Alkaline agar gel electrophoresis is a basic manual laborious technique for identifying

OBJECTIVE:To correlate Total Serum Bilirubin (TSB) values to the clinical course of hyperbilirubinemia in newborns as this can be an indirect method of quality assurance in the laboratory. METHODS: An observational study of bilirubin values from 100 randomly selected case records of newborn jaundice for a period of 6 months. TSB values were determined by diazo reaction on venous blood samples on a semi auto analyzer. MS excel sheet used for statistical analysis. RESULTS: Clinical course of hyperbilirubinemia in all subjects correlated well to the reported TSB values in first to last zones corresponding to <6mg/dL and >15mg/dL on 3rd day to 5th day of age. Zones 3, 4 and 5 varied from 7th day of birth, as phototherapy and recovery altered visual assessment of jaundice. One patient was expired with kernicterus had very high TSB value. The median bilirubin values trend downfall which correlated clinically to recovery from jaundice and 33% rapid decline in TSB also indicated the intervention by phototherapy. CONCLUSIONS: Bilirubin is one parameter with higher inter laboratory variability since its discovery till today. Hence more quality methods are to be developed to minimize this bias in clinical interpretation of reported bilirubin levels. Our study is an intermediary quality measure useful for both clinicians and lab personnel. This study can be adopted for retrospective quality evaluation and can be adopted for other parameters as well.

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