[Appropriate use of laboratory tests - direct bilirubin testing]
Gonthier K, Neveu B, Robitaille H
Record ID 32018014899
French
Original Title:
Utilisation judicieuse des analyses biomédicales - Dosage de la bilirubine directe
Authors' objectives:
The testing of direct bilirubin raises several issues concerning its relevance, as its use is
rarely justified without first obtaining an abnormal total serum bilirubin result. In Québec,
the number of direct bilirubin tests has remained relatively stable in recent years. The
objective of this work is to develop a guidance sheet to support appropriate use, in order
to reduce the volume of procedures with low added value within Québec’s healthcare
system.
Authors' results and conclusions:
RESULTS: (#1 DIRECT BILIRUBIN TESTING IS NOT INDICATED): • following a normal total serum bilirubin result. (#2 THE REPETITION OF DIRECT BILIRUBIN TESTING IS NOT SYSTEMATICALLY INDICATED): • in persons with Gilbert’s syndrome presenting with chronic hyperbilirubinemia,
even if the total serum bilirubin remains elevated. (#3 IN THE PRESENCE OF AN ELEVATED TOTAL SERUM BILIRUBIN RESULT, DIRECT BILIRUBIN TESTING MAY BE
INDICATED):• in newborns with a gestational age ≥ 35 weeks who are:
- jaundiced within the first 24 hours of life, or
- presenting with persistent jaundice. CONCLUSION: The guidance sheet that was developed aims to engage, guide, and support healthcare
professionals in promoting the appropriate use of direct bilirubin testing. It may thus
contribute to reduce the number of annual test requests and associated costs and
workload, while also generating a positive environmental impact.
Authors' methods:
A review of the literature on indications and recommendations related to direct bilirubin
testing was conducted using INESSS’s rapid review methodology. Healthcare
professionals provided experiential and contextual knowledge specific to Québec.
Details
Project Status:
Completed
URL for project:
https://www.inesss.qc.ca/publications/repertoire-des-publications/publication/utilisation-judicieuse-des-analyses-biomedicales.html
Year Published:
2025
URL for published report:
https://www.inesss.qc.ca/fileadmin/doc/INESSS/Rapports/Technologies/Analyses_biomed_Bilirubine_directe_GN_INESSS.pdf
English language abstract:
An English language summary is available
Publication Type:
Other
Country:
Canada
Province:
Quebec
MeSH Terms
- Bilirubin
- Diagnostic Tests, Routine
- Jaundice
- Jaundice, Neonatal
- Liver Diseases
Contact
Organisation Name:
Institut national d'excellence en sante et en services sociaux
Contact Address:
L'Institut national d'excellence en sante et en services sociaux (INESSS) , 2021, avenue Union, bureau 10.083, Montreal, Quebec, Canada, H3A 2S9;Tel: 1+514-873-2563, Fax: 1+514-873-1369
Contact Name:
demande@inesss.qc.ca
Contact Email:
demande@inesss.qc.ca
Copyright:
L'Institut national d'excellence en sante et en services sociaux (INESSS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.