Hilary S Wong1, Shalini Santhakumaran2, Frances M Cowan3, Neena Modi4. 1. Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom; and. 2. Imperial College Clinical Trials Unit and. 3. Section of Neonatal Medicine, Imperial College London, London, United Kingdom. 4. Section of Neonatal Medicine, Imperial College London, London, United Kingdom n.modi@imperial.ac.uk.
Abstract
CONTEXT: Developmental outcomes of very preterm (gestational age ≤32 weeks) or very low birth weight (<1500 g) children are commonly reported before age 3 years although the predictive validity for later outcomes are uncertain. OBJECTIVE: To determine the validity of early developmental assessments in predicting school-age cognitive deficits. DATA SOURCES: PubMed. STUDY SELECTION: English-language studies reporting at least 2 serial developmental/cognitive assessments on the same population, 1 between ages 1 and 3 years and 1 at ≥5 years. DATA EXTRACTION: For each study, we calculated the sensitivity, specificity, and positive and negative predictive values of early assessment for cognitive deficit (defined as test scores 1 SD below the population mean). Pooled meta-analytic sensitivity and specificity were estimated by using a hierarchical summary receiver operator characteristic curve. RESULTS: We included 24 studies (n = 3133 children). Early assessments were conducted at 18 to 40 months and generally involved the Bayley Scales of Infant Development or the Griffiths Mental Development Scales; 11 different cognitive tests were used at school-age assessments at 5 to 18 years. Positive predictive values ranged from 20.0% to 88.9%, and negative predictive vales ranged from 47.8% to 95.5%. The pooled sensitivity (95% confidence interval) of early assessment for identifying school-age cognitive deficit was 55.0% (45.7%-63.9%) and specificity was 84.1% (77.5%-89.1%). Gestational age, birth weight, age at assessment, and time between assessments did not explain between-study heterogeneity. LIMITATIONS: The accuracy of aggregated data could not be verified. Many assessment tools have been superseded by newer editions. CONCLUSIONS: Early developmental assessment has poor sensitivity but good specificity and negative predictive value for school-age cognitive deficit.
CONTEXT: Developmental outcomes of very preterm (gestational age ≤32 weeks) or very low birth weight (<1500 g) children are commonly reported before age 3 years although the predictive validity for later outcomes are uncertain. OBJECTIVE: To determine the validity of early developmental assessments in predicting school-age cognitive deficits. DATA SOURCES: PubMed. STUDY SELECTION: English-language studies reporting at least 2 serial developmental/cognitive assessments on the same population, 1 between ages 1 and 3 years and 1 at ≥5 years. DATA EXTRACTION: For each study, we calculated the sensitivity, specificity, and positive and negative predictive values of early assessment for cognitive deficit (defined as test scores 1 SD below the population mean). Pooled meta-analytic sensitivity and specificity were estimated by using a hierarchical summary receiver operator characteristic curve. RESULTS: We included 24 studies (n = 3133 children). Early assessments were conducted at 18 to 40 months and generally involved the Bayley Scales of Infant Development or the Griffiths Mental Development Scales; 11 different cognitive tests were used at school-age assessments at 5 to 18 years. Positive predictive values ranged from 20.0% to 88.9%, and negative predictive vales ranged from 47.8% to 95.5%. The pooled sensitivity (95% confidence interval) of early assessment for identifying school-age cognitive deficit was 55.0% (45.7%-63.9%) and specificity was 84.1% (77.5%-89.1%). Gestational age, birth weight, age at assessment, and time between assessments did not explain between-study heterogeneity. LIMITATIONS: The accuracy of aggregated data could not be verified. Many assessment tools have been superseded by newer editions. CONCLUSIONS: Early developmental assessment has poor sensitivity but good specificity and negative predictive value for school-age cognitive deficit.
Authors: Noemi Vieira de Freitas Rios; Luciene da Cruz Fernandes; Caio Leônidas Oliveira de Andrade; Luan Paulo Franco Magalhães; Ana Cecília Santiago; Crésio de Aragão Dantas Alves Journal: Rev Paul Pediatr Date: 2022-05-11
Authors: Tone Nordvik; Eva M Schumacher; Pål G Larsson; Are H Pripp; Gro C Løhaugen; Tom Stiris Journal: Pediatr Res Date: 2022-01-10 Impact factor: 3.953
Authors: Sandra E Juul; Bryan A Comstock; Rajan Wadhawan; Dennis E Mayock; Sherry E Courtney; Tonya Robinson; Kaashif A Ahmad; Ellen Bendel-Stenzel; Mariana Baserga; Edmund F LaGamma; L Corbin Downey; Raghavendra Rao; Nancy Fahim; Andrea Lampland; Ivan D Frantz Iii; Janine Y Khan; Michael Weiss; Maureen M Gilmore; Robin K Ohls; Nishant Srinivasan; Jorge E Perez; Victor McKay; Phuong T Vu; Jean Lowe; Karl Kuban; T Michael O'Shea; Adam L Hartman; Patrick J Heagerty Journal: N Engl J Med Date: 2020-01-16 Impact factor: 91.245
Authors: Andrea Manzotti; Francesco Cerritelli; Jorge E Esteves; Gianluca Lista; Erica Lombardi; Simona La Rocca; Alberto Gallace; Francis P McGlone; Susannah C Walker Journal: Dev Cogn Neurosci Date: 2019-08-21 Impact factor: 6.464
Authors: Daan R M G Ophelders; Ruth Gussenhoven; Luise Klein; Reint K Jellema; Rob J J Westerlaken; Matthias C Hütten; Jeroen Vermeulen; Guido Wassink; Alistair J Gunn; Tim G A M Wolfs Journal: Cells Date: 2020-08-10 Impact factor: 6.600