Fototerapia intermitente versus fototerapia continua para la ictericia neonatal
Appendices
Appendix 1. Cochrane CENTRAL strategy
Cochrane CENTRAL via CRS Web
January 31, 2022
| 1 | MESH DESCRIPTOR Infant, Newborn EXPLODE ALL AND CENTRAL:TARGET | 17409 |
| 2 | infant or infants or infant’s or "infant s" or infantile or infancy or newborn* or "new born" or "new borns" or "newly born" or neonat* or baby* or babies or premature or prematures or prematurity or preterm or preterms or "pre term" or premies or "low birth weight" or "low birthweight" or VLBW or LBW or ELBW or NICU AND CENTRAL:TARGET | 95692 |
| 3 | preemie OR preemies or pre‐mature or pre‐matures or pre‐maturity AND CENTRAL:TARGET | 54 |
| 4 | #1 OR #2 OR #3 | 95701 |
| 5 | MESH DESCRIPTOR Hyperbilirubinemia EXPLODE ALL AND CENTRAL:TARGET | 636 |
| 6 | MESH DESCRIPTOR Hyperbilirubinemia, Neonatal EXPLODE ALL AND CENTRAL:TARGET | 360 |
| 7 | MESH DESCRIPTOR Jaundice, Neonatal EXPLODE ALL AND CENTRAL:TARGET | 270 |
| 8 | MESH DESCRIPTOR jaundice EXPLODE ALL AND CENTRAL:TARGET | 198 |
| 9 | MESH DESCRIPTOR Jaundice, Obstructive EXPLODE ALL AND CENTRAL:TARGET | 81 |
| 10 | MESH DESCRIPTOR kernicterus EXPLODE ALL AND CENTRAL:TARGET | 11 |
| 11 | hyperbilirubinemi* OR hyperbilirubinaemi* OR bilirubinemi* OR bilirubinaemi* OR jaundice OR jaundices OR jaundiced OR kernicterus OR icter* OR (encephalopath* ADJ2 bilirubin) AND CENTRAL:TARGET | 4192 |
| 12 | #5 OR #6 OR #7 OR #8 OR #9 OR #10 OR #11 | 4192 |
| 13 | MESH DESCRIPTOR Phototherapy EXPLODE ALL AND CENTRAL:TARGET | 3612 |
| 14 | phototherap* OR (photoradiation ADJ3 therap*) OR (light ADJ3 therap*) AND CENTRAL:TARGET | 5827 |
| 15 | #13 OR #14 | 6982 |
| 16 | #4 AND #12 AND #15 | 793 |
Appendix 2. MEDLINE strategy
|
| Ovid MEDLINE(R) and Epub Ahead of Print, In‐Process, In‐Data‐Review & Other Non‐Indexed Citations, Daily and Versions(R) 1946 to January 28, 2022 | |
|
| Search date: January 31, 2022 |
|
| # | Searches | Results |
| 1 | exp hyperbilirubinemia/ or exp hyperbilirubinemia, neonatal/ or exp jaundice, neonatal/ or exp jaundice/ or exp jaundice, obstructive/ or exp kernicterus/ | 27027 |
| 2 | (hyperbilirubinemi* or hyperbilirubinaemi* or bilirubinemi* or bilirubinaemi*).mp. | 13409 |
| 3 | (jaundice or jaundices or jaundiced).mp. | 45237 |
| 4 | kernicterus.mp. | 1840 |
| 5 | icter*.mp. | 7776 |
| 6 | (encephalopath* adj2 bilirubin).mp. | 561 |
| 7 | or/1‐6 [Jaundice] | 58576 |
| 8 | exp phototherapy/ | 48275 |
| 9 | phototherap*.mp. | 17552 |
| 10 | (photoradiation adj3 therap*).mp. | 177 |
| 11 | (light adj3 therap*).mp. | 11586 |
| 12 | or/8‐11 [Phototherapy] | 55612 |
| 13 | exp infant, newborn/ or Intensive Care, Neonatal/ or Intensive Care Units, Neonatal/ | 647340 |
| 14 | (baby* or babies or infant? or infantile or infancy or low birth weight or low birthweight or neonat* or neo‐nat* or newborn* or new born? or newly born or premature or pre‐mature or pre‐matures or prematures or prematurity pre‐maturity or preterm or preterms or pre term? or preemie or preemies or premies or premie or VLBW or LBW or ELBW or NICU).ti,ab,kw,kf. | 953391 |
| 15 | or/13‐14 [Filter: Neonatal Population 01‐2022‐‐MEDLINE] | 1236419 |
| 16 | randomized controlled trial.pt. | 557239 |
| 17 | controlled clinical trial.pt. | 94671 |
| 18 | (randomized or randomised).ti,ab. | 708913 |
| 19 | placebo.ab. | 225169 |
| 20 | drug therapy.fs. | 2435446 |
| 21 | randomly.ab. | 374953 |
| 22 | trial.ab. | 585399 |
| 23 | groups.ab. | 2304386 |
| 24 | (quasirandom* or quasi‐random*).ti,ab. | 5297 |
| 25 | exp animals/ not humans/ | 4950739 |
| 26 | (or/16‐24) not 25 [RCT Filter‐Based on Cochrane‐ Box 6.4.c: Cochrane Highly Sensitive Search Strategy] | 4595292 |
| 27 | 7 and 12 and 15 [Jaundice & Phototherapy & Neonate] | 2734 |
| 28 | 26 and 27 [RCT Results Medline] | 725 |
Appendix 3. Embase strategy
|
| Embase 1974 to 2022 January 28 |
|
|
| Search date: January 31, 2022 |
|
| # | Searches | Results |
| 1 | exp jaundice/ or kernicterus/ or newborn jaundice/ | 58041 |
| 2 | exp hyperbilirubinemia/ | 76660 |
| 3 | (hyperbilirubinemi* or hyperbilirubinaemi* or bilirubinemi* or bilirubinaemi*).mp. | 26710 |
| 4 | (jaundice or jaundices or jaundiced).mp. | 71565 |
| 5 | kernicterus.mp. | 2391 |
| 6 | icter*.mp. | 8574 |
| 7 | or/1‐6 [Jaundice] | 96138 |
| 8 | exp phototherapy/ | 100952 |
| 9 | (phototherap* or (photoradiation adj3 therap*)).mp. | 32625 |
| 10 | or/8‐9 [Phototherapy] | 103884 |
| 11 | Randomized controlled trial/ or Controlled clinical study/ | 882058 |
| 12 | random$.ti,ab,kw. | 1753635 |
| 13 | Randomization/ | 92841 |
| 14 | placebo.ti,ab,kw. | 335930 |
| 15 | ((double or single or doubly or singly) adj (blind or blinded or blindly)).ti,ab,kw. | 252672 |
| 16 | double blind procedure/ | 191703 |
| 17 | (controlled adj7 (study or design or trial)).ti,ab,kw. | 398058 |
| 18 | parallel group$1.ti,ab. | 28774 |
| 19 | (crossover or cross over).ti,ab. | 114490 |
| 20 | ((assign$ or match or matched or allocation) adj5 (alternate or group$1 or intervention$1 or patient$1 or subject$1 or participant$1)).ti,ab. | 371547 |
| 21 | (open adj label).ti,ab. | 94148 |
| 22 | or/11‐21 [ Terms based on Cochrane Central strategy‐https://www‐cochranelibrary‐com.ezproxy.uvm.edu/central/central‐creation] | 2511851 |
| 23 | (exp animals/ or exp invertebrate/ or animal experiment/ or animal model/ or animal tissue/ or animal cell/ or nonhuman/) and (human/ or normal human/ or human cell/) | 23210414 |
| 24 | exp animals/ or exp invertebrate/ or animal experiment/ or animal model/ or animal tissue/ or animal cell/ or nonhuman/ | 30038201 |
| 25 | 24 not 23 [Animal Exclusion‐https://community‐cochrane‐org.ezproxy.uvm.edu/sites/default/files/uploads/inline‐files/Embase%20animal%20filter.pdf] | 6827787 |
| 26 | 22 not 25 [Filter: RCT‐EMBASE] | 2243794 |
| 27 | newborn/ or prematurity/ or newborn intensive care/ or newborn care/ | 638499 |
| 28 | (baby* or babies or infant? or infantile or infancy or low birth weight or low birthweight or neonat* or neo‐nat* or newborn* or new born? or newly born or premature or pre‐mature or pre‐matures or prematures or prematurity or preterm or preterms or pre term or preemie or preemies or premies or premie or VLBW or LBW or ELBW or NICU).ti,ab,kw,kf. | 1119136 |
| 29 | or/27‐28 [Filter: Neonatal Population 2021‐OVID EMBASE] | 1336133 |
| 30 | 7 and 10 and 26 and 29 | 565 |
Appendix 4. Protocol search methods
Search methods for identification of studies
The standard search strategy of the Cochrane Neonatal Review Group as outlined in The Cochrane Library was used. The following sources were searched for eligible reports in any language:
Electronic searches
Searches of electronic databases included:
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The Cochrane Central Register of Controlled Trials (CENTRAL);
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MEDLINE (1966 to the present);
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Embase(1980 to the present);
-
CINAHL (1982 to the present).
The search string for searching CENTRAL and MEDLINE via PubMed included the following terms: Jaundice OR Hyperbilirubinemia OR Hyperbilirubinaemia OR Bilirubin encephalopathy OR Kernicterus OR High serum bilirubin AND Neonate OR Neonatal OR Baby OR Babies OR Child OR Infant OR Infants OR Neonates AND Phototherapy OR Phototherapeutic OR Phototherapeutics OR Light therapy OR Phototherapies.
A similar search string was used for searching Embase and CINAHL via Ovid. The search terms were adapted to the structured vocabulary, syntax, and limits required for these databases.
Search strategies:
MEDLINE via Ovid ‐ Ovid MEDLINE(R) and Epub Ahead of Print, In‐Process & Other Non‐Indexed Citations, Daily and Versions(R):
-
exp infant, newborn/
-
(newborn* or new born or new borns or newly born or baby* or babies or premature or prematurity or preterm or pre term or low birth weight or low birthweight or VLBW or LBW or infant or infants or infantile or infancy or neonat*).ti,ab.
-
1 or 2
-
(phototherap* or light therapy).mp. [mp=title, abstract, original title, name of substance word, subject heading word, floating sub‐heading word, keyword heading word, organism supplementary concept word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier, synonyms]
-
randomised controlled trial.pt.
-
controlled clinical trial.pt.
-
randomized.ab.
-
placebo.ab.
-
drug therapy.fs.
-
randomly.ab.
-
trial.ab.
-
groups.ab.
-
or/5‐12
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exp animals/ not humans.sh.
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13 not 14
-
3 and 4 and 15
Embase via Ovid:
-
exp prematurity/
-
exp infant/
-
(newborn* or new born or new borns or newly born or baby* or babies or premature or prematurity or preterm or pre term or low birth weight or low birthweight or VLBW or LBW or infant or infants or infantile or infancy or neonat*).ti,ab.
-
1 or 2 or 3
-
(human not animal).mp.
-
(randomised controlled trial or controlled clinical trial or randomised or placebo or clinical trials as topic or randomly or trial or clinical trial).mp.
-
4 and 5 and 6
-
(phototherap* or light therapy).mp. [mp=title, abstract, heading word, drug trade name, original title, device manufacturer, drug manufacturer, device trade name, keyword, floating subheading word, candidate term word]
-
7 and 8
CINAHL:
(infant or infants or infantile or infancy or newborn* or "new born" or "new borns" or "newly born" or neonat* or baby* or babies or premature or prematures or prematurity or preterm or preterms or "pre term" or premies or "low birth weight" or "low birthweight" or VLBW or LBW) AND (randomised controlled trial OR controlled clinical trial OR randomised OR placebo OR clinical trials as topic OR randomly OR trial OR PT clinical trial) AND (phototherapy or light therapy or bright light therapy or illumination therapy)
Searching other resources
Abstracts presented in the past years at the annual meetings of the European Society for Paediatric Research and The Society for Pediatric Research were searched from the journal Pediatric Research and Abstracts On Line.
We searched the WHO clinical trials registry platform, and specifically the following websites:http://www.clinicaltrials.gov and http://www.controlled‐trials.com for ongoing studies.
Handsearches of the reference lists of all pertinent reviews and studies found were undertaken.
Where possible, authors of identified trials were contacted to find out if they were aware of other published or unpublished trials.
Appendix 5. Risk of bias tool
Sequence generation (checking for possible selection bias). Was the allocation sequence adequately generated?
For each included study, we categorised the method used to generate the allocation sequence as:
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low risk (any truly random process e.g. random number table; computer random number generator);
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high risk (any non‐random process e.g. odd or even date of birth; hospital or clinic record number); or
-
unclear risk.
Allocation concealment (checking for possible selection bias). Was allocation adequately concealed?
For each included study, we categorised the method used to conceal the allocation sequence as:
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low risk (e.g. telephone or central randomisation; consecutively numbered sealed opaque envelopes);
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high risk (open random allocation; unsealed or non‐opaque envelopes, alternation; date of birth); or
-
unclear risk.
Blinding of participants and personnel (checking for possible performance bias). Was knowledge of the allocated intervention adequately prevented during the study?
For each included study, we categorised the methods used to blind study participants and personnel from knowledge of which intervention a participant received. Blinding was assessed separately for different outcomes or class of outcomes. We categorised the methods as:
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low risk, high risk or unclear risk for participants; and
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low risk, high risk or unclear risk for personnel.
Blinding of outcome assessment (checking for possible detection bias). Was knowledge of the allocated intervention adequately prevented at the time of outcome assessment?
For each included study, we categorised the methods used to blind outcome assessment. Blinding was assessed separately for different outcomes or class of outcomes. We categorised the methods as:
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low risk for outcome assessors;
-
high risk for outcome assessors; or
-
unclear risk for outcome assessors.
Incomplete outcome data (checking for possible attrition bias through withdrawals, dropouts, protocol deviations). Were incomplete outcome data adequately addressed?
For each included study and for each outcome, we described the completeness of data including attrition and exclusions from the analysis. We noted whether attrition and exclusions were reported, the numbers included in the analysis at each stage (compared with the total randomised participants), reasons for attrition or exclusion where reported, and whether missing data were balanced across groups or were related to outcomes. Where sufficient information was reported or supplied by the trial authors, we re‐included missing data in the analyses. We categorised the methods as:
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low risk (< 20% missing data);
-
high risk (≥ 20% missing data); or
-
unclear risk
Selective reporting bias. Are reports of the study free of suggestion of selective outcome reporting?
For each included study, we described how we investigated the possibility of selective outcome reporting bias and what we found. For studies in which study protocols were published in advance, we compared prespecified outcomes versus outcomes eventually reported in the published results. If the study protocol was not published in advance, we contacted study authors to gain access to the study protocol. We assessed the methods as:
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low risk (where it is clear that all of the study's prespecified outcomes and all expected outcomes of interest to the review have been reported);
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high risk (where not all the study's prespecified outcomes have been reported; one or more reported primary outcomes were not prespecified outcomes of interest and are reported incompletely and so cannot be used; study fails to include results of a key outcome that would have been expected to have been reported); or
-
unclear risk.
Other sources of bias. Was the study apparently free of other problems that could put it at a high risk of bias?
For each included study, we described any important concerns we had about other possible sources of bias (for example, whether there was a potential source of bias related to the specific study design or whether the trial was stopped early due to some data‐dependent process). We assessed whether each study was free of other problems that could put it at risk of bias as:
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low risk;
-
high risk; or
-
unclear risk.
If needed, we explored the impact of the level of bias through undertaking sensitivity analyses.
Appendix 6. Trial registry strategies
| Search date: January 31, 2022 |
|
| ISRCTN |
|
|
|
|
| Text word: (bilirubin OR hyperbilirubinaemia OR hyperbilirubinemia OR jaundice) AND Interventions: Phototherapy Remove filter | 5 |
| Text word: intermittent AND Intervention: phototherapy | 0 |
|
|
|
| ICTRP (WHO International Clinical Trials Registry Platform) |
|
| jaundice AND phototherapy AND intermittent | 4 |
| jaundice AND phototherapy |
|
| hyperbilirubinemia AND phototherapy AND intermittent | 4 |
| hyperbilirubinaemia AND phototherapy AND intermittent | 0 |
| infant AND phototherapy AND intermittent | 0 |
| infants AND phototherapy AND intermittent | 2 |
| newborn AND phototherapy AND intermittent | 0 |
| newborns AND phototherapy AND intermittent | 1 |
| neonates AND phototherapy AND intermittent | 0 |
| phototherapy AND intermittent [Restricted to trials in children] | 6 |
|
|
|
| clinicaltrials.gov |
|
|
|
|
| phototherapy AND intermittent AND condition: Hyperbilirubinemia | 1 |
| intermittent phototherapy AND Hyperbilirubinemia AND Child (trials in) | 1 |
| intermittent phototherapy AND Child (trials in) : found 21 but only 1 related to jaundice or hyperbilirubinemia; | 1 |
| Total | 25 |
| Duplicates (compared to trial records found by Cochrane Central searches) | 25 |
| Net | 0 |
PRISMA flow diagram
Comparison 1: Intermittent phototherapy versus continuous phototherapy, Outcome 1: Rate of decline of serum bilirubin
Comparison 1: Intermittent phototherapy versus continuous phototherapy, Outcome 2: BIND
Comparison 1: Intermittent phototherapy versus continuous phototherapy, Outcome 3: Treatment failure
Comparison 1: Intermittent phototherapy versus continuous phototherapy, Outcome 4: Mortality
Comparison 1: Intermittent phototherapy versus continuous phototherapy, Outcome 5: Exchange transfusion
Comparison 1: Intermittent phototherapy versus continuous phototherapy, Outcome 6: Weight gain (g/kg/day)
Comparison 1: Intermittent phototherapy versus continuous phototherapy, Outcome 7: Length of hospital stay
Comparison 1: Intermittent phototherapy versus continuous phototherapy, Outcome 8: Infant feeding volumes (volume/day)
Comparison 1: Intermittent phototherapy versus continuous phototherapy, Outcome 9: Duration of phototherapy (hours)
Comparison 1: Intermittent phototherapy versus continuous phototherapy, Outcome 10: Duration of first episode of phototherapy
Comparison 1: Intermittent phototherapy versus continuous phototherapy, Outcome 11: Parental satisfaction
Comparison 1: Intermittent phototherapy versus continuous phototherapy, Outcome 12: Staff satisfaction
Comparison 1: Intermittent phototherapy versus continuous phototherapy, Outcome 13: Incidence of gastrointestinal dysmotility
Comparison 1: Intermittent phototherapy versus continuous phototherapy, Outcome 14: Incidence of patent ductus arteriosus
Comparison 1: Intermittent phototherapy versus continuous phototherapy, Outcome 15: Incidence of body rash
Comparison 2: Intermittent phototherapy versus continuous phototherapy: subgrouped by term infants versus preterm infants, Outcome 1: Rate of decline of serum bilirubin (micromol/L/hour)
Comparison 2: Intermittent phototherapy versus continuous phototherapy: subgrouped by term infants versus preterm infants, Outcome 2: BIND
Comparison 3: Intermittent phototherapy versus continuous phototherapy: subgrouped by intermittent phototherapy regimen (phototherapy on < 2 hours versus ≥ 2 hours), Outcome 1: Rate of decline of serum bilirubin (micromol/L/hour)
Comparison 3: Intermittent phototherapy versus continuous phototherapy: subgrouped by intermittent phototherapy regimen (phototherapy on < 2 hours versus ≥ 2 hours), Outcome 2: BIND
Comparison 4: Sensitivity analysis, Outcome 1: Rate of decline of bilirubin (micromol/L/hr)
| Intermittent phototherapy compared to continuous phototherapy for neonatal jaundice | ||||||
| Patient or population: neonatal jaundice | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect | № of participants | Certainty of the evidence | Comments | |
|---|---|---|---|---|---|---|
| Risk with continuous phototherapy | Risk with intermittent phototherapy | |||||
| Rate of decline of serum bilirubin (micromol/L/hr) | The mean rate of decline of serum bilirubin (micromol/L/hr) was 1.601 micromol/L/h | MD 0.09 micromol/L/h lower | ‐ | 1225 | ⊕⊕⊝⊝ |
|
| Bilirubin‐induced brain dysfunction (defined as either the pathological finding of deep‐yellow staining of neurons and neuronal necrosis of the basal ganglia and brainstem nuclei or acute or chronic neurological deficit including athetoid cerebral palsy, impaired upward gaze and deafness or isolated conditions, such as auditory neuropathy or dyssynchrony) | Study population | not estimable | 60 | ⊕⊝⊝⊝ |
| |
| 0 per 1000 | 0 per 1000 | |||||
| Treatment failure (need to restart phototherapy or exchange transfusion or both) | Study population | not estimable | 75 | ⊕⊝⊝⊝ |
| |
| 51 per 1000 | 0 per 1000 | |||||
| Mortality (all cause) | Study population | not estimable | 1470 | ⊕⊕⊝⊝ |
| |
| 28 per 1000 | 0 per 1000 | |||||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1 Moderate heterogeneity 2 Optimal information size not met 3 Reported by single study 4 No events reported in a single study 5 Effect size includes both appreciable benefit and appreciable harm. 6 Optimal information size not met. Effect size includes both appreciable benefit and appreciable harm. | ||||||
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1.1 Rate of decline of serum bilirubin Show forest plot | 10 | 1225 | Mean Difference (IV, Fixed, 95% CI) | ‐0.09 [‐0.21, 0.03] |
| 1.2 BIND Show forest plot | 1 | 60 | Odds Ratio (M‐H, Fixed, 95% CI) | Not estimable |
| 1.3 Treatment failure Show forest plot | 1 | 75 | Risk Difference (IV, Fixed, 95% CI) | 0.03 [‐0.08, 0.15] |
| 1.4 Mortality Show forest plot | 10 | 1470 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.01 [‐0.03, 0.01] |
| 1.5 Exchange transfusion Show forest plot | 2 | 364 | Risk Difference (M‐H, Fixed, 95% CI) | 0.00 [‐0.02, 0.02] |
| 1.6 Weight gain (g/kg/day) Show forest plot | 1 | 59 | Mean Difference (IV, Fixed, 95% CI) | ‐3.71 [‐10.25, 2.82] |
| 1.7 Length of hospital stay Show forest plot | 3 | 325 | Mean Difference (IV, Fixed, 95% CI) | ‐0.07 [‐0.22, 0.09] |
| 1.8 Infant feeding volumes (volume/day) Show forest plot | 2 | 136 | Mean Difference (IV, Fixed, 95% CI) | ‐0.82 [‐8.80, 7.16] |
| 1.9 Duration of phototherapy (hours) Show forest plot | 7 | 917 | Mean Difference (IV, Fixed, 95% CI) | ‐15.27 [‐16.42, ‐14.12] |
| 1.10 Duration of first episode of phototherapy Show forest plot | 6 | 629 | Mean Difference (IV, Fixed, 95% CI) | ‐0.89 [‐2.50, 0.72] |
| 1.11 Parental satisfaction Show forest plot | 1 | 174 | Mean Difference (IV, Fixed, 95% CI) | 2.00 [1.56, 2.44] |
| 1.12 Staff satisfaction Show forest plot | 1 | 174 | Mean Difference (IV, Fixed, 95% CI) | ‐2.00 [‐2.35, ‐1.65] |
| 1.13 Incidence of gastrointestinal dysmotility Show forest plot | 1 | 174 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.01 [‐0.06, 0.04] |
| 1.14 Incidence of patent ductus arteriosus Show forest plot | 1 | 271 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.02 [‐0.12, 0.08] |
| 1.15 Incidence of body rash Show forest plot | 1 | 174 | Risk Difference (M‐H, Fixed, 95% CI) | ‐0.01 [‐0.07, 0.05] |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 2.1 Rate of decline of serum bilirubin (micromol/L/hour) Show forest plot | 10 | 1225 | Mean Difference (IV, Fixed, 95% CI) | ‐0.09 [‐0.21, 0.03] |
| 2.1.1 Term infants | 7 | 1049 | Mean Difference (IV, Fixed, 95% CI) | ‐0.04 [‐0.17, 0.09] |
| 2.1.2 Preterm infants | 3 | 176 | Mean Difference (IV, Fixed, 95% CI) | ‐0.51 [‐0.86, ‐0.15] |
| 2.2 BIND Show forest plot | 1 | 60 | Odds Ratio (M‐H, Fixed, 95% CI) | Not estimable |
| 2.2.1 Term infants | 1 | 60 | Odds Ratio (M‐H, Fixed, 95% CI) | Not estimable |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 3.1 Rate of decline of serum bilirubin (micromol/L/hour) Show forest plot | 10 | 1294 | Mean Difference (IV, Fixed, 95% CI) | ‐0.10 [‐0.21, 0.02] |
| 3.1.1 Phototherapy on for < 2 hours | 4 | 713 | Mean Difference (IV, Fixed, 95% CI) | ‐0.06 [‐0.20, 0.09] |
| 3.1.2 Phototherapy on for ≥ 2 hours | 7 | 581 | Mean Difference (IV, Fixed, 95% CI) | ‐0.17 [‐0.36, 0.02] |
| 3.2 BIND Show forest plot | 1 | 60 | Odds Ratio (M‐H, Fixed, 95% CI) | Not estimable |
| 3.2.1 Phototherapy on ≥2 hours | 1 | 60 | Odds Ratio (M‐H, Fixed, 95% CI) | Not estimable |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 4.1 Rate of decline of bilirubin (micromol/L/hr) Show forest plot | 3 | 549 | Mean Difference (IV, Fixed, 95% CI) | 0.02 [‐0.14, 0.19] |
