Insights MSD, Ministry of Social Development.
Analytics and Insights, Performance Hub, New Zealand Treasury, Wellington, New Zealand.
Am J Prev Med. 2015 May;48(5):509-19. doi: 10.1016/j.amepre.2014.12.003. Epub 2015 Mar 17.
In 2012, the New Zealand Government announced a proposal to introduce predictive risk models (PRMs) to help professionals identify and assess children at risk of abuse or neglect as part of a preventive early intervention strategy, subject to further feasibility study and trialing. The purpose of this study is to examine technical feasibility and predictive validity of the proposal, focusing on a PRM that would draw on population-wide linked administrative data to identify newborn children who are at high priority for intensive preventive services.
Data analysis was conducted in 2013 based on data collected in 2000-2012. A PRM was developed using data for children born in 2010 and externally validated for children born in 2007, examining outcomes to age 5 years.
Performance of the PRM in predicting administratively recorded substantiations of maltreatment was good compared to the performance of other tools reviewed in the literature, both overall, and for indigenous Māori children.
Some, but not all, of the children who go on to have recorded substantiations of maltreatment could be identified early using PRMs. PRMs should be considered as a potential complement to, rather than a replacement for, professional judgment. Trials are needed to establish whether risks can be mitigated and PRMs can make a positive contribution to frontline practice, engagement in preventive services, and outcomes for children. Deciding whether to proceed to trial requires balancing a range of considerations, including ethical and privacy risks and the risk of compounding surveillance bias.
2012 年，新西兰政府宣布了一项提议，计划引入预测风险模型（PRM），以帮助专业人员识别和评估有虐待或忽视风险的儿童，作为预防早期干预策略的一部分，但需进一步进行可行性研究和试验。本研究旨在检验该提议的技术可行性和预测有效性，重点关注一种 PRM，该模型将利用全人群关联行政数据来识别有高优先级接受强化预防服务的新生儿。
数据分析于 2013 年进行，数据基于 2000-2012 年收集。使用 2010 年出生的儿童数据开发 PRM，并对 2007 年出生的儿童进行外部验证，以评估至 5 岁时的结局。
与文献中回顾的其他工具相比，该 PRM 在预测行政记录的虐待认定方面表现良好，无论是整体表现还是针对本土毛利儿童的表现。
一些（但不是全部）有记录的虐待认定儿童可以通过 PRM 早期识别。PRM 应被视为专业判断的补充，而不是替代。需要进行试验以确定风险是否可以降低，以及 PRM 是否可以对一线实践、参与预防服务以及儿童结局产生积极影响。是否决定进行试验需要平衡一系列考虑因素，包括伦理和隐私风险以及加剧监测偏差的风险。
