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Validity of neurodevelopmental outcomes of children born very preterm assessed during routine clinical follow-up in England.
- Source :
- Archives of Disease in Childhood -- Fetal & Neonatal Edition; Sep2018, Vol. 103 Issue 5, pF479-F484, 6p, 1 Diagram, 3 Charts, 1 Graph
- Publication Year :
- 2018
-
Abstract
- <bold>Objective: </bold>To determine the validity of assessing and recording the neurodevelopmental outcome of very preterm infants during routine clinical follow-up in England.<bold>Design: </bold>Children born <30 weeks gestation, attending routine clinical follow-up at post-term ages 20-28 months, were recruited. Data on neurodevelopmental outcomes were recorded by the reviewing clinician in a standardised format in the child's electronic patient record, based on a set of key questions designed to be used without formal training or developmental testing. Using a predefined algorithm, each participant was classified as having 'no', 'mild/moderate' or 'severe' impairment in cognitive, communication and motor domains. All participants also received a research assessment by a single assessor using the Bayley Scales of Infant Development, third edition (Bayley-III). The sensitivity and specificity of routine data in capturing impairment (any Bayley-III score <85) or severe impairment (any Bayley-III score <70) was calculated.<bold>Results: </bold>190 children participated. The validity of routine assessments in identifying children with no impairment and no severe impairment was high across all domains (specificities 83.9%-100.0% and 96.6%-100.0%, respectively). However, identification of impairments, particularly in the cognitive (sensitivity 69.7% (55.1%-84.3%)) and communication (sensitivity (53.2% (42.0%-64.5%)) domains, was poor.<bold>Conclusions: </bold>Neurodevelopmental status determined during routine clinical assessment lacks adequate sensitivity in cognitive and communication domains. It is uncertain whether this reflects the assessment or/and the recording of findings. As early intervention may improve education and social outcomes, this is an important area for healthcare quality improvement research. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 13592998
- Volume :
- 103
- Issue :
- 5
- Database :
- Complementary Index
- Journal :
- Archives of Disease in Childhood -- Fetal & Neonatal Edition
- Publication Type :
- Academic Journal
- Accession number :
- 131377867
- Full Text :
- https://doi.org/10.1136/archdischild-2016-312535