Rostad A M, Martinsen H, Eilertsen D E, Ovrelid M, Aas S, Kjelsvik O
Habiliteringstjenesten for barn Innherred sykehus, Levanger.
Tidsskr Nor Laegeforen. 2000 Jan 30;120(3):317-21.
Methods to identify developmental problems in children have been requested for a long time. We wanted to find out whether high scores of cumulative non-optimality during infancy indicated disability or developmental problems. In a prospective study, a population of children (n = 1,217) was followed from pregnancy until the age of four. Medical, motor, and neurological data, as well as information about attention and social interaction were added in a cumulative non-optimality score. Information about family and environment was also included. When the children were four years of age, multiple methods were used to identify those with disability and developmental problems. Complete data were obtained for 926 children. The predictive values of the instrument were based on children diagnosed as functionally disabled at the age of four (n = 32). The sensitivity was 87.5%, specificity 93%, positive predictive value 30.8% and negative predictive value was 99.5%. These values are higher than those of comparable methods. The method could be implemented in the normal Norwegian "child health centre" without difficulty. The discussion in this article focuses on whether or not the method should be implemented in the ordinary health care system.
长期以来，人们一直需要用于识别儿童发育问题的方法。我们想弄清楚婴儿期累积非最优得分高是否表明存在残疾或发育问题。在一项前瞻性研究中，对一群儿童（n = 1217）从孕期一直追踪到四岁。医疗、运动和神经学数据，以及关于注意力和社交互动的信息被纳入累积非最优得分中。还包括有关家庭和环境的信息。当这些儿童四岁时，使用多种方法来识别那些有残疾和发育问题的儿童。获得了926名儿童的完整数据。该工具的预测值基于四岁时被诊断为功能残疾的儿童（n = 32）。敏感性为87.5%，特异性为93%，阳性预测值为30.8%，阴性预测值为99.5%。这些值高于可比方法的值。该方法可以毫无困难地在挪威普通的“儿童健康中心”实施。本文的讨论重点在于该方法是否应在普通医疗保健系统中实施。
