Musculoskeletal screening examination (pGALS) for school-age children based on the adult GALS screen
Musculoskeletal screening examination (pGALS) for school-age children based on the adult GALS screen
复制标题
DOI：
10.1002/art.22230
复制
发表时间：
2006-10-15
期刊：
影响因子：
--
通讯作者：
Myers, A.
中科院分区：
文献类型：
--
作者：
Foster, H. E.;Kay, L. J.;Myers, A.
客观的。基于成人步态、手臂、腿部、脊柱 (GALS) 筛查，开发和验证适用于学龄儿童的肌肉骨骼筛查检查。方法。成人 GALS 在儿科风湿病诊所连续进行的学龄儿童中进行了测试，并与儿科风湿病学家在同一天进行的检查进行了比较，该检查将儿童分为关节异常或正常。与儿科风湿病学家的评估相比，测试了成人 GALS 的有效性，并发现了成人 GALS 的缺陷。专家们提出了对成人GALS的修订，并通过修改德尔菲技术达成共识。由此产生的儿科筛查工具 (pGALS) 在另一组儿童中进行了测试（方法与成人 GALS 的测试相同）。结果。对 50 名儿童（中位年龄 11 岁，范围 4-16 岁）进行了成人 GALS 测试，其中 37 名 (74%) 患有幼年特发性关节炎。成人 GALS 漏掉了 18% 儿童的重要异常，主要是踝关节、足部和颞下颌关节。 pGALS 在 65 名儿童（中位年龄 13 岁，范围 5-17 岁）中进行了测试，并在所有关节上表现出出色的敏感性 (97-100%) 和特异性 (98-100%)，儿童和家长/监护人的可接受性评分很高。执行 pGALS 的中位时间为 2 分钟（范围 1.5-3 分钟）。结论。 pGALS 肌肉骨骼筛查工具具有出色的有效性、执行速度快，并且为学龄儿童和家长/监护人所接受。我们建议将 pGALS 纳入本科和研究生医学培训，以提高儿科肌肉骨骼临床技能并促进诊断和转诊给专家。
Objective. To develop and validate a musculoskeletal screening examination applicable to school-age children based on the adult Gait, Arms, Legs, Spine (GALS) screen.Methods. Adult GALS was tested in consecutive school-age children attending pediatric rhemnatology clinics and was compared with an examination conducted, on the same day, by a pediatric rheumatologist who classified children as having abnormal or normal joints. Adult GALS was tested for validity compared with the pediatric rheumatologist's assessment and deficiencies in adult GALS were identified. Experts proposed amendments to adult GALS, achieving consensus by modified Delphi techniques. The resultant pediatric screening tool (pGALS) was tested (methodology identical to the testing of adult GALS) in an additional group of children.Results. Adult GALS was tested in 50 children (median age 11 years, range 4-16), of whom 37 (74%) had juvenile idiopathic arthritis. Adult GALS missed important abnormalities in 18% of children, mostly at the ankle, foot, and temporomandibular joints. The pGALS was tested in 65 children (median age 13 years, range 5-17 years) and demonstrated excellent sensitivity (97-100%) and specificity (98-100%) at all joints, with high acceptability scored by child and parent/guardian. The median time to perform pGALS was 2 minutes (range 1.5-3 minutes).Conclusion. The pGALS musculoskeletal screening tool has excellent validity, is quick to perform, and is acceptable to school-age children and parents/guardians. We propose that pGALS be incorporated into undergraduate and postgraduate medical training to improve pediatric musculoskeletal clinical skills and facilitate diagnosis and referral to specialists.