Westerlund M, Sundelin C
Department of Women's and Children's Health, Uppsala University Children's Hospital, Sweden.
Acta Paediatr. 2000 Jan;89(1):94-100. doi: 10.1080/080352500750029149.
This study evaluates the predictability of a new language screening procedure in 3-y-olds. It is used in several Child Health Centres (CHC) in Sweden and has the character of a field study involving more than 60 CHC nurses. The main questions concern the (i) development in 3-y-olds assessed as severely language delayed and (ii) whether there are any earlier unknown severely disabled children identified at 4 y of age. Ninety-six percent of the original study population participated in the follow-up. The calculations are based on results from 2237 children. A well-established screening routine, which has been shown capable of predicting the risk of not being able to follow expected schooling, and case records were used as an acceptable proxy outcome measure, pending a better gold standard. In the group of severely disabled 3-y-olds, sensitivity, specificity and positive predictive values were 86, 99 and 43%, respectively. Finally, three false-negatives were identified. In light of the present results, continued application of the 3-y screening is discussed.
本研究评估了一种针对3岁儿童的新语言筛查程序的可预测性。该程序在瑞典的多个儿童健康中心（CHC）使用，具有一项涉及60多名CHC护士的现场研究的性质。主要问题涉及（i）被评估为严重语言发育迟缓的3岁儿童的发育情况，以及（ii）在4岁时是否能识别出任何此前未知的严重残疾儿童。原始研究人群中有96%参与了随访。计算基于2237名儿童的结果。一种成熟的筛查程序已被证明能够预测无法接受预期学校教育的风险，在有更好的金标准之前，病例记录被用作可接受的替代结局指标。在严重残疾的3岁儿童组中，敏感性、特异性和阳性预测值分别为86%、99%和43%。最后，识别出3例假阴性。根据目前的结果，讨论了3岁筛查的持续应用。
