Quantitative Evaluation of Content and Age Concordance Across Developmental Milestone Checklists.
Quantitative Evaluation of Content and Age Concordance Across Developmental Milestone Checklists.
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跨发展里程碑清单的内容和年龄一致性的定量评估。
DOI：
10.1097/dbp.0000000000000695
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Huntington,Noelle
中科院分区：
文献类型：
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作者：
Wilkinson,CarolL;Wilkinson,MJackson;Lucarelli,Jennifer;Fogler,JasonM;Becker,RonaldE;Huntington,Noelle
目标：临床医生和护理人员依靠里程碑检查表作为跟踪儿童发育的工具。此外，医学生和住院医生使用里程碑检查表来了解正常的儿童发育。然而，有多个已发布的里程碑清单在结构和内容上存在质量差异，阻碍了它们在发育监测和医学教育中的有效使用。该项目系统地评估了常用里程碑检查表之间的一致性和变异性。方法：儿童心理学家和发育儿科医生团队审查了来自 4 个已发布检查表（2 个为提供者开发，2 个为护理人员开发）的总共 1094 个里程碑，创建了一套全面的 728 个离散发育观察结果，每个观察结果都映射到相应的里程碑。然后使用该观察-里程碑关系数据库来确定里程碑清单之间的内容重叠程度和里程碑年龄范围一致性。结果：在 728 个离散发展观察中，40 个 (5.5%) 映射到所有 4 个里程碑清单中的里程碑，另外 90 个 (12.4%) 映射到 3 个清单。在这 40 个“普遍”观察中，大多数（42.5%）都在运动领域。在映射到 4 个清单中至少 3 个中的里程碑的 130 个观察结果中，26.9%（35/130）映射到与其相关年龄范围不一致的里程碑。 结论：发现四个常用的发育里程碑清单在内容上有有限的重叠，而重叠的则在其相关年龄范围内不一致。由此产生的观察-里程碑关系数据库可用于进一步验证里程碑的年龄估计，并通过电子健康记录促进里程碑监测。
Objective:Clinicians and caregivers rely on milestone checklists as tools for tracking a child's development. In addition, medical students and residents use milestone checklists to learn about normal child development. However, there are multiple published milestone checklists that vary qualitatively in structure and content, hindering their effective use in developmental surveillance and medical education. This project systematically evaluated the consistency and variability between commonly used milestone checklists.Methods:A team of child psychologists and developmental pediatricians reviewed a total of 1094 milestones derived from 4 published checklists (2 developed for providers, 2 developed for caregivers) to create a comprehensive set of 728 discrete developmental observations, with each observation mapped to corresponding milestones. This observation-milestone relational database was then used to determine the degree of content overlap and milestone age range concordance across milestone checklists.Results:Of the 728 discrete developmental observations, 40 (5.5%) were mapped to milestones in all 4 milestone checklists, and an additional 90 (12.4%) were mapped to 3 checklists. Among these 40 “universal” observations, most (42.5%) were in the motor domain. Of those 130 observations mapped to milestones in at least 3 of the 4 checklists, 26.9%(35/130) were mapped to milestones that were discordant in their associated age range.Conclusion:Four commonly used developmental milestone checklists were found to have limited overlap in content, and those that overlapped were inconsistent in their associated age ranges. The resulting observation-milestone relational database could be used to further validate age estimates of milestones and facilitate milestone surveillance through the electronic health record.