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Glob Pediatr Health. 2019 Feb 26;6:2333794X19829757. doi: 10.1177/2333794X19829757. eCollection 2019.

Knowledge, Attitudes, and Behaviors of Pediatric Primary Care Providers on Management of Cholestasis.

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Division of Pediatric Gastroenterology, Hasbro Children's Hospital, Providence/Rhode Island Hospital, RI, USA.
Department of Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA.
Departments of Emergency Medicine and Pediatrics, Alpert Medical School of Brown University, Providence, RI, USA.


Biliary atresia is a common cause of cholestasis in infants and is a time-sensitive diagnosis. A survey was distributed to pediatric primary care providers in order to assess variations in diagnosis and management of cholestasis. Participants were identified from physician parent groups on social media and regional pediatric residency programs. Information on knowledge and interpretation of screening tests, past experience/behavior, confidence, and comfort level managing cholestasis, as well as demographic information was collected. Out of 116 eligible respondents, 94.8% were confident in diagnosing hyperbilirubinemia but only 10.3% knew the biochemical definition of direct hyperbilirubinemia. Of the 56% of providers who had some knowledge of the guidelines, 18.5% stated the guidelines changed the way they evaluate cholestasis. These results demonstrate a gap in knowledge of diagnosing and evaluating cholestasis, which could provide the framework for standardized screening, leading to earlier identification of biliary atresia.


biliary atresia; cholestasis; pediatric primary care; quality improvement

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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