Adams H R, Augustine E F, Bonifacio K, Collins A E, Danielson M L, Mink J W, Morrison P, van Wijngaarden E, Vermilion J, Vierhile A, Bitsko R H
Department of Neurology, University of Rochester Medical Center (URMC), Rochester, NY.
Clinical Trials Unit and Department of Neurology and Developmental Medicine, Kennedy Krieger Institute, Baltimore, MD.
Evid Based Pract Child Adolesc Ment Health. 2023;9(2):216-230. doi: 10.1080/23794925.2023.2178040.
Tics and tic disorders can significantly impact children, but limited screening tools and diagnostic challenges may delay access to care. The current study attempted to address these gaps by evaluating sensitivity and specificity of the Motor or Vocal Inventory of Tics (MOVeIT), a tic symptom screener, and the Description of Tic Symptoms (DoTS), a brief diagnostic assessment for tic disorders. Children (n=100, age 6-17 years old) with tic disorders attending a Tourette specialty clinic and a community-recruited sample without tics completed a gold-standard assessment by a tic expert; these evaluations were compared to child self-report and parent and teacher report versions of the MOVeIT, and child and parent versions of the DoTS. The parent and child MOVeIT met or exceeded pre-specified 85% sensitivity and specificity criteria for detecting the presence of tics when compared to a gold-standard tic expert diagnosis. The Teacher MOVeIT had lower sensitivity (71.4%) but good specificity (95.7%) for identifying any tic symptoms compared to gold standard. For determination of the presence or absence of any tic disorder, sensitivity of both parent and child DoTS was 100%; specificity of the parent DoTS was 92.7% and child DoTS specificity was 75.9%. More work may be needed to refine the teacher MOVeIT, but it is also recognized that tic expression may vary by setting. While the MOVeIT and DoTS parent and child questionnaires demonstrated adequate sensitivity and specificity for determining the presence of tics and tic disorders in this well-defined sample, additional testing in a general population is warranted.
抽动和抽动障碍会对儿童产生重大影响，但筛查工具有限和诊断方面的挑战可能会延误获得治疗的时机。本研究试图通过评估抽动症状筛查工具《抽动运动或发声量表》（MOVeIT）以及抽动障碍简短诊断评估工具《抽动症状描述》（DoTS）的敏感性和特异性来填补这些空白。在抽动秽语专科诊所就诊的患有抽动障碍的儿童（n = 100，年龄6 - 17岁）以及通过社区招募的无抽动症状的样本，均由一位抽动症专家完成了金标准评估；将这些评估结果与儿童自我报告、家长和教师报告版本的MOVeIT以及儿童和家长版本的DoTS进行比较。与金标准的抽动症专家诊断相比，家长和儿童版的MOVeIT在检测抽动症状存在时达到或超过了预先设定的85%敏感性和特异性标准。与金标准相比，教师版的MOVeIT在识别任何抽动症状时敏感性较低（71.4%），但特异性较好（95.7%）。对于确定是否存在任何抽动障碍，家长和儿童版DoTS的敏感性均为100%；家长版DoTS的特异性为92.7%，儿童版DoTS的特异性为75.9%。可能需要做更多工作来完善教师版的MOVeIT，但也认识到抽动症状的表现可能因环境而异。虽然MOVeIT和DoTS的家长及儿童问卷在这个定义明确的样本中对于确定抽动和抽动障碍的存在表现出了足够的敏感性和特异性，但仍有必要在普通人群中进行额外测试。
