Bada et al (1992) | 28 neonates screening cord blood haematocrit, and found to have both arterial haematocrit ≥63% with hyperviscosity, and asymptomatic Randomised to PPET or symptomatic care | RCT (level 1b) | Mental development index/IQ | Mean score in treated group 85 v observed 88; difference −3 (95% CI −19 to +13) | Mean 27.5 mth follow up, assessors blind to neonatal course 71% follow up rate |
| | | Mental retardation rate | Higher borderline retardation rate in treated group (66% v 45%; ARR = 0.21 (95% CI −0.21 to 0.63) | |
| | | | | |
Black et al (1985) | 93 neonates selected by: admission to nursery at 4–6 h of age, screened by heel prick testing, and found to have both venous polycythaemia (HCT ≥65%) and hyperviscosity, includes symptomatic and asymptomatic Randomised to PPET or symptomatic care | RCT (level 1b) | Mental delay rate | Reduced by PPET (18% v 13%); “not significant” (numbers not given) | 2 years follow up 65% follow up rate Includes 2 deaths in observed group, one of head trauma and one of hepatitis |
| | | Motor delay rate | Reduced by PPET (19% v 35%); “not significant” (numbers not given) | |
| | | Neurological diagnosis rate | Reduced by PPET (25% v 55%); p<0.05 | |
| | | | | |
Goldberg et al (1982) | 20 neonates, selected by: screening heel prick on all babies, result ≥68%, and hyperviscous on venous blood, excludes neurologically symptomatic Randomised to PPET or symptomatic care | RCT (level 1b) | Bayley mental development index | Mean difference 2.6 (95% CI −16 to 21) | 8 months 80% |
| | | Bayley psychomotor development index | (control score 112) | |
| | | Abnormal neurological findings | Mean difference −0.8 (95% CI −13 to 15) (control score 108) | |
| | | Abnormal postural reflexes | 1/6 of treatment group, 5/10 observed group, NNT = 3 (95% CI −10 to 1) 6/10 in treatment group, 0/6 in observed group, NNT = 2 (95% CI 1 to 3) | |
| | | | | |
van der Elst et al (1980) | 49 neonates selected by: appearance of polycythaemia, central haematocrit ≥65%, and no symptoms, or mildly symptomatic* Randomised to PPET or symptomatic care | RCT (level 1b) | Developmental score | “No difference” | 8 months follow up |
| | | Neurological examination | “No difference” (normal in all) | 86% follow up one death (NEC) in treatment group |