Effect of MRI on preterm infants and their families: a randomized trial with nested diagnostic and economic evaluation
<p>Background: We tested the hypothesis that routine magnetic resonance imaging (MRI) would improve the care and wellbeing of preterm infants and their families.</p> <p>Design: Parallel-group randomized trial (1.1 allocation; intention-to-treat) with nested diagnostic and cost eval...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Journal article |
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BMJ Publishing Group
2017
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| _version_ | 1826259826087297024 |
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| author | Edwards, A Redshaw, M Kennea, N Rivero Arias, O Gonzalez-Cinca, N Nongena, P Ederies, M Falconer, S Chew, A Omar, O Hardy, P Harvey, M Eddama, O Hayward, N Wurie, J Azzopardi, D Rutherford, M Counsell, S |
| author_facet | Edwards, A Redshaw, M Kennea, N Rivero Arias, O Gonzalez-Cinca, N Nongena, P Ederies, M Falconer, S Chew, A Omar, O Hardy, P Harvey, M Eddama, O Hayward, N Wurie, J Azzopardi, D Rutherford, M Counsell, S |
| author_sort | Edwards, A |
| collection | OXFORD |
| description | <p>Background: We tested the hypothesis that routine magnetic resonance imaging (MRI) would improve the care and wellbeing of preterm infants and their families.</p> <p>Design: Parallel-group randomized trial (1.1 allocation; intention-to-treat) with nested diagnostic and cost evaluations (EudraCT 2009-011602-42).</p> <p>Setting: Participants from 14 London hospitals, imaged at a single centre.</p> <p>Patients: 511 infants born before 33 weeks gestation underwent both MRI and ultrasound around term. 255 were randomly allocated (siblings together) to receive only MRI results, and 255 only ultrasound from a pediatrician unaware of unallocated results; one withdrew before allocation.</p> <p>Main outcome measures: Maternal anxiety, measured by the State-Trait Anxiety Index (STAI) assessed in 206/214 mothers receiving MRI and 217/220 receiving ultrasound. Secondary outcomes included: prediction of neurodevelopment; health-related costs and quality of life.</p> <p>Results: After MRI, STAI fell from 36·81 (95% confidence interval (CI); 35·18-38·44) to 32·77 (31·54-34·01), 31·87 (30·63-33·12) and 31·82 (30·65-33·00) at 14 days, 12 and 20 months respectively. STAI fell less after ultrasound: from 37·59 (36·00-39·18) to 33·97 (32·78-35·17), 33·43 (32·22-34·63), and 33·63 (32·49-34·77); P=0·02. There were no differences in health-related quality of life. MRI predicted moderate or severe functional motor impairment at 20 months slightly better than ultrasound (AUROC (CI) 0·74; 0·66-0·83 v 0·64; 0·56-0·72; P=0·01) but cost £315 (CI £295-£336) more per infant.</p> <p>Conclusions: MRI increased costs and provided only modest benefits</p> |
| first_indexed | 2024-03-06T18:55:55Z |
| format | Journal article |
| id | oxford-uuid:11d6b116-9d8a-441d-ab9e-35278cac4ac6 |
| institution | University of Oxford |
| last_indexed | 2024-03-06T18:55:55Z |
| publishDate | 2017 |
| publisher | BMJ Publishing Group |
| record_format | dspace |
| spelling | oxford-uuid:11d6b116-9d8a-441d-ab9e-35278cac4ac62022-03-26T10:04:30ZEffect of MRI on preterm infants and their families: a randomized trial with nested diagnostic and economic evaluationJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:11d6b116-9d8a-441d-ab9e-35278cac4ac6Symplectic Elements at OxfordBMJ Publishing Group2017Edwards, ARedshaw, MKennea, NRivero Arias, OGonzalez-Cinca, NNongena, PEderies, MFalconer, SChew, AOmar, OHardy, PHarvey, MEddama, OHayward, NWurie, JAzzopardi, DRutherford, MCounsell, S<p>Background: We tested the hypothesis that routine magnetic resonance imaging (MRI) would improve the care and wellbeing of preterm infants and their families.</p> <p>Design: Parallel-group randomized trial (1.1 allocation; intention-to-treat) with nested diagnostic and cost evaluations (EudraCT 2009-011602-42).</p> <p>Setting: Participants from 14 London hospitals, imaged at a single centre.</p> <p>Patients: 511 infants born before 33 weeks gestation underwent both MRI and ultrasound around term. 255 were randomly allocated (siblings together) to receive only MRI results, and 255 only ultrasound from a pediatrician unaware of unallocated results; one withdrew before allocation.</p> <p>Main outcome measures: Maternal anxiety, measured by the State-Trait Anxiety Index (STAI) assessed in 206/214 mothers receiving MRI and 217/220 receiving ultrasound. Secondary outcomes included: prediction of neurodevelopment; health-related costs and quality of life.</p> <p>Results: After MRI, STAI fell from 36·81 (95% confidence interval (CI); 35·18-38·44) to 32·77 (31·54-34·01), 31·87 (30·63-33·12) and 31·82 (30·65-33·00) at 14 days, 12 and 20 months respectively. STAI fell less after ultrasound: from 37·59 (36·00-39·18) to 33·97 (32·78-35·17), 33·43 (32·22-34·63), and 33·63 (32·49-34·77); P=0·02. There were no differences in health-related quality of life. MRI predicted moderate or severe functional motor impairment at 20 months slightly better than ultrasound (AUROC (CI) 0·74; 0·66-0·83 v 0·64; 0·56-0·72; P=0·01) but cost £315 (CI £295-£336) more per infant.</p> <p>Conclusions: MRI increased costs and provided only modest benefits</p> |
| spellingShingle | Edwards, A Redshaw, M Kennea, N Rivero Arias, O Gonzalez-Cinca, N Nongena, P Ederies, M Falconer, S Chew, A Omar, O Hardy, P Harvey, M Eddama, O Hayward, N Wurie, J Azzopardi, D Rutherford, M Counsell, S Effect of MRI on preterm infants and their families: a randomized trial with nested diagnostic and economic evaluation |
| title | Effect of MRI on preterm infants and their families: a randomized trial with nested diagnostic and economic evaluation |
| title_full | Effect of MRI on preterm infants and their families: a randomized trial with nested diagnostic and economic evaluation |
| title_fullStr | Effect of MRI on preterm infants and their families: a randomized trial with nested diagnostic and economic evaluation |
| title_full_unstemmed | Effect of MRI on preterm infants and their families: a randomized trial with nested diagnostic and economic evaluation |
| title_short | Effect of MRI on preterm infants and their families: a randomized trial with nested diagnostic and economic evaluation |
| title_sort | effect of mri on preterm infants and their families a randomized trial with nested diagnostic and economic evaluation |
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