title: How reliably can paediatric professionals identify pale stool from cholestatic newborns?
abstract: BACKGROUND
  The success of surgery in infants with hepatobiliary disease is inversely proportional to the age when surgery was performed. Pale stool colour is a major indicator of biliary obstruction. However, simple recognition has been inadequate, resulting in late diagnosis and referral. Objective To assess the skills of healthcare professionals in recognising pale stools.
  
  
  METHODS
  Photographs of normal, acholic and indeterminate infant stools were shown to paediatric professionals who have regular contact with jaundiced babies at three London teaching hospitals. Each stool was classified as 'healthy' or 'suspect'.
  
  
  RESULTS
  One-third of the stools were not correctly identified by physicians and nurses.
  
  
  CONCLUSIONS
  Experienced professionals often do not recognise stool colour associated with biliary obstruction. The authors propose that stool colour cards similar to those used in Japan and Taiwan may improve early detection of hepatobiliary disease at a minimal cost.
authors.affiliation: King’s College Hospital, London, UK.
authors.forename: B
authors.initials: B
authors.lastname: Bakshi
authors.forename: A
authors.initials: A
authors.lastname: Sutcliffe
authors.forename: M
authors.initials: M
authors.lastname: Akindolie
authors.forename: B
authors.initials: B
authors.lastname: Vadamalayan
authors.forename: S
authors.initials: S
authors.lastname: John
authors.forename: C
authors.initials: C
authors.lastname: Arkley
authors.forename: L D
authors.initials: LD
authors.lastname: Griffin
authors.forename: A
authors.initials: A
authors.lastname: Baker
mesh_terms: D001656:Biliary Atresia / Q000175:diagnosis; D002779:Cholestasis / Q000175:diagnosis*; D002983:Clinical Competence; D003116:Color; D005243:Feces; D006801:Humans; D007231:Infant, Newborn; D010372:Pediatrics; D010781:Photography; D015203:Reproducibility of Results