Maleka Boledi K, Van Der Linde Jeannie, Glascoe Frances Page, Swanepoel De Wet
1 Department of Speech-Language Pathology and Audiology, University of Pretoria , Pretoria, South Africa .
2 Department of Pediatrics, Vanderbilt University , Nashville, Tennessee.
Telemed J E Health. 2016 Dec;22(12):1013-1018. doi: 10.1089/tmj.2016.0007. Epub 2016 Jun 10.
Developmental delays are more prevalent in low-income countries and access to developmental screening is severely limited.
This study evaluated an m-Health version of a standard developmental screening tool, Parents Evaluation Developmental Status (PEDS) and PEDS:Developmental Milestones (PEDS:DM) for use by community health workers (CHWs) in terms of (1) correspondence with conventional paper-based testing by a speech language pathologist (SLP) and (2) inter-rater reliability compared to an SLP.
CHWs were trained in a primary healthcare (PHC) setting to administer the newly developed smartphone application version of the PEDS tools. One SLP and two CHWs recruited 207 caregivers who were attending a baby wellness clinic. Caregivers were tested by one CHW using the smartphone application of the PEDS tools; a qualified SLP simultaneously recorded and scored the PEDS tools on the same participants.
High positive (100%) and negative correspondence (96%) was found between the paper-based PEDS tools and the smartphone application PEDS tools and between the SLP and CHW. Almost perfect (Cohen's Kappa) inter-rater agreement between conditions was demonstrated (κ = 0.873 to κ = 0.961).
Outcomes of the smartphone application, operated by a CHW, corresponded closely to the gold standard PEDS tools operated by a health professional. Trained CHWs can conduct accurate developmental screening using the smartphone version of the PEDS tools.
发育迟缓在低收入国家更为普遍，且发育筛查的可及性严重受限。
本研究评估了标准发育筛查工具“父母发育状况评估量表（PEDS）”及“PEDS：发育里程碑（PEDS：DM）”的移动健康版本，以供社区卫生工作者（CHW）使用，评估内容包括：（1）与言语语言病理学家（SLP）进行的传统纸质测试的一致性；（2）与SLP相比的评分者间信度。
在初级卫生保健（PHC）机构对CHW进行培训，使其能够使用新开发的PEDS工具智能手机应用程序。一名SLP和两名CHW招募了207名前往婴儿健康诊所就诊的照料者。一名CHW使用PEDS工具的智能手机应用程序对照料者进行测试；一名合格的SLP同时对相同参与者的PEDS工具进行记录和评分。
纸质PEDS工具与智能手机应用程序PEDS工具之间以及SLP与CHW之间均发现了较高的阳性一致性（100%）和阴性一致性（96%）。不同条件之间显示出几乎完美的（科恩kappa系数）评分者间一致性（κ = 0.873至κ = 0.961）。
由CHW操作的智能手机应用程序的结果与由卫生专业人员操作的金标准PEDS工具密切对应。经过培训的CHW可以使用PEDS工具的智能手机版本进行准确的发育筛查。
