Screening for biliary atresia by infant stool color card in Taiwan

Shan Ming Chen, Mei Hwei Chang, Jung Chieh Du, Chieh Chung Lin, An Chyi Chen, Hung Chang Lee, Beng Huat Lau, Yao Jong Yang, Tzee Chung Wu, Chia Hsiang Chu, Ming Wei Lai, Huey Ling Chen, Shu Fen Wu, Yu Cheng Lin, Lung Huang Lin, Ya Huei Tasi, Wen Terng Lin, Chun Hsien Yu, Shiun Bin Fang, Ching Fing Huang & 6 others Hui Wen Chen, Ming Hua Chen, Wn Hsin Wen, Ming Tzong Cheng, Yu Kung Chou, Te Jen Chen

Research output: Contribution to journalArticle

96 Citations (Scopus)

Abstract

OBJECTIVE. We aimed to detect biliary atresia (BA) in early infancy to prevent additional liver damage because of the delay of referral and surgical treatment and to investigate the incidence rate of BA in Taiwan. METHODS. A pilot study to screen the stool color in infants for the early diagnosis of BA was undertaken from March 2002 to December 2003. We had designed an "infant stool color card" with 7 numbers of different color pictures and attached it to the child health booklet. Parents were then asked to observe their infant's stool color by using this card. The medical staff would check the number that the parents chose according to their infant's stool color at 1 month of age during the health checkup and then send the card back to the stool color card registry center. RESULTS. The average return rate was ∼65.2% (78 184 infants). A total of 29 infants were diagnosed as having BA, and 26 were screened out by stool color card before 60 days of age. The sensitivity, specificity, and positive predictive value were 89.7%, 99.9%, and 28.6%, respectively. Seventeen (58.6%) infants with BA received a Kasai operation within 60-day age period. The estimated incidence of BA in screened newborns was 3.7 of 10 000. CONCLUSIONS. The stool color card was a simple, efficient, and applicable mass screening method for early diagnosis and management of BA. The program can also help in estimating the incidence and creating a registry of these patients.

Original languageEnglish
Pages (from-to)1147-1154
Number of pages8
JournalPediatrics
Volume117
Issue number4
DOIs
Publication statusPublished - 2006
Externally publishedYes

Fingerprint

Biliary Atresia
Taiwan
Color
Registries
Early Diagnosis
Incidence
Parents
Mass Screening
Pamphlets
Medical Staff
Referral and Consultation
Newborn Infant
Sensitivity and Specificity
Liver
Health

Keywords

  • Biliary atresia
  • Incidence
  • Infant stool color card
  • Kasai operation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Chen, S. M., Chang, M. H., Du, J. C., Lin, C. C., Chen, A. C., Lee, H. C., ... Chen, T. J. (2006). Screening for biliary atresia by infant stool color card in Taiwan. Pediatrics, 117(4), 1147-1154. https://doi.org/10.1542/peds.2005-1267

Screening for biliary atresia by infant stool color card in Taiwan. / Chen, Shan Ming; Chang, Mei Hwei; Du, Jung Chieh; Lin, Chieh Chung; Chen, An Chyi; Lee, Hung Chang; Lau, Beng Huat; Yang, Yao Jong; Wu, Tzee Chung; Chu, Chia Hsiang; Lai, Ming Wei; Chen, Huey Ling; Wu, Shu Fen; Lin, Yu Cheng; Lin, Lung Huang; Tasi, Ya Huei; Lin, Wen Terng; Yu, Chun Hsien; Fang, Shiun Bin; Huang, Ching Fing; Chen, Hui Wen; Chen, Ming Hua; Wen, Wn Hsin; Cheng, Ming Tzong; Chou, Yu Kung; Chen, Te Jen.

In: Pediatrics, Vol. 117, No. 4, 2006, p. 1147-1154.

Research output: Contribution to journalArticle

Chen, SM, Chang, MH, Du, JC, Lin, CC, Chen, AC, Lee, HC, Lau, BH, Yang, YJ, Wu, TC, Chu, CH, Lai, MW, Chen, HL, Wu, SF, Lin, YC, Lin, LH, Tasi, YH, Lin, WT, Yu, CH, Fang, SB, Huang, CF, Chen, HW, Chen, MH, Wen, WH, Cheng, MT, Chou, YK & Chen, TJ 2006, 'Screening for biliary atresia by infant stool color card in Taiwan', Pediatrics, vol. 117, no. 4, pp. 1147-1154. https://doi.org/10.1542/peds.2005-1267
Chen SM, Chang MH, Du JC, Lin CC, Chen AC, Lee HC et al. Screening for biliary atresia by infant stool color card in Taiwan. Pediatrics. 2006;117(4):1147-1154. https://doi.org/10.1542/peds.2005-1267
Chen, Shan Ming ; Chang, Mei Hwei ; Du, Jung Chieh ; Lin, Chieh Chung ; Chen, An Chyi ; Lee, Hung Chang ; Lau, Beng Huat ; Yang, Yao Jong ; Wu, Tzee Chung ; Chu, Chia Hsiang ; Lai, Ming Wei ; Chen, Huey Ling ; Wu, Shu Fen ; Lin, Yu Cheng ; Lin, Lung Huang ; Tasi, Ya Huei ; Lin, Wen Terng ; Yu, Chun Hsien ; Fang, Shiun Bin ; Huang, Ching Fing ; Chen, Hui Wen ; Chen, Ming Hua ; Wen, Wn Hsin ; Cheng, Ming Tzong ; Chou, Yu Kung ; Chen, Te Jen. / Screening for biliary atresia by infant stool color card in Taiwan. In: Pediatrics. 2006 ; Vol. 117, No. 4. pp. 1147-1154.
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AU - Chen, Shan Ming

AU - Chang, Mei Hwei

AU - Du, Jung Chieh

AU - Lin, Chieh Chung

AU - Chen, An Chyi

AU - Lee, Hung Chang

AU - Lau, Beng Huat

AU - Yang, Yao Jong

AU - Wu, Tzee Chung

AU - Chu, Chia Hsiang

AU - Lai, Ming Wei

AU - Chen, Huey Ling

AU - Wu, Shu Fen

AU - Lin, Yu Cheng

AU - Lin, Lung Huang

AU - Tasi, Ya Huei

AU - Lin, Wen Terng

AU - Yu, Chun Hsien

AU - Fang, Shiun Bin

AU - Huang, Ching Fing

AU - Chen, Hui Wen

AU - Chen, Ming Hua

AU - Wen, Wn Hsin

AU - Cheng, Ming Tzong

AU - Chou, Yu Kung

AU - Chen, Te Jen

PY - 2006

Y1 - 2006

N2 - OBJECTIVE. We aimed to detect biliary atresia (BA) in early infancy to prevent additional liver damage because of the delay of referral and surgical treatment and to investigate the incidence rate of BA in Taiwan. METHODS. A pilot study to screen the stool color in infants for the early diagnosis of BA was undertaken from March 2002 to December 2003. We had designed an "infant stool color card" with 7 numbers of different color pictures and attached it to the child health booklet. Parents were then asked to observe their infant's stool color by using this card. The medical staff would check the number that the parents chose according to their infant's stool color at 1 month of age during the health checkup and then send the card back to the stool color card registry center. RESULTS. The average return rate was ∼65.2% (78 184 infants). A total of 29 infants were diagnosed as having BA, and 26 were screened out by stool color card before 60 days of age. The sensitivity, specificity, and positive predictive value were 89.7%, 99.9%, and 28.6%, respectively. Seventeen (58.6%) infants with BA received a Kasai operation within 60-day age period. The estimated incidence of BA in screened newborns was 3.7 of 10 000. CONCLUSIONS. The stool color card was a simple, efficient, and applicable mass screening method for early diagnosis and management of BA. The program can also help in estimating the incidence and creating a registry of these patients.

AB - OBJECTIVE. We aimed to detect biliary atresia (BA) in early infancy to prevent additional liver damage because of the delay of referral and surgical treatment and to investigate the incidence rate of BA in Taiwan. METHODS. A pilot study to screen the stool color in infants for the early diagnosis of BA was undertaken from March 2002 to December 2003. We had designed an "infant stool color card" with 7 numbers of different color pictures and attached it to the child health booklet. Parents were then asked to observe their infant's stool color by using this card. The medical staff would check the number that the parents chose according to their infant's stool color at 1 month of age during the health checkup and then send the card back to the stool color card registry center. RESULTS. The average return rate was ∼65.2% (78 184 infants). A total of 29 infants were diagnosed as having BA, and 26 were screened out by stool color card before 60 days of age. The sensitivity, specificity, and positive predictive value were 89.7%, 99.9%, and 28.6%, respectively. Seventeen (58.6%) infants with BA received a Kasai operation within 60-day age period. The estimated incidence of BA in screened newborns was 3.7 of 10 000. CONCLUSIONS. The stool color card was a simple, efficient, and applicable mass screening method for early diagnosis and management of BA. The program can also help in estimating the incidence and creating a registry of these patients.

KW - Biliary atresia

KW - Incidence

KW - Infant stool color card

KW - Kasai operation

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