diff --git a/public/js/calculators.js b/public/js/calculators.js index 6330988..27c283a 100644 --- a/public/js/calculators.js +++ b/public/js/calculators.js @@ -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 @@ '
Bhutani hour-specific nomogram for infants ≥ 35 weeks GA. Values approximated from the Stanford Medicine Bhutani nomogram (reproduces Bhutani et al., Pediatrics 1999). Uncertainty ±0.3 mg/dL — use the AAP 2022 tab for phototherapy decisions.
'; + 'Bhutani hour-specific risk nomogram for infants ≥ 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.
'; // Chart: Bhutani zone curves with patient renderBiliChart(hours, tsb, [