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    HElmet therapy Assessment in infants with Deformed Skulls (HEADS): protocol for a randomised controlled trial

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    Author
    van Wijk, RM; Boere-Boonekamp, MM; Groothuis-Oudshoorn, CGM; van Vlimmeren, LA; IJzerman, MJ
    Date
    2012-07-09
    Source Title
    Trials
    Publisher
    BMC
    University of Melbourne Author/s
    IJzerman, Maarten
    Affiliation
    Melbourne School of Population and Global Health
    Metadata
    Show full item record
    Document Type
    Journal Article
    Citations
    van Wijk, R. M., Boere-Boonekamp, M. M., Groothuis-Oudshoorn, C. G. M., van Vlimmeren, L. A. & IJzerman, M. J. (2012). HElmet therapy Assessment in infants with Deformed Skulls (HEADS): protocol for a randomised controlled trial. TRIALS, 13 (1), https://doi.org/10.1186/1745-6215-13-108.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/254991
    DOI
    10.1186/1745-6215-13-108
    Abstract
    BACKGROUND: In The Netherlands, helmet therapy is a commonly used treatment in infants with skull deformation (deformational plagiocephaly or deformational brachycephaly). However, evidence of the effectiveness of this treatment remains lacking. The HEADS study (HElmet therapy Assessment in Deformed Skulls) aims to determine the effects and costs of helmet therapy compared to no helmet therapy in infants with moderate to severe skull deformation. METHODS/DESIGN: Pragmatic randomised controlled trial (RCT) nested in a cohort study. The cohort study included infants with a positional preference and/or skull deformation at two to four months (first assessment). At 5 months of age, all children were assessed again and infants meeting the criteria for helmet therapy were asked to participate in the RCT. Participants were randomly allocated to either helmet therapy or no helmet therapy. Parents of eligible infants that do not agree with enrolment in the RCT were invited to stay enrolled for follow up in a non-randomisedrandomised controlled trial (nRCT); they were then free to make the decision to start helmet therapy or not. Follow-up assessments took place at 8, 12 and 24 months of age. The main outcome will be head shape at 24 months that is measured using plagiocephalometry. Secondary outcomes will be satisfaction of parents and professionals with the appearance of the child, parental concerns about the future, anxiety level and satisfaction with the treatment, motor development and quality of life of the infant. Finally, compliance and costs will also be determined. DISCUSSION: HEADS will be the first study presenting data from an RCT on the effectiveness of helmet therapy. Outcomes will be important for affected children and their parents, health care professionals and future treatment policies. Our findings are likely to influence the reimbursement policies of health insurance companies.Besides these health outcomes, we will be able to address several methodological questions, e.g. do participants in an RCT represent the eligible target population and do outcomes of the RCT differ from outcomes found in the nRCT? TRIAL REGISTRATION: ISRCTN18473161.

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