Hypothermia for perinatal asphyxia: trial-based resource use and costs at 6-7 years.

Objective: To assess the impact of hypothermic neural rescue for perinatal asphyxia at birth on healthcare costs of survivors aged 6-7 years, and to quantify the relationship between costs and overall disability levels.

Design: 6-7 years follow-up of surviving children from the Total Body Hypothermia for Neonatal Encephalopathy (TOBY) trial.

Setting: Community study including a single parental questionnaire to collect information on children's healthcare resource use.

Hypothermia for perinatal asphyxia: trial-based quality of life at 6-7 years.

Objective: To assess the impact of hypothermic neural rescue at birth on health-related quality of life (HRQL) in middle childhood.

Design: Six-year to 7-year follow-up of surviving children from the Total Body Hypothermia for Neonatal Encephalopathy (TOBY) Trial.

Setting: Community study including a single parental questionnaire to collect information on children's HRQL.

Effect of MRI on preterm infants and their families: a randomised trial with nested diagnostic and economic evaluation.

Background: We tested the hypothesis that routine MRI would improve the care and well-being of preterm infants and their families.

Design: Parallel-group randomised trial (1.1 allocation; intention-to-treat) with nested diagnostic and cost evaluations (EudraCT 2009-011602-42).

Effects of hypothermia for perinatal asphyxia on childhood outcomes.

Background: In the Total Body Hypothermia for Neonatal Encephalopathy Trial (TOBY), newborns with asphyxial encephalopathy who received hypothermic therapy had improved neurologic outcomes at 18 months of age, but it is uncertain whether such therapy results in longer-term neurocognitive benefits.

Methods: We randomly assigned 325 newborns with asphyxial encephalopathy who were born at a gestational age of 36 weeks or more to receive standard care alone (control) or standard care with hypothermia to a rectal temperature of 33 to 34°C for 72 hours within 6 hours after birth. We evaluated the neurocognitive function of these children at 6 to 7 years of age.

Patient isolation measures for infants with candida colonization or infection for preventing or reducing transmission of candida in neonatal units.

Background: Candida is a common nosocomial infection and is associated with increased healthcare costs. In neonates, candida infection is associated with high mortality and morbidity and is transmitted by direct and indirect contact. Patient isolation measures, i.

Cost-effectiveness of therapeutic hypothermia to treat neonatal encephalopathy.

Objective: To estimate the cost-effectiveness (CE) of total body hypothermia plus intensive care versus intensive care alone to treat neonatal encephalopathy.

Methods: Decision analytic modeling was used to synthesize mortality and morbidity data from three randomized controlled trials, the Total Body Hypothermia for Neonatal Encephalopathy Trial (TOBY), National Institute of Child Health and Human Development (NICHD), and CoolCap trials. Cost data inputs were informed by TOBY, the sole source of prospectively collected resource utilization data for encephalopathic infants.

A structured review of the recent literature on the economic consequences of preterm birth.

Although survival rates for preterm infants have greatly improved over the last three to four decades, these infants remain at risk of developing a broad range of short-term and long-term complications. Despite the large body of work on the clinical sequelae of preterm birth, relatively little is known about its economic consequences. This paper represents a structured review of the recent scientific literature on the economic consequences of preterm birth for the health services, for other sectors of the economy, for families and carers and, more broadly, for society.

Study of progesterone for the prevention of preterm birth in twins (STOPPIT): findings from a trial-based cost-effectiveness analysis.

Objectives: Preterm birth contributes to a range of healthcare problems amongst infants surmounting to sizeable healthcare costs. Twin pregnancies are at particular risk of preterm birth. The objective of this study was to assess the cost-effectiveness of vaginal progesterone gel for the prevention of preterm birth in twin pregnancies.

Use of economic evaluation in local health care decision-making in England: a qualitative investigation.

Objective: To explore decision-making and the use of economic evaluation at the local health care decision-making level in England (UK).

Methods: Data collection was over a 16-month period (January 2003 to April 2004). Data collection comprised 29 in-depth interviews with a range of decision makers, 13 observations of decision-making meetings, and analysis of documents produced at meetings.

A systematic review of the use of economic evaluation in local decision-making.

Objectives: In view of resource scarcity, decisions have to be made on the optimal allocation of resources and one possible option in health care is economic evaluation. Little is known, however, about the use of economic evaluation. The objectives of this review were to assimilate the empirical evidence on this topic, discuss the main findings, and explore the possible need for further work needed in this area.