@article{Wong:2018:10.1136/archdischild-2016-312535,
author = {Wong, HS and Cowan, FM and Modi, N and Medicines, for Neonates Investigator Group},
doi = {10.1136/archdischild-2016-312535},
journal = {Archives of Disease in Childhood. Fetal and Neonatal Edition},
pages = {F497--F484},
title = {Validity of neurodevelopmental outcomes of children born very preterm assessed during routine clinical follow-up in England},
url = {http://dx.doi.org/10.1136/archdischild-2016-312535},
volume = {103},
year = {2018}
}

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TY  - JOUR
AB  - OBJECTIVE: To determine the validity of assessing and recording the neurodevelopmental outcome of very preterm infants during routine clinical follow-up in England. DESIGN: Children born <30 weeks gestation, attending routine clinical follow-up at post-term ages 20-28 months, were recruited. Data on neurodevelopmental outcomes were recorded by the reviewing clinician in a standardised format in the child's electronic patient record, based on a set of key questions designed to be used without formal training or developmental testing. Using a predefined algorithm, each participant was classified as having 'no', 'mild/moderate' or 'severe' impairment in cognitive, communication and motor domains. All participants also received a research assessment by a single assessor using the Bayley Scales of Infant Development, third edition (Bayley-III). The sensitivity and specificity of routine data in capturing impairment (any Bayley-III score <85) or severe impairment (any Bayley-III score <70) was calculated. RESULTS: 190 children participated. The validity of routine assessments in identifying children with no impairment and no severe impairment was high across all domains (specificities 83.9%-100.0% and 96.6%-100.0%, respectively). However, identification of impairments, particularly in the cognitive (sensitivity 69.7% (55.1%-84.3%)) and communication (sensitivity (53.2% (42.0%-64.5%)) domains, was poor. CONCLUSIONS: Neurodevelopmental status determined during routine clinical assessment lacks adequate sensitivity in cognitive and communication domains. It is uncertain whether this reflects the assessment or/and the recording of findings. As early intervention may improve education and social outcomes, this is an important area for healthcare quality improvement research.
AU  - Wong,HS
AU  - Cowan,FM
AU  - Modi,N
AU  - Medicines,for Neonates Investigator Group
DO  - 10.1136/archdischild-2016-312535
EP  - 484
PY  - 2018///
SN  - 1359-2998
SP  - 497
TI  - Validity of neurodevelopmental outcomes of children born very preterm assessed during routine clinical follow-up in England
T2  - Archives of Disease in Childhood. Fetal and Neonatal Edition
UR  - http://dx.doi.org/10.1136/archdischild-2016-312535
UR  - http://hdl.handle.net/10044/1/55400
VL  - 103
ER  - 

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