Sensitivity and specificity of general movements assessment for detecting cerebral palsy in an Australian context: 2-year outcomes
Sensitivity and specificity of general movements assessment for detecting cerebral palsy in an Australian context: 2-year outcomes
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DOI：
10.1111/jpc.14953
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发表时间：
2020-08-07
影响因子：
1.7
通讯作者：
Badawi, Nadia
中科院分区：
文献类型：
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作者：
Goyen, Traci-Anne;Morgan, Catherine;Badawi, Nadia
目的我们以前报道的敏感性和特异性水平的一般运动评估（GMA）检测脑瘫（CP）在1年内的临床设置和新南威尔士州（NSW）评分网络的援助。本研究的目的是确定是否可以在相同的组中保持同样高的有效性水平在2年。方法采用前瞻性纵向横断面研究。GMA由两名独立认证的评分员从传统视频中盲测，对病史不知情。第三个评价者解决了分歧。在烦躁期（12-20周），在4个新生儿重症监护病房和1个CP服务中心进行了为期30个月的高危人群筛查。参与者是259名高危婴儿的初步研究。2-3年的多学科随访包括贝利婴儿发育量表和CP的确诊。用定义为CP确诊的真阳性计算灵敏度和特异性值。结果在2-3年时，184例（71%）患者完成了随访评估。134例（73%，CP低风险）的GMA正常，48例（26%，CP高风险）无烦躁，2例（1%，异常神经系统疾病高风险）异常烦躁。检测CP的敏感性为97.6%（40/41），特异性为95.7%（133/139）。检测任何不存在/异常烦躁全身运动（GM）的异常结果的敏感性为57.9%（44/76），特异性为94.4%（101/107）。结论GMA在临床环境中检测CP的敏感性和特异性水平在2年内保持良好，与我们以前报道的结果相似。
Aim We previously reported sensitivity and specificity levels of the general movements assessment (GMA) to detect cerebral palsy (CP) at 1 year within a clinical setting and with the assistance of the New South Wales (NSW) Rater Network. The aim of this study was to determine whether similarly high levels of validity could be maintained in the same group at 2 years. Methods A prospective longitudinal cross-sectional study was conducted. GMA was blind-rated from conventional video by two independent certified raters, blinded to medical history. A third rater resolved disagreements. High-risk population screening for CP using the GMA during the fidgety period (12-20 weeks) was carried out in four neonatal intensive care units and one CP service over a 30-month period. Participants were 259 high-risk infants for the initial study. Multidisciplinary follow-up at 2-3 years included Bayley Scales of Infant Development and confirmed diagnosis of CP. Sensitivity and specificity values were calculated with true positives defined as a confirmed diagnosis of CP. Results At 2-3 years, 184 (71%) completed the follow-up assessment. GMA was normal for 134 (73%, low risk for CP), absent fidgety for 48 (26%, high risk for CP) and abnormal fidgety for 2 (1%, high risk for abnormal neurological disorder). Sensitivity for detecting CP was 97.6% (40/41) and specificity 95.7% (133/139). Sensitivity for detecting any abnormal outcome with absent/abnormal fidgety general movements (GMs) was 57.9% (44/76) and specificity 94.4% (101/107). Conclusion Excellent levels of sensitivity and specificity of the GMA for detecting CP in the clinical setting were maintained at 2 years and were similar to our previously reported findings.