Abstract
The present study evaluated end-user experience for effectiveness, efficiency, and satisfaction of a mobile application (app) to estimate the risk of rebound hyperbilirubinemia within 72 hours after initial phototherapy ends for infants at 35 weeks’ gestation or longer and age younger than 14 days. This prospective parallel study was performed at one medical center. The 26 participants are neonatology and pediatric and family physicians, neonatal and family nurse practitioners, and family practice residents, who were asked to estimate the risk of rebound hyperbilirubinemia when phototherapy is stopped for a fictional newborn. Participants in Group 1 (no app) were compared with Group 2 (with app). Satisfaction measured from 1 (0%) to 7 (100%). Group 1 had fewer correct answers than Group 2 (38.5% vs. 84.6%; P = .04). The mean satisfaction score for Group 1 was 2, lower than the score for Group 2, 6.6 (P < .001). This provider-developed app is effective and receives high end-user satisfaction.
Highlights
Worldwide, hyperbilirubinemia is a leading cause of neonatal morbidity and death.(1,2) The treatment goal of neonatal jaundice is WKHSUHYHQWLRQRINHUQLFWHUXVDQGQHZERUQSKRWRWKHUDS\LVHႇHFtive
Emerging evidence shows that DNA damage with phototherapy may cause melanocytic nevi and, potentially, infantile cancer.(3,4) Newborns who receive phototherapy have a small increased risk of childhood seizures, noted even after adjusting for bilirubin levels, at 4 per 1,000 excess risks over ten years.(5)
The purpose of the present study was WR HYDOXDWH HQGXVHU H[SHULHQFH IRU HႇHFWLYHQHVV HႈFLHQF\ DQG satisfaction of the app, which provides decision support and does the calculation to estimate the risk of rebound hyperbilirubinemia if phototherapy is stopped for infants born at 35 weeks’ gestation or greater and before age 14 days
Summary
Hyperbilirubinemia is a leading cause of neonatal morbidity and death.(1,2) The treatment goal of neonatal jaundice is WKHSUHYHQWLRQRINHUQLFWHUXVDQGQHZERUQSKRWRWKHUDS\LVHႇHFtive. Every treatment has associated adverse events, and this includes phototherapy of newborns for hyperbilirubinemia. Emerging evidence shows that DNA damage with phototherapy may cause melanocytic nevi and, potentially, infantile cancer.(3,4) Newborns who receive phototherapy have a small increased risk of childhood seizures, noted even after adjusting for bilirubin levels, at 4 per 1,000 excess risks over ten years.(5). Chang et al(6) investigated the timing of stopping ¿UVWWLPH LQSDWLHQW QHZERUQ SKRWRWKHUDS\ IRU ODWHSUHWHUP DQG term infants younger than 14 days. They reported that “34% of infants may have been able to discontinue inpatient phototherapy a day earlier with < 4% risk of rebound hyperbilirubinemia.”
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