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September 26, 2014
Letter to the Editor

Cost of traumatic brain injury in New Zealand
Evidence from a population-based study

Braden Te Ao, MPH, Paul Brown, PhD, Martin Tobias, MBBCh, Shanthi Ameratunga, PhD, Suzanne Barker-Collo, PhD, Alice Theadom, PhD, Kathryn McPherson, PhD, Nicola Starkey, PhD, Anthony Dowell, MBChB, Kelly Jones, PhD, and Valery L. Feigin, PhD, MD On behalf of the BIONIC Study GroupAuthors Info & Affiliations
October 28, 2014 issue
83 (18) 1645-1652
https://doi.org/10.1212/WNL.0000000000000933
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Abstract

Objective:

We aimed to estimate from a societal perspective the 1-year and lifetime direct and indirect costs of traumatic brain injury (TBI) for New Zealand (NZ) in 2010 projected to 2020.

Methods:

An incidence-based cost of illness model was developed using data from the Brain Injury Outcomes New Zealand in the Community Study. Details of TBI-related resource use during the first 12 months after injury were obtained for 725 cases using resource utilization information from participant surveys and medical records. Total costs are presented in US dollars year 2010 value.

Results:

In 2010, 11,301 first-ever TBI cases were estimated to have occurred in NZ; total first-year cost of all new TBI cases was estimated to be US $47.9 million with total prevalence costs of US $101.4 million. The average cost per new TBI case during the first 12 months and over a lifetime was US $5,922 (95% confidence interval [CI] $4,777–$7,858), varying from US $4,636 (95% CI $3,756–$5,561) for mild cases to US $36,648 (95% CI $16,348–$65,350) for moderate/severe cases. Because of the unexpectedly large number of mild TBI cases (95% of all TBI cases), the total cost of treating these cases is nearly 3 times that of moderate/severe. The total lifetime cost of all TBI survivors in 2010 was US $146.5 million and is expected to increase to US $177.1 million in 2020.

Conclusion:

The results suggest that there is an urgent need to develop effective interventions to prevent both mild and moderate/severe TBI.

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Supplementary Material

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Letters to the Editor
10 November 2014
BURDEN OF TRAUMATIC BRAIN INJURY:INDIAN SCENARIO
Khichar Purnaram Shubhakaran, Associate Professor Neurology

Braden et al. [1] estimated the cost of traumatic brain injury (TBI) in New Zealand. They suggested an urgent need to develop effective interventions, preventing both mild and moderate/severe TBI. If no action is taken, the goals of the proposed Decade for Action for Road Safety 2011-2020 will not be achieved. [2]

The cost of TBI prevention is much higher in large nations like India because safety measures for roads and workplaces are technically less advanced. There are about 231,000 deaths per year in India from road traffic accidents. [2,3] The government has planned to decrease this number by half in the next three years. [3] To achieve this goal, a draft for road safety on par with the US and UK was created. [3] In general, this is a welcome step for the medical field. [3]

1. Te Ao B, Brown P, Tobias M, et al. Cost of traumatic brain injury in New Zealand-Evidence from a population-based study. Neurology 2014;83:1645-1652.

2. Ruikar M. National statistics of road traffic accidents in India. J Orthop Traumatol Rehab 2013;6:1-6.

3. Choganwkar S. (2014, October 30). Our road safety law will be like that of UK and USA. In: Rajasthan Patrika [online]. Available at: http://www.patrika.com/india-news-hindi. Accessed October 30, 2014.

For disclosures, please contact the editorial office at [email protected].

Information & Authors

Information

Published In

Neurology®
Volume 83 • Number 18 • October 28, 2014
Pages: 1645-1652
PubMed: 25261503

Copyright

© 2014 American Academy of Neurology.

Publication History

Received: March 1, 2014
Accepted: July 29, 2014
Published online: September 26, 2014
Published in print: October 28, 2014

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Disclosure

The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.

Study Funding

The study was funded by the Health Research Council of New Zealand. Braden Te Ao was supported by a PhD fellowship from the Health Research Council of New Zealand and a Waikato Tainui doctoral grant.

Authors

Affiliations & Disclosures

Braden Te Ao, MPH
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
PhD Fellowship from the Health Research Council of New Zealand
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
Doctoral grant from Waikato-Tainui (a Maori Charitable Trust in Hamilton New Zealand).
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Paul Brown, PhD
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Martin Tobias, MBBCh
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
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Shanthi Ameratunga, PhD
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
Injury Prevention (BMJ Publishing Group) - Editorial Board Journal of Adolescent Health - Editorial Board
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
(1) Health Research Council of New Zealand (HRC) 10/631 Principal Investigator, 2010-2013 (2) HRC 11/626 Principal Investigator, 2011-current (3) HRC 09/142 Co-investigator, 2009-2014 (4) HRC 10/588 Co-investigator, 2010-2013
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Suzanne Barker-Collo, PhD
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
editorial board of Neuroepidemiology
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Alice Theadom, PhD
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
Assistant Editor, Neuroepidemiology
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
Research grants received from commercial organisations for testing of herbal supplements for people following a TBI
Research Support, Government Entities:
1.
Health Research Council (09/063;11/192;13/408)Senior Research Fellow and study operational lead, 2009-2014
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
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Kathryn McPherson, PhD
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
Disclosure
Scientific Advisory Boards:
1.
1) Honoraria for serving as an associate editor on a BMJ group Journal (PMJ)
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
1) Non Profit - travel for invited conference presentations
Editorial Boards:
1.
1) Associate Editor Postgraduate Medical Journal since 2012 2) Editorial Board Clinical Rehabilitation since 2004 3) Editorial Board Occupational Rehabilitation since 2007 4) Editorial Board Disability and. Rehabilitation since 2001
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
1) Crown Entity - consultancy to the Accident Compensation Corporation (NZ) 2) Government ministry - Board a Member of the Work and Income Board of the Ministry of Social Development
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
1) 2014 Theadom, McPherson, Feigin et al HRC Improving multi- faceted functioning in people after brain injury: A feasibility study $150,000 2) 2014 Kayes, McPherson et al HRC Implementing new ways of working in physiotherapy practice to optimise outcome $150,000 3) 2013 McPherson, Harwood, Kayes, Kersten et al HRC Living well with a long term neurological condition $1.2 million 2013 Kersten, McPherson, Kayes, Seigert HRC Improving participatory outcomes in TBI: a feasibility study $144,780
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
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Nicola Starkey, PhD
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
Current Psychology, editorial board member, 2013- current
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
Health Research Council of New Zealand
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
View all articles by this author
Anthony Dowell, MBChB
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
1. Non profit. NZ Health Quality and Safety Commission. Travel to present HQSCC initiative at RNZCGP COllege conference. July 25-7 2014
Editorial Boards:
1.
1). Journal of Primary Health Care. Deputy Editor - 2010- present. 2. Australian Journal of Primary Care. Editorial Board member. 2011 - present. 3. BMC Family Practice. Associate Editor. 2011 - present.
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
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Kelly Jones, PhD
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
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Valery L. Feigin, PhD, MD
From the National Institute for Stroke and Applied Neurosciences (B.T.A., A.T., K.J., V.L.F.), and Health and Rehabilitation Research Institute (K.M.), Faculty of Health and Environmental Studies, AUT University, Auckland, New Zealand; School of Social Sciences, Humanities and Arts (P.B.), University of California, Merced; Public Health Intelligence (M.T.), Ministry of Health, Wellington; School of Population Health, Faculty of Medical and Health Sciences (S.A.), and Department of Psychology (S.B.-C.), The University of Auckland; Department of Psychology (N.S.), Faculty of Arts and Social Sciences, The University of Waikato, Hamilton; and Primary Health Care and General Practice (A.D.), University of Otago, Wellington, New Zealand.
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On behalf of the BIONIC Study Group

Notes

Correspondence to Braden Te Ao: [email protected]
BIONIC Study Group coinvestigators are listed on the Neurology® Web site at Neurology.org.
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

Author Contributions

Braden Te Ao: drafting/revising the manuscript, study concept or design, analysis or interpretation of data, accepts responsibility for conduct of research and will give final approval. Paul Brown: drafting/revising the manuscript, study concept or design, analysis or interpretation of data, accepts responsibility for conduct of research and will give final approval, statistical analysis, study supervision. Martin Tobias: drafting/revising the manuscript, study concept or design, analysis or interpretation of data, accepts responsibility for conduct of research and will give final approval. Shanthi Ameratunga: drafting/revising the manuscript, study concept or design, analysis or interpretation of data, accepts responsibility for conduct of research and will give final approval. Suzanne Barker-Collo: drafting/revising the manuscript, study concept or design, accepts responsibility for conduct of research and will give final approval, study supervision, operations and steering committee. Alice Theadom: drafting/revising the manuscript, study concept or design, analysis or interpretation of data, accepts responsibility for conduct of research and will give final approval, acquisition of data, statistical analysis, study supervision, obtaining funding. Kathryn McPherson: drafting/revising the manuscript, analysis or interpretation of data, accepts responsibility for conduct of research and will give final approval, obtaining funding. Nicola Starkey: drafting/revising the manuscript, study concept or design, analysis or interpretation of data, accepts responsibility for conduct of research and will give final approval, acquisition of data, study supervision, obtaining funding. Anthony Dowell: drafting/revising the manuscript, accepts responsibility for conduct of research and will give final approval, study supervision. Kelly Jones: drafting/revising the manuscript, accepts responsibility for conduct of research and will give final approval, study supervision. Valery L. Feigin: study concept or design, accepts responsibility for conduct of research and will give final approval, study supervision, obtaining funding.

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