TY - JOUR T1 - Investigating early developmental impairment: what's the cost? JF - Archives of Disease in Childhood JO - Arch Dis Child DO - 10.1136/archdischild-2017-313532 SP - archdischild-2017-313532 AU - Anthony R Hart AU - Daniel JA Connolly AU - Ruchi Sharma Y1 - 2017/07/26 UR - http://adc.bmj.com/content/early/2017/07/26/archdischild-2017-313532.abstract N2 - Considerable resources are spent on determining the cause of early developmental impairment (EDI) in children, yet the most appropriate investigations are unknown. Significant differences in opinion exist between UK clinicians on whether children with EDI are investigated appropriately and on the value of specific investigations.1 Algorithms on how to investigate EDI have been proposed over the last 20 years, and the number of recommended first-line laboratory investigations has increased,2–4 without good evidence on their usefulness or cost efficiency. We obtained guidelines for investigating EDI from 23 centres as part of a survey of UK clinicians1 and found variation in recommended investigations, with only karyotype/microarray being consistent across all guidelines (figure 1).Figure 1 Investigations recommended in 23 guidelines obtained from UK clinicians. Columns represent individual guidelines, and rows individual investigations. Grey boxes represent a first-line investigation to be performed in all children with early developmental … ER -