Gomez Pomar Enrique, Finnegan Loretta P, Devlin Lori, Bada Henrietta, Concina Vanessa A, Ibonia Katrina T, Westgate Philip M
Department of Pediatrics, Division of Neonatology, University of Kentucky, Frankfort, Kentucky, USA.
College on Problems of Drug Dependence, Philadelphia, Pennsylvania, USA.
BMJ Open. 2017 Sep 27;7(9):e016176. doi: 10.1136/bmjopen-2017-016176.
To develop a simplified Finnegan Neonatal Abstinence Scoring System (sFNAS) that will highly correlate with scores ≥8 and ≥12 in infants being assessed with the FNAS.
DESIGN, SETTING AND PARTICIPANTS: This is a retrospective analysis involving 367 patients admitted to two level IV neonatal intensive care units with a total of 40 294 observations. Inclusion criteria included neonates with gestational age ≥37 0/7 weeks, who are being assessed for neonatal abstinence syndrome (NAS) using the FNAS. Infants with a gestational age <37 weeks were excluded.
A linear regression model based on the original FNAS data from one institution was developed to determine optimal values for each item in the sFNAS. A backward elimination approach was used, removing the items that contributed least to the Pearson's correlation. The sFNAS was then cross-validated with data from a second institution.
Pearson's correlation between the proposed sFNAS and the FNAS was 0.914. The optimal treatment cut-off values for the sFNAS were 6 and 10 to predict FNAS scores ≥8 and ≥12, respectively. The sensitivity and specificity of these cut-off values to detect FNAS scores ≥8 and ≥12 were 0.888 and 0.883 for a cut-off of 6, and 0.637 and 0.992 for a cut-off of 10, respectively. The sFNAS cross-validation resulted in a Pearson's correlation of 0.908, sensitivity and specificity of 0.860 and 0.873 for a cut-off of 6, and 0.525 and 0.986 for a cut-off of 10, respectively.
The sFNAS has a high statistical correlation with the FNAS, and it is cross-validated for the assessment of infants with NAS. It has excellent specificity and negative predictive value for identifying infants with FNAS scores ≥8 and ≥12.
开发一种简化的芬尼根新生儿戒断评分系统（sFNAS），该系统与使用芬尼根新生儿戒断评分系统（FNAS）评估的婴儿中得分≥8分和≥12分高度相关。
设计、地点和参与者：这是一项回顾性分析，涉及367名入住两家四级新生儿重症监护病房的患者，共进行了40294次观察。纳入标准包括孕周≥37 0/7周、使用FNAS评估新生儿戒断综合征（NAS）的新生儿。孕周<37周的婴儿被排除。
基于一个机构的原始FNAS数据建立线性回归模型，以确定sFNAS中每个项目的最佳值。采用向后消除法，去除对皮尔逊相关性贡献最小的项目。然后用第二个机构的数据对sFNAS进行交叉验证。
所提出的sFNAS与FNAS之间的皮尔逊相关性为0.914。sFNAS预测FNAS得分≥8分和≥12分的最佳治疗临界值分别为6分和10分。这些临界值检测FNAS得分≥8分和≥12分的敏感性和特异性，临界值为6分时分别为0.888和0.883，临界值为10分时分别为0.637和0.992。sFNAS交叉验证的皮尔逊相关性为0.908，临界值为6分时敏感性和特异性分别为0.860和0.873，临界值为10分时分别为0.525和0.986。
sFNAS与FNAS具有高度的统计学相关性，并且已通过交叉验证用于评估NAS婴儿。在识别FNAS得分≥8分和≥12分的婴儿方面，它具有出色的特异性和阴性预测价值。
