{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:05:42Z","timestamp":1769040342014,"version":"3.49.0"},"reference-count":36,"publisher":"BMJ","issue":"3","funder":[{"name":"National Institute for Health Research Biomedical Research Centres at Imperial College London, the University of Oxford, and King\u2019s College London."},{"name":"United Kingdom Medical Research Council"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2018,6,8]]},"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To assess the impact of hypothermic neural rescue for perinatal asphyxia at birth on healthcare costs of survivors aged 6\u20137 years, and to quantify the relationship between costs and overall disability levels.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>6\u20137\u2009years follow-up of surviving children from the Total Body Hypothermia for Neonatal Encephalopathy (TOBY) trial.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Community study including a single parental questionnaire to collect information on children\u2019s healthcare resource use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients<\/jats:title>\n                  <jats:p>130 UK children (63 in the control group, 67 in the hypothermia group) whose parents consented and returned the questionnaire.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interventions<\/jats:title>\n                  <jats:p>Intensive care with cooling of the body to 33.5\u00b0C for 72\u2009hours or intensive care alone.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measures<\/jats:title>\n                  <jats:p>Healthcare resource usage and costs over the preceding 6\u2009months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>At 6\u20137 years, mean (SE) healthcare costs per child were \u00a31543 (\u00a3361) in the hypothermia group and \u00a32549 (\u00a3812) in the control group, giving a saving of \u2212\u00a31005 (95% CI \u2212\u00a32734 to \u00a3724). Greater levels of overall disability were associated with progressively higher costs, and more parents in the hypothermia group were employed (64%\u2009vs 47%). Results were sensitive to outlying observations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Cost results although not significant favoured moderate hypothermia and so complement the clinical results of the TOBY Children study. Estimates were however sensitive to the care requirements of two seriously ill children in the control group. A quantification of the relationship between costs and levels of disability experienced will be useful to healthcare professionals, policy makers and health economists contemplating the long-term economic consequences of perinatal asphyxia and hypothermic neural rescue.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>This study reports on the follow-up of the TOBY clinical trial: ClinicalTrials. gov number <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"NCT01092637\" ext-link-type=\"clintrialgov\">NCT01092637<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/archdischild-2017-314685","type":"journal-article","created":{"date-parts":[[2018,7,11]],"date-time":"2018-07-11T12:26:16Z","timestamp":1531311976000},"page":"F285-F292","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Hypothermia for perinatal asphyxia: trial-based resource use and costs at 6\u20137 years"],"prefix":"10.1136","volume":"104","clinical-trial-number":[{"clinical-trial-number":"nct01092637","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2233-6544","authenticated-orcid":false,"given":"Oliver","family":"Rivero-Arias","sequence":"first","affiliation":[{"name":"Nuffield Department of Population Health, National Perinatal Epidemiology Unit (NPEU), University of Oxford, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oya","family":"Eddama","sequence":"additional","affiliation":[{"name":"Nuffield Department of Population Health, National Perinatal Epidemiology Unit (NPEU), University of Oxford, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denis","family":"Azzopardi","sequence":"additional","affiliation":[{"name":"Centre for the Developing Brain, King\u2019s College London, London, UK"},{"name":"Institute of Clinical Sciences, Imperial College, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4801-7066","authenticated-orcid":false,"given":"A David","family":"Edwards","sequence":"additional","affiliation":[{"name":"Centre for the Developing Brain, King\u2019s College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brenda","family":"Strohm","sequence":"additional","affiliation":[{"name":"Nuffield Department of Population Health, National Perinatal Epidemiology Unit (NPEU), University of Oxford, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2070-7794","authenticated-orcid":false,"given":"Helen","family":"Campbell","sequence":"additional","affiliation":[{"name":"Nuffield Department of Population Health, National Perinatal Epidemiology Unit (NPEU), University of Oxford, Oxford, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,7,11]]},"reference":[{"key":"2025090512335599000_104.3.F285.1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2008.148205"},{"key":"2025090512335599000_104.3.F285.2","first-page":"CD003311","article-title":"Cooling for newborns with hypoxic ischaemic encephalopathy","volume":"69","author":"Jacobs","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"2025090512335599000_104.3.F285.3","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2011.30"},{"key":"2025090512335599000_104.3.F285.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1112066"},{"key":"2025090512335599000_104.3.F285.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1315788"},{"key":"2025090512335599000_104.3.F285.6","unstructured":"National Institute for Health and Care Excellence. 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