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Diagnosis of Neonatal and Infantile Cholestasis

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"last update: 24 Feb 2026"                                                                                                Download Guideline

- Annexes

➡️Web annexes

The following annexes can be added as a package of standalone supplementary documents.

➡️Keywords: The MeSH terms for "Guideline for diagnosis of …neonatal and infantile cholestasis’. " on PubMed are: neonate, infantile, cholestasis, guideline


➡️Annex Table 1.

Declaration of Conflict of Interests

The members of the guideline development/ adaptation group and the external review group have no academic, financial, or competing interests to declare and none of them were involved in the development of the original source guideline(s).

Any identified potential COI has been reported below.

 

Egyptian Pediatric Clinical Practice Guidelines Committee (EPG)

Guideline Adaptation Group (Clinical subgroup)

Name

Affiliation, Area of expertise / Role, Country / Primary location [work]

Declaration of interests

Interest

identified

Management plan & decision

 

 

None

Not Applicable

 

 

None

Not Applicable

Guideline Adaptation Group (Methodology Subgroup)

Prof. Ashraf Abdel Baky

Professor of Pediatrics

Ain Shams University, Egypt

Founder and Chair of EPG

None

Not Applicable

Dr. Yasser Sami Amer

1. Pediatrics Department and Clinical Practice Guidelines and Quality Research Unit, Quality Management Department, King Saud University Medical City, Riyadh, Saudi Arabia;

2. Research Chair for Evidence-Based Health Care and Knowledge Translation, King Saud University, Riyadh, Saudi Arabia;

3. Chair, Adaptation Working Group, Guidelines International Network (GIN), Perth, Scotland

4. Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil.

None

Not Applicable

Dr. Nanis Sulieman

Associate Professor of Pediatrics

Ain Shams University, Egypt

None

Not Applicable

Dr. Ranin Soliman     

 

1. Assistant Professor of Evidence-based Practice, School of Life and Medical Sciences, University of Hertfordshire, Egypt.

2. Consultant at WHO/EMRO for the Clinical and Public Heath Guideline Adaptation Project in the EMR.

3. Head of Heath Economics and Value Unit, Children’s Cancer Hospital Egypt.          

None

Not applicable

Dr. Lamis Mohsen Elsholkamy

Lecturer of Pediatrics, Faculty of Medicine, Modern University for Technology and Information (MTI), Egypt

None

Not Applicable

Dr. Ahmad Yousef

Lecturer of Pediatrics, Faculty of Medicine, Modern University for Technology and Information (MTI), Egypt

None

Not Applicable

Dr. Nahla Gamaleldin

Lecturer of pediatrics, Faculty of Medicine, Modern University for Technology and Information (MTI), Egypt

None

Not Applicable

Dr. Mona Saber

Lecturer of Pediatrics, Faculty of Medicine, Modern University for Technology and Information (MTI), Egypt

None

Not Applicable

External Review Group

 

 

None

Not Applicable

 

 

None

Not Applicable

 

 

None

Not Applicable

External Reviewer for methodology

 

 

 

 

International Peer Reviewers

 

 

 

 

None

Not Applicable

 

 

None

Not Applicable

 

 

None

Not Applicable

 

Annex Table 2. Guideline documentation; List of Retrieved Guidelines

N

Title

Database

English

Date

Organization

Type

Evidence Based

(method used)

1

Diagnostic approach to neonatal and infantile cholestasis: A position paper by the SIGENP liver disease working groups

Google scholar

Yes

2022

SIGENP liver disease working group; Italy

Position paper

Yes,

Method: GRADE

2

Italian guidelines for the management and treatment of neonatal cholestasis

Google scholar

Yes

2015

Italian Society of Neonatology

Guideline “review”

Yes

Method: Center for Evidence-Based-Medicine

3

Efficacy and safety of ursodeoxycholic acid in children with cholestasis

Google scholar

Yes

2023

Science and Technology Department of Sichuan Province, China

A systematic review and meta-analysis

-Quality of evidence (GRADE)

 

-Used Cochrane Collaboration risk of bias tool (Rob 2.0)

4

Early differential diagnosis methods of biliary atresia

Google scholar

Yes

2018

Authors, China

A meta-analysis

. Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2)

5

Diagnostic Performance of Sonographic Features in Patients with Biliary Atresia

Google scholar

Yes

2016

Authors, Korea

A systematic review and meta-analysis

. Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2)

6

Systematic review of progressive familial intrahepatic cholestasis

Google scholar

Yes

2019

Authors, multinational

A systematic review and meta-analysis

Used (PRISMA) guidelines protocol

7

Systematic Review: The Epidemiology, Natural History, and Burden of Alagille Syndrome

Google scholar

Yes

2018

Authors, multinational

A systematic review

Used (PRISMA) guidelines protocol

8

Diagnostic Efficacy of Advanced Ultrasonography Imaging Techniques in Infants with Biliary Atresia (BA)

Google scholar

Yes

2022

Authors, China

A systematic review and meta-analysis

Used (PRISMA) guidelines protocol 

Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2)

9

Guideline for the Evaluation of Cholestatic Jaundice in Infants: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition.2017

PubMed

 yes

2017 

ESPGHAN;

NSPGHAN 

 CPG

      Yes

Method: GRADE

10

Outcomes of Alagille syndrome following the Kasai operation: a systematic review and meta-analysis

PubMed

 yes

2018 

Fujishiro et al. 

 systematic review

Used: PRISMA guidelines Protocol

11

 Etiologies of conjugated hyperbilirubinemia in infancy: a systematic review of 1692 Subjects

PubMed

yes

2015 

Gottesman et al. 

 systematic review

Used: PRISMA guidelines Protocol

12

The value of preoperative liver biopsy in the diagnosis of extrahepatic biliary atresia: A systematic review and meta-analysis

PubMed

 yes

2016 

Lee et al. 

Systematic review

 

 

➡️Annex Table 3. Results of the AGREE II assessment of the three source guidelines for  

Guidelines

Domain 1

Scope& purpose

Domain 2

 

Stake hold involve

Domain 3

Rigor of develop.

Domain 4

Clarity of present.

Domain 5

Applicability

Domain 6

 

Editorial independence

Overall

1. Guideline for the Evaluation of Cholestatic Jaundice in Infants: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition

71%

47%

44%

88%

44%

30%

OA1:77% yes 3, yes with modifications 2, No 0

2. Diagnostic approach to neonatal and infantile cholestasis: A position paper by the SIGENP liver disease working group

87%

61%

66%

94%

65%

25%

 

 

 

 

 

 

                

OA 1 :60%

OA 2: Yes - 4, Yes with modifications - 0, No - 0

3. Italian guidelines for the management and treatment of neonatal cholestasis

76%

39%

30%

80%

28%

65%

OA1: 53%

OA 2 : Yes - 2, Yes with modifications - 2, No - 1

 

Annex 4. Nurses and Parents Educational Guide in Arabic


بطاقة لون براز الرضع فى بريتش كولومبيا

برنامج كشف رتق القناة الصفراوية (14)

 

Appendix Table 5. The RIGHT-Ad@pt checklist

7 sections, 27 topics, and 34 items

Assessment

Page(s)*

Note(s)

BASIC INFORMATION

Title/subtitle

1

Identify the report as an adaptation of practice guideline(s), that is include "guideline adaptation", "adapting", "adapted guideline/recommendation(s)", or similar terminology in the title/subtitle.

☒ Yes

☐ No

☐ Unclear

 

 

2

Describe the topic/focus/scope of the adapted guideline.

☒ Yes

☐ No

☐ Unclear

 

 

Cover/first page

3

Report the respective dates of publication and the literature search of the adapted guideline.

☒ Yes

☐ No

☐ Unclear

 

 

4

Describe the developer and country/region of the adapted guideline.

☒ Yes

☐ No

☐ Unclear

 

 

Executive summary/abstract

5

Provide a summary of the recommendations contained in the adapted guideline.

☒ Yes

☐ No

☐ Unclear

 

 

Abbreviations and acronyms

6

Define key terms and provide a list of abbreviations and acronyms (if applicable).

☒ Yes

☐ No

☐ Unclear

 

 

Contact information of the guideline adaptation group

7

Report the contact information of the developer of the adapted guideline.

☒ Yes

☐ No

☐ Unclear

 

 

SCOPE

Source guideline(s)

8

Report the name and year of publication of the source guideline(s), provide the citation(s), and whether source authors were contacted.

☒ Yes

☐ No

☐ Unclear

 

 

Brief description of the health problem(s)

9

Provide the basic epidemiological information about the problem (including the associated burden), health systems relevant issues, and note any relevant differences compared to the source guideline(s).

 

☒ Yes

☐ No

☐ Unclear

 

 

Aim(s) and specific objectives

10

Describe the aim(s) of the adapted guideline and specific objectives, and note any relevant differences compared to the source guideline(s).

☒ Yes

☐ No

☐ Unclear

 

 

Target population(s)

11

Describe the target population(s) and subgroup(s) (if applicable) to which the recommendation(s) is addressed in the adapted guideline, and note any relevant differences compared to the source guideline(s).

☒ Yes

☐ No

☐ Unclear

 

 

End-users and settings

12

Describe the intended target users of the adapted guideline, and note any relevant differences compared to the source guideline(s).

☒ Yes

☐ No

☐ Unclear

 

 

13

Describe the setting(s) for which the adapted guideline is intended, and note any relevant differences compared to the source guideline(s).

☒ Yes

☐ No

☐ Unclear

 

 

RIGOR OF DEVELOPMENT

Guideline adaptation group

14

List all contributors to the guideline adaptation process and describe their selection process and responsibilities.

☒ Yes

☐ No

☐ Unclear

 

 

Adaptation framework/methodology

15

Report which framework or methodology was used in the guideline adaptation process.

☒ Yes

☐ No

☐ Unclear

 

 

Source guideline(s)

16

Describe how the specific source guideline(s) was(were) selected.

☒ Yes

☐ No

☐ Unclear

 

 

Key questions

17

State the key questions of the adapted guideline using a structured format, such as PICO (population, intervention, comparator, and outcome), or another format as appropriate.

☒ Yes

☐ No

☐ Unclear

 

 

18

Describe how the key questions were developed/modified, and/or prioritized.

☐ Yes

☒ No

☐ Unclear

 

 

Source recommendation(s)

19

Describe how the recommendation(s) from the source guideline(s) was(were) assessed with respect to the evidence considered for the different criteria, the judgements and considerations made by the original panel.

☐ Yes

☒ No

☐ Unclear

 

 

Evidence synthesis

20

Indicate whether the adapted recommendation(s) is/are based on existing evidence from the source guideline(s), and/or additional evidence.

☐ Yes

☒ No

☐ Unclear

 

 

21

If new research evidence was used, describe how it was identified and assessed.

☐ Yes

☒ No

☐ Unclear

NA

 

Assessment of the certainty of the body of evidence and strength of recommendation

22

Describe the approach used to assess the certainty/quality of the body/ies of evidence and the strength of recommendations in the adapted guideline and note any differences (if applicable) compared to the source guideline(s).

☐ Yes

☒ No

☐ Unclear

NA

 

Decision-making processes

23

Describe the processes used by the guideline adaptation group to make decisions, particularly the formulation of recommendations.

 

☒ Yes

☐ No

☐ Unclear

 

 

RECOMMENDATIONS

Recommendations

24

Report recommendations and indicate whether they were adapted, adopted, or de novo.

☒ Yes

☐ No

☐ Unclear

 

 

25

Indicate the direction and strength of the recommendations and the certainty/quality of the supporting evidence and note any differences compared to the source recommendations(s) (if applicable).

☒ Yes

☐ No

☐ Unclear

 

 

26

Present separate recommendations for important subgroups if the evidence suggests important differences in factors influencing recommendations and note any differences compared to the source recommendations(s) (If applicable).

☒ Yes

☐ No

☐ Unclear

 

 

Rationale/explanation for recommendations

27

Describe the criteria/factors that were considered to formulate the recommendations or note any relevant differences compared to the source guideline(s) (if applicable).

☒ Yes

☐ No

☐ Unclear

 

 

EXTERNAL REVIEW AND QUALITY ASSURANCE

External review

28

Indicate whether the adapted guideline underwent an independent external review. If yes, describe the process.

☒ Yes

☐ No

☐ Unclear

 

 

Organizational approval

29

Indicate whether the adapted guideline obtained organizational approval. If yes, describe the process.

☒ Yes

☐ No

☐ Unclear

SNS  & NEBMC

 

FUNDING, DECLARATION, AND MANAGEMENT OF INTEREST

Funding source(s) and funder role(s)

30

Report all sources of funding for the adapted guideline and source guideline(s), and the role of the funders.

☒ Yes

☐ No

☐ Unclear

 

 

Declaration and management of interests

31

Report all conflicts of interest of the adapted and the source guideline(s) panels, and how they were evaluated and managed.

☒ Yes

☐ No

☐ Unclear

 

 

OTHER INFORMATION

Implementation

32

Describe the potential barriers and strategies for implementing the recommendations (if applicable).

☒ Yes

☐ No

☐ Unclear

 

 

Update

33

Briefly describe the strategy for updating the adapted guideline (if applicable).

☒ Yes

☐ No

☐ Unclear

 

 

Limitations and suggestions for further research

34

Describe the challenges of the adaptation process, the limitations of the evidence, and provide suggestions for future research.

☐ Yes

☒ No

☐ Unclear

--

 


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