{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T18:13:33Z","timestamp":1773944013263,"version":"3.50.1"},"reference-count":27,"publisher":"National Institute for Health and Care Research","license":[{"start":{"date-parts":[[2023,10,24]],"date-time":"2023-10-24T00:00:00Z","timestamp":1698105600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR202025"],"award-info":[{"award-number":["NIHR202025"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["openresearch.nihr.ac.uk"],"crossmark-restriction":false},"short-container-title":["NIHR Open Res"],"abstract":"<ns3:p>Background Special educational needs (SEN) provision is designed to help pupils with additional educational, behavioural or health needs; for example, pupils with cleft lip and\/or palate may be offered SEN provision to improve their speech and language skills. Our aim is to contribute to the literature and assess the impact of SEN provision on health and educational outcomes for a well-defined population. Methods We will use the ECHILD database, which links educational and health records across England. Our target population consists of children identified within ECHILD to have a specific congenital anomaly: isolated cleft lip and\/or palate. We will apply a trial emulation framework to reduce biases in design and analysis of observational data to investigate the causal impact of SEN provision (including none) by the start of compulsory education (Year One \u2013 age five year on entry) on the number of unplanned hospital utilisation and school absences by the end of primary education (Year Six \u2013 age ten\/eleven). We will use propensity score-based estimators (inverse probability weighting (IPW) and IPW regression adjustment IPW) to compare categories of SEN provision in terms of these outcomes and to triangulate results obtained using complementary estimation methods (Na\u00efve estimator, multivariable regression, parametric g-formula, and if possible, instrumental variables), targeting a variety of causal contrasts (average treatment effect\/in the treated\/in the not treated) of SEN provision. Conclusions This study will evaluate the impact of reasonable adjustments at the start of compulsory education on health and educational outcomes in the isolated cleft lip and palate population by triangulating complementary methods under a target-trial framework.<\/ns3:p>","DOI":"10.3310\/nihropenres.13472.1","type":"journal-article","created":{"date-parts":[[2023,10,24]],"date-time":"2023-10-24T07:19:42Z","timestamp":1698131982000},"page":"54","update-policy":"https:\/\/doi.org\/10.3310\/nihropenres.crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Early special educational needs provision and its impact on unplanned hospital utilisation and school absences in children with isolated cleft lip and\/or palate: a demonstration target trial emulation study protocol using 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status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.3310\/nihropenres.14618.r30721, Amy L Conrad, The Stead Family Department of Pediatrics, The University of Iowa, Iowa City, Iowa, 30 Nov 2023, version 1, indexed","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/3-54\/v1#referee-response-30721","order":0,"name":"referee-response-30721","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.3310\/nihropenres.14618.r30814, Yvonne Wren, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University & Bristol Dental School, University of Bristol, Bristol, 14 Dec 2023, version 1, indexed","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/3-54\/v1#referee-response-30814","order":1,"name":"referee-response-30814","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.3310\/nihropenres.14618.r30818, Chunlin Li, School of Biomedical Engineering & Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Capital Medical University, Beijing, 17 Jan 2024, version 1, indexed","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/3-54\/v1#referee-response-30818","order":2,"name":"referee-response-30818","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This project is funded by the National Institute for Health and Care Research (NIHR) under its Programme Grants for Applied Research Programme (Grant Reference Number NIHR202025). RG is supported by a NIHR Senior Investigator award. ECHILD is supported by ADR UK (Administrative Data Research UK), an Economic and Social Research Council (part of UK Research and Innovation) programme (Grant Reference Numbers ES\/V000977\/1, ES\/X003663\/1, ES\/X000427\/1). Research at UCL Great Ormond Street Institute of Child Health is supported by the NIHR Great Ormond Street Hospital Biomedical Research Centre.\u202f. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}