Pritchard Margo A, Colditz Paul B, Beller Elaine M
Perinatal Research Centre, University of Queensland, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
J Paediatr Child Health. 2005 Apr;41(4):191-6. doi: 10.1111/j.1440-1754.2005.00586.x.
To evaluate the agreement between parental reporting of development of children born very preterm using the Parents' Evaluation of Developmental Status (PEDS) questionnaire and professional assessment by a paediatric developmental team in the detection of sensorineural disability.
A cross-sectional cohort study of 362 children born in Queensland with a birthweight < or = 1250 g, who were surviving at 2 and 4 years of age corrected for prematurity, was conducted. Parents completed the PEDS questionnaire prior to their child receiving a neurodevelopmental assessment. The level of agreement for sensorineural disability between the neurodevelopmental assessment and the parents' score on the PEDS questionnaire was measured using the kappa statistic, and screening test characteristics were calculated. Logistic regression was used to investigate factors that might affect agreement.
Two hundred and eighty-three (78%) of the eligible children were located and contacted. Of these, 216 (76%) agreed to participate in the study (110, 2-year-olds; 106, 4-year-olds). Agreement between the two forms of rating sensorineural disability (developmental quotient > -2SD (standard deviation), cerebral palsy, bilateral blindness and deafness requiring aids) for the 4-year age group children was fair (kappa = 0.27, P = 0.001). PEDS accurately identified 69% (11 of 16) of disabled children and 72% (65 of 90) non-disabled children. The test characteristics for these children were similar to Glascoe's norming sample with a PPV 31% (95% CI: 14-48%), specificity 72% (95% CI: 62-81%), but lower sensitivity 69% (95% CI: 62-81%) and higher false-negative rate 31% (95% CI: 11, 59). Agreement for the 2-year age group was fair with poor test characteristics. Other comparisons for both age groups (PEDS A and B compared using a disability status with DQ > -1SD) showed poor agreement and test characteristics. Gestation age < 27 weeks and maternal education at or below grade 10 in the 2-year age group were the only factors independently affecting agreement.
The agreement between parental evaluation of sensorineural disability status using PEDS and paediatrics developmental assessment in children born very preterm at 4-years corrected age for prematurity compares favourably with Glascoe's norming sample. The lower agreement seen in the 2-year age group limits the utility of PEDS to be used as a screen for disability at an age when early intervention may be useful. The PEDS questionnaire is designed and normed for the general paediatric population, and it is not clear if parents of children born very preterm may have interpreted the PEDS questionnaire in relation to their satisfaction with their child's developmental progress rather than their child's functional ability.
使用父母发育状况评估（PEDS）问卷评估极早产儿父母报告的儿童发育情况与儿科发育团队的专业评估在检测感觉神经性残疾方面的一致性。
对昆士兰州出生体重≤1250克且在矫正胎龄2岁和4岁时存活的362名儿童进行了一项横断面队列研究。父母在孩子接受神经发育评估之前完成PEDS问卷。使用kappa统计量测量神经发育评估与父母在PEDS问卷上的得分之间在感觉神经性残疾方面的一致程度，并计算筛查测试特征。使用逻辑回归研究可能影响一致性的因素。
找到了283名（78%）符合条件的儿童并与他们取得了联系。其中，216名（76%）同意参与研究（110名2岁儿童；106名4岁儿童）。4岁年龄组儿童在两种评定感觉神经性残疾（发育商＞-2标准差、脑瘫、双侧失明和需要辅助器具的耳聋）方式之间的一致性为中等（kappa = 0.27，P = 0.001）。PEDS准确识别出69%（16名中的11名）残疾儿童和72%（90名中的65名）非残疾儿童。这些儿童的测试特征与格拉斯科的标准化样本相似，阳性预测值为31%（95%置信区间：[14, 48]%），特异性为72%（95%置信区间：[62, 81]%），但敏感性较低为69%（95%置信区间：[62, 81]%），假阴性率较高为31%（95%置信区间：[11, 59]）。2岁年龄组的一致性为中等，测试特征较差。两个年龄组的其他比较（使用发育商＞-1标准差的残疾状况比较PEDS A和B）显示一致性和测试特征较差。2岁年龄组中胎龄＜27周和母亲教育程度在10年级及以下是仅有的独立影响一致性的因素。
对于矫正胎龄4岁的极早产儿，使用PEDS进行的父母对感觉神经性残疾状况的评估与儿科发育评估之间的一致性与格拉斯科的标准化样本相比具有优势。2岁年龄组中较低的一致性限制了PEDS在早期干预可能有用的年龄用作残疾筛查的效用。PEDS问卷是为一般儿科人群设计和标准化的，尚不清楚极早产儿的父母是否可能根据他们对孩子发育进展的满意度而非孩子的功能能力来解释PEDS问卷。
