How reliably can paediatric professionals identify pale stool from cholestatic newborns?

Area of Science:

• Pediatric Gastroenterology
• Neonatal Surgery
• Diagnostic Accuracy

Background:

• Infant hepatobiliary disease requires timely surgical intervention for optimal outcomes.
• Pale stool color is a critical indicator of biliary obstruction, yet diagnosis is often delayed.
• Current methods for recognizing pale stools are insufficient, leading to late referrals.

Purpose of the Study:

• To evaluate the diagnostic skills of healthcare professionals in identifying pale infant stools.
• To determine the accuracy of recognizing stool color indicative of biliary obstruction.

Main Methods:

• Paediatric healthcare professionals from three London teaching hospitals participated.
• Participants reviewed photographs of normal, acholic (pale), and indeterminate infant stools.
• Stools were classified as 'healthy' or 'suspect' based on visual assessment.

Main Results:

• A significant proportion, one-third, of infant stools were misidentified by physicians and nurses.
• This highlights a critical gap in the recognition of stool color abnormalities.

Conclusions:

• Even experienced healthcare professionals frequently fail to recognize stool colors associated with biliary obstruction.
• The implementation of standardized stool color charts, similar to those used internationally, is proposed.
• These visual aids could enhance early detection of infant hepatobiliary disease cost-effectively.