Neonatal examination and screening trial (NEST) : a randomised, controlled, switchback trial of alternative policies for low risk infants.
Objective To evaluate the effectiveness of one rather than two hospital neonatal examinations in detection of abnormalities.
Design Randomised controlled switchback trial.
Setting Postnatal wards in a teaching hospital in north east Scotland.
Participants All infants delivered at the hospital between March 1993 and February 1995.
Intervention A policy of one neonatal screening examination compared with a policy of two.
Main outcome measures Congenital conditions diagnosed in hospital ; results of community healtl assessments at 8 weeks and 8 months ; outpatient referrals ; inpatient admissions ; use of general practioner services ; focused analysis of outcomes for suspected hip and heart abnormalities.
Results 4835 babies were allocated to receive one screening examination (one screen policy) and 4877 to receive two (two screen policy).
More congenital conditions were suspected at discharge among babies examined twice (9.9 upsilon 8.3 diagnoses per 100 babies ; 95% confidence interval for difference 0.3 to 2.7).
There was no overall significant difference between the groups in use of community, outpatient, or inpatient resources or in health care received.
Although more babies who were examined twice attended orthopaedic outpatient clinics (340 (7%) upsilon 289 (6%)), particularly for suspected congenital dislocation of the hip (176 (3.6/100 babies) upsilon 137 (2.8/100 babies) ; difference - 0.8 ; - 1.5 to 0.1) (...)
Mots-clés Pascal : Néonatal, Dépistage, Randomisation, Anomalie, Congénital, Essai clinique, Evaluation, Efficacité, Etude comparative, Hôpital, Grande Bretagne, Royaume Uni, Europe, Pédiatrie, Prévention
Mots-clés Pascal anglais : Neonatal, Medical screening, Randomization, Anomaly, Congenital, Clinical trial, Evaluation, Efficiency, Comparative study, Hospital, Great Britain, United Kingdom, Europe, Pediatrics, Prevention
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0168381
Code Inist : 002B20G03. Création : 16/11/1999.