{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T12:46:42Z","timestamp":1792673202123,"version":"4.5.0"},"reference-count":0,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Biochem"],"abstract":"<jats:p>Background: The National Institute for Health and Care Excellence (NICE) guideline: management of neonatal jaundice [CG98] outlines total bilirubin (TBil) thresholds for the treatment of neonatal jaundice. Despite wide analytical variation in TBil, evidenced on external quality assessment schemes, the thresholds are based on a single Roche diazo assay. Adoption of these thresholds may result in inappropriate treatment decisions depending on the analytical methodology. This study assesses TBil method bias using pooled neonatal (&lt;29 days) samples, prompted by incidents within Greater Manchester where differences in neonatal TBil measurements obtained due to transfer of care across sites caused clinical confusion. \r\rMethods: Seventeen serum and 9 plasma neonatal pools were analysed in duplicate on 6  platforms: Roche Cobas 701, Roche Pro, Abbott Alinity, Beckman Coulter AU5800, Siemens Atellica and Siemens XPT , utilising 5 diazo and 2 vanadate oxidation methodologies. Measurement biases compared to Roche Cobas were assessed.  \r\rResults: Siemens Atellica and XPT vanadate oxidation methods exhibited significant positive bias: 17.4% [95% CI: 15.0-19.8%] and 17.0% [95% CI: 15.0-19.0%], respectively. All diazo methods were within desirable bias limits (+\/-8%) as defined by the European Federation of Clinical Chemistry and Laboratory Medicine analytical performance specifications. Bias for Siemens vanadate oxidation and Beckman Coulter diazo methods exhibited matrix variation.\r\rConclusions: Use of Siemens TBil vanadate oxidation method may lead to over treatment of neonatal jaundice when using NICE [CG98] thresholds. Laboratory professionals should evaluate the appropriateness of their TBil methodology in collaboration with their neonatal teams to minimise risks of overtreatment.<\/jats:p>","DOI":"10.1177\/00045632261492544","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T13:46:37Z","timestamp":1789479997000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparability of Total Bilirubin methods for neonatal samples across 6 NHS trusts within North West England"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7505-0104","authenticated-orcid":false,"given":"Francesca","family":"Ryan-Beswick","sequence":"first","affiliation":[{"name":"Manchester University NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlin","family":"Kyle","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Parke","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley","family":"Tetlow","sequence":"additional","affiliation":[{"name":"Central Manchester University Hospitals NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven John","family":"McCann","sequence":"additional","affiliation":[{"name":"Stepping Hill Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharman","family":"Harris","sequence":"additional","affiliation":[{"name":"Stepping Hill Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Armitage","sequence":"additional","affiliation":[{"name":"Alder Hey Children's NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mandy","family":"Pickersgill","sequence":"additional","affiliation":[{"name":"Tameside and Glossop Integrated Care NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faustina","family":"Owusu","sequence":"additional","affiliation":[{"name":"Manchester University NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Scargill","sequence":"additional","affiliation":[{"name":"Northern Care Alliance NHS Foundation Trust"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,15]]},"container-title":["Annals of Clinical Biochemistry: International Journal of Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00045632261492544","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00045632261492544","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T12:12:42Z","timestamp":1792671162000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00045632261492544"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,15]]},"references-count":0,"alternative-id":["10.1177\/00045632261492544"],"URL":"https:\/\/doi.org\/10.1177\/00045632261492544","relation":{},"ISSN":["0004-5632","1758-1001"],"issn-type":[{"value":"0004-5632","type":"print"},{"value":"1758-1001","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,15]]},"article-number":"00045632261492544"}}