Diagnosis of Neonatal and Infantile Cholestasis

The limitations we found are:

➡️Implementation limitations:

·       Lack of availability of some diagnostic tests such as point of care ultrasound and Gamma-glutamyl transferase measurement.

·       Lack of young physicians’ knowledge regarding neonatal cholestasis.

·       Lack of public awareness regarding pathological causes of neonatal jaundice.

➡️Guideline limitations:

1.     There was a very limited number of evidence-based guidelines dealing with NIC. After appraising that limited number using Agree II only one position paper was appropriate. So, we had to depend in our guideline on that position paper.

2.     We had to resort to (good practice statement) more than once as there were no available appraised guideline statements to adapt.

3.     Detailed management of NIC is not included in this guideline as after appraisal there were no good quality guidelines dealing with the entity of NIC management at the time of writing it. We hope to allegate another CPG for this topic.

 ➡️Monitoring and evaluating the impact of the guideline.

The following is a measure or indicators for implementing this adapted CPG for NIC:

·       Adherence to Evidence-Based Clinical Practice Guideline for Diagnosis of Neonatal and Infantile Cholestasis:

‒       Numerator: Number of children with cholestasis, who were diagnosed as per the guideline recommendations.

‒       Denominator: Total number of children diagnosed with jaundice

‒       Data Source: Hospital or clinic patient records.

These key performance indicators are designed to measure the effectiveness and adherence to the guidelines, the efficiency of the treatment in terms of resource utilization (hospital stay), and the success of the treatment in preventing further complications (readmissions).