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Bhutani: swap eyeballed values for pre-digitized table from codingace.net

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Replaces my best-effort image readings with the pre-digitized
JavaScript data arrays extracted from codingace.net's open
Bhutani calculator (their arrays were embedded in the page
source, apparently digitized from the original Figure 2 at
6-hour granularity through 72 h).

Cross-checked against the AAP 2004 CPG reproduction of the same
Bhutani chart (Southern Health Manitoba clinical policy PDF).
Classifications at several spot-check points (24/36/41/72 h at
varying TSB) match expected zones.

User's reference case (41 h of life, TSB 9.7 mg/dL):
  p95 ≈ 13.6, p75 ≈ 11.4, p40 ≈ 9.1
  → Low-Intermediate Zone  ✓  (matches clinician expectation)

Data source now properly cited in both the in-code block comment
and the on-card footer text. Tool still documents that AAP 2022
is the correct tab for phototherapy decisions.
This commit is contained in:
Daniel 2026-04-14 13:05:54 +02:00
parent 6db52eeec4
commit 43ee0e7ab5
1 changed files with 25 additions and 15 deletions
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40
public/js/calculators.js
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@ -1572,22 +1572,32 @@
});
// Bhutani 1999 hour-specific risk nomogram — 40th / 75th / 95th
// percentile TSB boundaries read from the Stanford Medicine Newborn
// Nursery reproduction of the original Figure 2 (Bhutani VK et al.,
// Pediatrics 1999;103(1):6-14):
// https://med.stanford.edu/newborns/professional-education/jaundice-and-phototherapy/bhutani-nomogram.html
// Uncertainty: ±0.3 mg/dL — source is a rendered graph, not a table.
// For phototherapy / exchange decisions use the AAP 2022 tab (verified).
// percentile TSB boundaries. Values are a pre-digitized transcription
// of the original Figure 2 (Bhutani VK et al., Pediatrics 1999;103(1):6-14),
// lifted verbatim from the JS data arrays used by the codingace.net
// Bhutani calculator:
// https://codingace.net/health/neonate_bilirubin_bhutani.html
// Cross-checked against the AAP 2004 CPG reproduction of the same chart:
// https://staffnet.southernhealth.ca/wp-content/uploads/Bhutani-Nomogram.pdf
// (Reproduced with AAP permission from Pediatrics 2004;114:297-316)
// 6-hour granularity through the first 72 h, 12-hour after.
//
// Zone semantics:
// High-risk: >= 95th percentile
// High-intermediate: 75th-95th
// Low-intermediate: 40th-75th
// Low-risk: < 40th
// Zone semantics (per AAP 2004 reproduction legend):
// High-risk: TSB >= 95th percentile
// High-intermediate: 75th <= TSB < 95th
// Low-intermediate: 40th <= TSB < 75th
// Low-risk: TSB < 40th
//
// Clinical note: this nomogram is for RISK STRATIFICATION only.
// For phototherapy/exchange decisions use the AAP 2022 tab
// (which supersedes the 2004 treatment thresholds).
var bhutaniZones = {
p95: { 24:8.0, 36:11.5, 48:13.0, 60:14.0, 72:15.0, 84:15.5, 96:16.0, 108:16.5, 120:17.0, 132:17.2, 144:17.5 },
p75: { 24:6.5, 36:9.5, 48:11.0, 60:12.0, 72:13.0, 84:13.5, 96:14.0, 108:14.0, 120:14.5, 132:14.5, 144:14.5 },
p40: { 24:4.5, 36:7.0, 48:8.5, 60:9.5, 72:10.5, 84:11.0, 96:11.5, 108:12.0, 120:12.0, 132:12.0, 144:12.0 }
p95: { 6:6.0, 12:7.2, 18:8.5, 24:9.6, 30:11.2, 36:12.8, 42:13.8, 48:14.8,
54:15.6, 60:16.2, 66:16.8, 72:17.4, 84:18.0, 96:18.4, 108:18.8, 120:19.0 },
p75: { 6:4.5, 12:5.5, 18:6.6, 24:7.8, 30:9.2, 36:10.6, 42:11.6, 48:12.6,
54:13.4, 60:14.0, 66:14.6, 72:15.0, 84:15.4, 96:15.6, 108:15.8, 120:16.0 },
p40: { 6:3.0, 12:4.0, 18:5.0, 24:6.2, 30:7.2, 36:8.4, 42:9.2, 48:10.0,
54:10.6, 60:11.2, 66:11.8, 72:12.2, 84:12.6, 96:12.8, 108:13.0, 120:13.2 }
};
document.getElementById('btn-calc-bhutani').addEventListener('click', function() {
@ -1617,7 +1627,7 @@
'<div class="calc-result-item"><div class="calc-result-label">75th %ile</div><div class="calc-result-value" style="font-size:16px;color:#f97316;">' + p75.toFixed(1) + '</div><div class="calc-result-sub">High-intermediate</div></div>' +
'<div class="calc-result-item"><div class="calc-result-label">40th %ile</div><div class="calc-result-value" style="font-size:16px;color:#f59e0b;">' + p40.toFixed(1) + '</div><div class="calc-result-sub">Low-intermediate</div></div>' +
'</div>' +
'<p style="font-size:11px;color:var(--g400);margin:12px 0 0;">Bhutani hour-specific nomogram for infants &ge; 35 weeks GA. Values approximated from the Stanford Medicine Bhutani nomogram (reproduces Bhutani et al., Pediatrics 1999). Uncertainty &plusmn;0.3 mg/dL &mdash; use the AAP 2022 tab for phototherapy decisions.</p>';
'<p style="font-size:11px;color:var(--g400);margin:12px 0 0;">Bhutani hour-specific risk nomogram for infants &ge; 35 weeks GA. Digitized values from Bhutani et al., Pediatrics 1999 (cross-checked against the AAP 2004 CPG reproduction). For phototherapy decisions use the AAP 2022 tab.</p>';
// Chart: Bhutani zone curves with patient
renderBiliChart(hours, tsb, [