{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:16:03Z","timestamp":1788336963714,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T00:00:00Z","timestamp":1725840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>Diagnostic delay remains a barrier to improving biliary atresia (BA) outcomes. We tested the implementation feasibility of a two stage BA newborn screening program in an integrated healthcare system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Under a waiver of consent, we measured direct bilirubin (DB) levels in well newborns undergoing standard of care hyperbilirubinemia screening at four hospitals. Initial DB was measured by modifying nursery admission electronic medical record order sets. Second\u2010stage DB was obtained at ~2 weeks of age under parental permission\/informed consent (PP\/IC). Implementation measures included the proportions of (1) eligible newborns that were screened before nursery discharge, (2) newborns undergoing second stage screening at ~2 weeks of age, and (3) newborns that underwent clinical evaluation for persistently elevated DB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 12,276 newborns met eligibility criteria for screening, of which 12,055 (98.2%) underwent first\u2010stage screening in the newborn nursery. Ninety\u2010four (0.78%) had elevated positive initial screens. Ninety newborns (95.7%) underwent second\u2010stage screening (<jats:italic>n<\/jats:italic>\u2009=\u200920) or contact was made with the primary care provider to recommend second\u2010stage screening (<jats:italic>n<\/jats:italic>\u2009=\u200970). Among all screened newborns, 15 (0.12%) had abnormal second screens. All had follow\u2010up clinical evaluation for potential cholestatic liver disease. No BA cases were identified through screening, though two infants who met exclusion criteria (admission to the newborn intensive care unit) were subsequently diagnosed with BA during the screening period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>BA newborn screening is feasible in an integrated health network. Low consent rates have implications for future studies. Program infrastructure is required for implementation success and sustainability.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpn3.12367","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T11:04:36Z","timestamp":1725879876000},"page":"954-961","source":"Crossref","is-referenced-by-count":3,"title":["Feasibility of biliary atresia newborn screening in an integrated health network"],"prefix":"10.1002","volume":"79","author":[{"given":"Stephen L.","family":"Guthery","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Spencer F. Eccles School of Medicine, Division of Pediatric Gastroenterology, Hepatology and Nutrition University of Utah Salt Lake City Utah USA"},{"name":"Intermountain Primary Children's Hospital Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Kyle Jensen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Spencer F. Eccles School of Medicine, Division of Pediatric Gastroenterology, Hepatology and Nutrition University of Utah Salt Lake City Utah USA"},{"name":"Intermountain Primary Children's Hospital Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Sean Esplin","sequence":"additional","affiliation":[{"name":"Women's Health Clinical Program Intermountain Health Salt Lake City Utah USA"},{"name":"Department of Obstetrics and Gynecology, Spencer F. Eccles School of Medicine University of Utah Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Obstetric &amp; Neonatal Operations Intermountain Health Salt Lake City Utah USA"},{"name":"Division of Neonatology, Department of Pediatrics, Spencer F. Eccles School of Medicine University of Utah Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jake","family":"Krong","sequence":"additional","affiliation":[{"name":"Office of Research Intermountain Health Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajendu","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Intermountain Primary Children's Hospital Salt Lake City Utah USA"},{"name":"Healthcare Delivery Institute Intermountain Health Salt Lake City Utah USA"},{"name":"Department of Pediatrics, Spencer F. 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