May Lindy, Hayward Richard, Chakraborty Aabir, Franck Linda, Manzotti Grazia, Wray Jo, Thompson Dominic
Department of Paediatric Neurosurgery, Great Ormond Street Hospital for Children, NHS Foundation Trust, Great Ormond Street, London, UK.
Childs Nerv Syst. 2013 Jun;29(6):961-70. doi: 10.1007/s00381-013-2063-2. Epub 2013 Mar 20.
An objective clinical assessment tool whose accuracy and reproducibility can be validated is essential for the initial evaluation, selection for surgery and surveillance of children with lipomyelomeningocele (LMMC). The aim of this study was to analyse the large number of such tools presently in use and recommend an alternative that could lead to greater uniformity between different series and greater consistency in the assessment of individual patients.
A systematic review of the literature between January 1980 and December 2010 was undertaken and details of how the children in each series were assessed and the degree to which age was taken into account recorded.
Thirty-six different assessment tools were used in 40 different publications. None was validated in all aspects. Objective measures were used most in urological assessments but rarely in other domains. Age-specific assessments were used in only 10 % of publications.
This study confirmed that the assessment tools for evaluation of children with LMMC are inconsistent, often vague and poorly validated. This compromises the ability of clinicians who care for them to compare studies across centres for both treated and untreated children. We have sought to highlight those criteria which are relevant, measurable and reproducible and which might be combined into an easily applied assessment.
一种准确性和可重复性能够得到验证的客观临床评估工具，对于脂肪脊髓脊膜膨出（LMMC）患儿的初始评估、手术选择及监测至关重要。本研究旨在分析目前大量使用的此类工具，并推荐一种能使不同系列研究之间具有更高一致性以及在个体患者评估中具有更高连贯性的替代工具。
对1980年1月至2010年12月期间的文献进行系统综述，并记录每个系列中儿童的评估方式以及年龄因素的考虑程度。
40篇不同的出版物中使用了36种不同的评估工具。没有一种工具在所有方面都得到验证。客观测量在泌尿外科评估中使用最多，但在其他领域很少使用。仅10%的出版物使用了针对特定年龄的评估。
本研究证实，用于评估LMMC患儿的评估工具不一致，通常模糊且验证不足。这损害了照顾这些患儿的临床医生对已治疗和未治疗患儿进行跨中心研究比较的能力。我们试图突出那些相关、可测量且可重复的标准，并将其整合为一种易于应用的评估方法。
