, and training of personnel. Hospital-specific data were assessed as Relative Risk (RR) ratios comparing ET rates pre- and post-intervention, and individual hospital results were pooled when appropriate.

resultsIn 2011, there were 118 ETs among inborn neonates and 140 ETs among outborn neonates. The ET rate was unchanged at Inborn Hospital A (RR = 1.07; 95 % CI: 0.80-1.43; p = 0.67), and reduced by 69 % at Inborn Hospital B (RR = 0.31; 95 % CI: 0.17-0.57; p < 0.0001). For outborn neonates, the pooled estimate indicated that ET rates reduced by 33 % post-intervention (RRMH = 0.67; 95 % CI: 0.52-0.87; p = 0.002); heterogeneity was not a problem.

conclusionTogether with a photoradiometer and education, intensive phototherapy can significantly reduce the ET rate. Inborn Hospital A had four times as many admissions for jaundice as Inborn Hospital B, and did not reduce ET until it received additional high intensity machines. The results highlight the importance of providing enough intensive phototherapy units to treat all neonates requiring high intensity treatment for a full course.

trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12615001171505 , 2 November 2015.

Indexed as

Exchange Transfusion, Whole BloodGuideline AdherenceHumansInfant, NewbornJaundice, NeonatalMedical Staff, HospitalMyanmarPhototherapyPilot ProjectsPractice Guidelines as TopicRadiometry

Identifiers

PMID26678312
PMCPMC4683769
OpenAlexW2205074197

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.