Predicting developmental delay in a longitudinal cohort of preschool children with single-suture craniosynostosis: is neurobehavioral assessment important?
Predicting developmental delay in a longitudinal cohort of preschool children with single-suture craniosynostosis: is neurobehavioral assessment important?
复制标题
预测单缝颅缝早闭学龄前儿童纵向队列的发育迟缓：神经行为评估重要吗？
DOI：
10.1111/dmcn.12643
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发表时间：
2015
影响因子：
3.8
通讯作者：
Speltz,MatthewL
中科院分区：
文献类型：
--
作者：
Gray,KristenE;Kapp-Simon,KathleenA;Starr,JacquelineR;Collett,BrentR;Wallace,ErinR;Speltz,MatthewL
AimThe aim of this study was to determine whether neurobehavioral assessment before and after cranial vault surgery can improve prediction of developmental delay in children with single‐suture craniosynostosis (SSC), after accounting for ‘baseline’ demographic and clinical variables (SSC diagnosis and surgery age).MethodChildren with SSC were referred by the treating surgeon or pediatrician before surgery. Neurobehavioral assessments were performed at ages of approximately 6, 18, and 36 months. Iterative models were developed to predict delay, as determined by one or more tests of cognitive, motor, and language skills at 36 months. We selected from groups of variables entered in order of timing (before or after corrective surgery), and source of information (parent questionnaire or psychometric testing).ResultsGood predictive accuracy as determined by area under the receiver operating characteristic curve (AUC), was obtained with the baseline model (AUC=0.66), which incorporated age at surgery, sex, and socio‐economic status. However, predictive accuracy was improved by including pre‐ and post‐surgery neurobehavioral assessments. Models incorporating post‐surgery neurobehavioral testing (AUC=0.79), pre‐surgery testing (AUC=0.74), or both pre‐ and post‐surgery testing (AUC=0.79) performed similarly. However, the specifity of all models was considered to be moderate (≤0.62).InterpretationPrediction of delay was enhanced by assessment of neurobehavioral status. Findings providetentativesupport for guidelines of care that call for routine testing of children with SSC.
