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• Journal article
  Vasu V, Durighel G, Thomas L, Malamateniou C, Bell JD, Rutherford MA, Modi Net al., 2014,

  Preterm nutritional intake and MRI phenotype at term age: a prospective observational study

  , BMJ OPEN, Vol: 4, ISSN: 2044-6055
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  • Citations: 24
• Journal article
  Modi N, 2014,

  Probiotics and Necrotising Enterocolitis: The Devil (as Always) Is in the Detail

  , NEONATOLOGY, Vol: 105, Pages: 71-73, ISSN: 1661-7800
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  • Citations: 35
• Journal article
  Watson SI, Arulampalam W, Petrou S, Marlow N, Morgan AS, Draper ES, Santhakumaran S, Modi Net al., 2014,

  The effects of designation and volume of neonatal care on mortality and morbidity outcomes of very preterm infants in England: retrospective population-based cohort study

  , BMJ OPEN, Vol: 4, ISSN: 2044-6055
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  • Citations: 44
• Journal article
  Modi N, 2014,

  Ethical pitfalls in neonatal comparative effectiveness trials.

  , Neonatology, Vol: 105, Pages: 350-351

  Evidence-based medicine has been embraced wholeheartedly, and rightly so, as the best approach for reducing clinical uncertainty and ensuring that patients receive treatment and care that are efficacious (i.e. they work) and effective (i.e. they work in real life). High-quality evidence comes from high-quality clinical research. It would hence be reasonable to assume that these two would form a closely integrated partnership. Alas, this is not yet the case. So many uncertainties in medical care relate to treatments and practices already widely in use. In neonatal medicine, for example, some of us use protein-carbohydrate fortification of human milk and some of us do not, some of us stop enteral feeds during blood transfusions whereas some of us do not, some of us reach for dopamine when blood pressure falls while some of us use dobutamine. For our patients, these uncertainties represent a lottery, the throw of the dice that determines whether they receive the treatment advocated by Dr. A or Dr. B. They deserve better than this. Randomization is considered the gold standard approach to eliminating the clinician bias that very often dominates the choice of treatments. Randomization reduces the influence on outcomes of confounding by unknown factors, and ensures that every patient has a fair and equal chance of receiving the best possible treatment when this is, in fact, not known. In an ideal world, every medical uncertainty would be addressed in this way. The evaluation of treatments that are in accepted use has been termed 'comparative effectiveness research', i.e. the comparison of existing healthcare interventions to determine which works best, for whom and under which circumstances. Recently a long-standing uncertainty, the optimum saturation target for preterm babies receiving oxygen was put to the test of randomization. The accepted standard-of-care saturation range of 85-95% has been used for a considerable time and its use is intended to avoid both levels of

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• Journal article
  Modi N, 2014,

  Breast Milk, Probiotics and Lactoferrin in Newborn Care: What Is the Evidence?

  , NEONATOLOGY, Vol: 106, Pages: 279-280, ISSN: 1661-7800
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• Journal article
  Cole TJ, Statnikov Y, Santhakumaran S, Pan H, Modi Net al., 2013,

  Birth weight and longitudinal growth in infants born below 32 weeks’ gestation: a UK population study

  , Archives of Disease in Childhood-Fetal and Neonatal Edition, Vol: 99, Pages: F34-F40, ISSN: 1468-2052

  OBJECTIVE: To describe birth weight and postnatal weight gain in a contemporaneous population of babies born <32 weeks' gestation, using routinely captured electronic clinical data. DESIGN: Anonymised longitudinal weight data from 2006 to 2011. SETTING: National Health Service neonatal units in England. METHODS: Birth weight centiles were constructed using the LMS method, and longitudinal weight gain was summarised as mean growth curves for each week of gestation until discharge, using SITAR (Superimposition by Translation and Rotation) growth curve analysis. RESULTS: Data on 103 194 weights of 5009 babies born from 22-31 weeks' gestation were received from 40 neonatal units. At birth, girls weighed 6.6% (SE 0.4%) less than boys (p<0.0001). For babies born at 31 weeks' gestation, weight fell after birth by an average of 258 g, with the nadir on the 8th postnatal day. The rate of weight gain then increased to a maximum of 28.4 g/d or 16.0 g/kg/d after 3 weeks. Conversely for babies of 22 to 28 weeks' gestation, there was on average no weight loss after birth. At all gestations, babies tended to cross weight centiles downwards for at least 2 weeks. CONCLUSIONS: In very preterm infants, mean weight crosses centiles downwards by at least two centile channel widths. Postnatal weight loss is generally absent in those born before 29 weeks, but marked in those born later. Assigning an infant's target centile at birth is potentially harmful as it requires rapid weight gain and should only be done once weight gain has stabilised. The use of electronic data reflects contemporary medical management.

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• Journal article
  Blencowe H, Lee ACC, Cousens S, Bahalim A, Narwal R, Zhong N, Chous D, Say L, Modi N, Katz J, Vos T, Marlow N, Lawn JEet al., 2013,

  Preterm birth-associated neurodevelopmental impairment estimates at regional and global levels for 2010

  , PEDIATRIC RESEARCH, Vol: 74, Pages: 17-34, ISSN: 0031-3998
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  • Citations: 262
• Journal article
  Modi N, 2013,

  Science and research for clinicians

  , ARCHIVES OF DISEASE IN CHILDHOOD-EDUCATION AND PRACTICE EDITION, Vol: 98, Pages: 131-131, ISSN: 1743-0585
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  • Citations: 1
• Journal article
  Modi N, 2013,

  How not to reduce uncertainties in care

  , BMJ-BRITISH MEDICAL JOURNAL, Vol: 346, ISSN: 1756-1833
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  • Citations: 10
• Journal article
  Gale C, Jeffries S, Logan K, Parkinson J, Uthaya S, Durighel G, Thomas E, Bell J, Modi Net al., 2013,

  P04 Adiposity of Healthy, Full-Term Breast-Fed and Formula-Fed Infants: A Prospective Cohort Study

  , Archives of Disease in Childhood, Vol: 98, Pages: A2-A2, ISSN: 0003-9888
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