{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T05:45:18Z","timestamp":1792734318793,"version":"4.5.0"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T00:00:00Z","timestamp":1715904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>A pilot randomised controlled trial assessed the early application of nasal high\u2010flow (NHF) therapy compared with standard oxygen therapy (SOT), in children aged 0 to 16\u2009years presenting to paediatric emergency departments with acute hypoxaemic respiratory failure (AHRF). The study estimated the need to escalate therapy and hospital length of stay in the NHF group compared with SOT. This sub\u2010study then assessed the subsequent cost\u2010effectiveness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A decision tree\u2010based model was developed, alongside the clinical study, to estimate cost\u2010effectiveness, from the healthcare sector perspective. The primary health economics outcome is measured as incremental cost per length of hospital stay avoided. Incremental cost effectiveness ratios (ICER) measuring change in cost per change in length of stay, were obtained for four samples, depending on responder status and obstructive airways disease. These were (1) obstructive and responder, (2) non\u2010obstructive and responder, (3) obstructive and non\u2010responder and (4) non obstructive and non\u2010responder. Bootstrapping of parameters accounted for uncertainty in estimates of cost and outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The ICER for patients randomised to NHF, indicated an additional A$367.20 for a lower hospital length of stay (in days) in the non\u2010obstructive\/non\u2010responder sample. In the bootstrap sample, this was found to be cost effective above a willingness to pay threshold of A$10\u2009000. The ICER was A$440.86 in the obstructive\/responder sample and A$469.56 in the non\u2010obstructive\/responder sample \u2013 but both resulted in a longer length of stay. The ICER in the obstructive\/non\u2010responder sample was A$52\u2009167.76, also with a longer length of stay, mainly impacted by a small sample of severe cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>As first\u2010line treatment, NHF is unlikely to be cost\u2010effective compared with SOT, but for non\u2010obstructive patients who required escalation in care (non\u2010obstructive non\u2010responder), NHF is likely to be cost\u2010effective if willingness\u2010to\u2010pay per reduced hospital length of stay is more than A$10\u2009000 per patient.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.16558","type":"journal-article","created":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T12:11:44Z","timestamp":1715947904000},"page":"229-239","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Cost\u2010effectiveness of nasal high\u2010flow in children with acute hypoxaemic respiratory failure"],"prefix":"10.1111","volume":"60","author":[{"given":"Brenda","family":"Gannon","sequence":"first","affiliation":[{"name":"School of Economics University of Queensland  Brisbane Queensland Australia"},{"name":"University of Queensland Centre for the Business and Economics of Health  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1650-3270","authenticated-orcid":false,"given":"Donna","family":"Franklin","sequence":"additional","affiliation":[{"name":"Children's Emergency and Critical Care Research Gold Coast University Hospital  Gold Coast Queensland Australia"},{"name":"Emergency Department Gold Coast University Hospital  Gold Coast Queensland Australia"},{"name":"Faculty of Medicine The University of Queensland  Brisbane Queensland Australia"},{"name":"Menzies Health Institute Queensland Griffith University  Gold Coast Queensland Australia"},{"name":"Paediatric Research in Emergency Departments International Collaborative (PREDICT)  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinh","family":"Vo","sequence":"additional","affiliation":[{"name":"School of Economics University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franz E","family":"Babl","sequence":"additional","affiliation":[{"name":"Paediatric Research in Emergency Departments International Collaborative (PREDICT)  Melbourne Victoria Australia"},{"name":"Emergency Department Royal Children's Hospital  Melbourne Victoria Australia"},{"name":"Murdoch Children's Research Institute  Melbourne Victoria Australia"},{"name":"Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Schibler","sequence":"additional","affiliation":[{"name":"Paediatric Research in Emergency Departments International Collaborative (PREDICT)  Melbourne Victoria Australia"},{"name":"St Andrew's War Memorial Hospital  Brisbane Queensland Australia"},{"name":"Critical Care Research Group, St Andrew's War Memorial Hospital  Brisbane Queensland Australia"},{"name":"Wesley Medical Research  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61698-6"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.12688\/wellcomeopenres.12747.2"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(15)70017-4"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61901-1"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60222-6"},{"key":"e_1_2_7_7_1","volume-title":"Recommendations for Management 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