scholarly journals P06.01: Routine late trimester ultrasound for the detection of small‐for‐gestational‐age and growth‐restricted fetus in low‐risk pregnancy: a randomised controlled trial

2019 ◽  
Vol 54 (S1) ◽  
pp. 169-170
Author(s):  
S.Z. Wanyonyi ◽  
D.M. Osoro ◽  
M. Temmerman
Keyword(s):  
Randomised Controlled Trial ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Controlled Trial ◽  
Low Risk ◽  
Age And Growth ◽  
Risk Pregnancy ◽  
Low Risk Pregnancy ◽  
Randomised Controlled

scholarly journals Home treatment of COPD exacerbation selected by DECAF score: a non-inferiority, randomised controlled trial and economic evaluation

Thorax ◽  
2018 ◽  
Vol 73 (8) ◽  
pp. 713-722 ◽  
Author(s):  
Carlos Echevarria ◽  
Joanne Gray ◽  
Tom Hartley ◽  
John Steer ◽  
Jonathan Miller ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Length Of Stay ◽  
Controlled Trial ◽  
Prognostic Score ◽  
Cost Effective ◽  
Low Risk ◽  
Copd Exacerbation ◽  
Hospitalised Patients ◽  
Life Years ◽  
Randomised Controlled

BackgroundPrevious models of Hospital at Home (HAH) for COPD exacerbation (ECOPD) were limited by the lack of a reliable prognostic score to guide patient selection. Approximately 50% of hospitalised patients have a low mortality risk by DECAF, thus are potentially suitable.MethodsIn a non-inferiority randomised controlled trial, 118 patients admitted with a low-risk ECOPD (DECAF 0 or 1) were recruited to HAH or usual care (UC). The primary outcome was health and social costs at 90 days.ResultsMean 90-day costs were £1016 lower in HAH, but the one-sided 95% CI crossed the non-inferiority limit of £150 (CI −2343 to 312). Savings were primarily due to reduced hospital bed days: HAH=1 (IQR 1–7), UC=5 (IQR 2–12) (P=0.001). Length of stay during the index admission in UC was only 3 days, which was 2 days shorter than expected. Based on quality-adjusted life years, the probability of HAH being cost-effective was 90%. There was one death within 90 days in each arm, readmission rates were similar and 90% of patients preferred HAH for subsequent ECOPD.ConclusionHAH selected by low-risk DECAF score was safe, clinically effective, cost-effective, and preferred by most patients. Compared with earlier models, selection is simpler and approximately twice as many patients are eligible. The introduction of DECAF was associated with a fall in UC length of stay without adverse outcome, supporting use of DECAF to direct early discharge.Trial registration numberRegistered prospectively ISRCTN29082260.

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