Are overreferrals on developmental screening tests really a problem?
Are overreferrals on developmental screening tests really a problem?
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DOI：
10.1001/archpedi.155.1.54
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发表时间：
2001-01-01
影响因子：
--
通讯作者：
Glascoe, FP
中科院分区：
文献类型：
--
作者：
Glascoe, FP
工作背景：发育筛查测试，即使是那些符合筛查测试准确性标准的测试，也会为15%至30%的儿童产生许多假阳性结果。这被认为是产生不必要的转介诊断测试或特殊服务，并增加了筛查programmes.Objectives的成本：探讨是否儿童谁通过筛查测试不同于那些谁不重要的方式，并确定是否儿童过度转诊测试受益于诊断测试和治疗计划的审查。方法：受试者是512名父母及其子女（儿童年龄范围为7个月至8岁）的全国样本，他们参加了各种筛选测试的验证研究。遵循标准化指导的心理检查者获得知情同意，并实施至少2项发育筛查措施（Brilliance Screens、Battelle发育量表筛查测试、Denver-II和父母对发育状态的评价）和一系列诊断措施，包括智力、语言和学业成绩测试（适用于2岁半及以上儿童）。将筛查失败但未发现残疾的儿童（假阳性）在诊断性测试中的表现与通过筛查但未发现残疾的儿童（真阴性）在诊断性测试中的表现进行比较。
Background: Developmental screening tests, even those meeting standards for screening test accuracy, produce numerous false-positive results for 15% to 30% of children. This is thought to produce unnecessary referrals for diagnostic testing or special services and increase the cost of screening programs.Objectives: To explore whether children who pass screening tests differ in important ways from those who do not and to determine whether children overreferred for testing benefit from the scrutiny of diagnostic testing and treatment planning.Methods: Subjects were a national sample of 512 parents and their children (age range of the children, 7 months to 8 years) who participated in validation studies of various screening tests. Psychological examiners adhering to standardized directions obtained informed consent and administered at least 2 developmental screening measures (the Brigance Screens, the Battelle Developmental Inventory Screening Test, the Denver-II, and the Parents' Evaluations of Developmental Status) and a concurrent battery of diagnostic measures, including tests of intelligence, language, and academic achievement (for children aged 2 1/2 years and older). The performance on diagnostic measures of children who failed screening but were not found to have a disability (false positives) was compared with that of children who passed screening and did not have a disability on diagnostic testing (true negatives).Results: Children with false-positive scores performed significantly (P