Sturner R A, Horton M, Funk S G, Barton J, Frothingham T E, Cress J N
Pediatrics. 1982 Mar;69(3):346-50.
Developmental screening tests are only rarely used in pediatric practice, reportedly because of lack of available time. This study evaluated a shortened form of the Denver Developmental Screening Test (DDST-S) consisting of only those items immediately to the left of the child's individual are line, three in each sector or a total of 12. This DDST-S was administered to four cohorts of preschool children (aged 52 to 64 months), 1,819 children in all. Subsamples of these children returned within three months for one of several developmental (criterion) tests (McCarthy Scales of Children's Abilities, the complete DDST, or the Stanford-Binet). The DDST-S was scored by selecting the profile of passes and failures most predictive of McCarthy test results, using indices of copositivity, connegativity, underreferral, and overreferral as the basis for the decision. Utilizing this scoring system, use of the DDST-S was able to identify low scorers (those scoring less than 70) on the Stanford-Binet (sensitivity = .67, specificity = .95, predictive value = .54, underreferral = 2.5%, overreferral = 4%) as well as the complete DDST. Low scoring children could thus be identified in less than half the time required by the complete DDST. A two-stage DDST-S and DDST procedure was found to have even greater predictive value (76%; 100% if borderline cases [score of 70 to 80] are considered positive) than either form alone.
发育筛查测试在儿科实践中很少使用,据报道是因为缺乏可用时间。本研究评估了丹佛发育筛查测试的简化版(DDST-S),该版本仅包含位于儿童个体年龄线左侧的项目,每个区域三个,共12个。对四组学龄前儿童(年龄在52至64个月之间)进行了DDST-S测试,总共1819名儿童。这些儿童的子样本在三个月内返回,接受了几种发育(标准)测试之一(麦卡锡儿童能力量表、完整的DDST或斯坦福-比奈智力量表)。通过选择最能预测麦卡锡测试结果的通过和未通过情况来对DDST-S进行评分,以一致性、非一致性、转诊不足和转诊过度指数作为决策依据。利用该评分系统,DDST-S能够识别出斯坦福-比奈智力量表得分低的儿童(得分低于70分)(敏感性=0.67,特异性=0.95,预测值=0.54,转诊不足=2.5%,转诊过度=4%),与完整的DDST效果相当。因此,识别得分低的儿童所需时间不到完整DDST的一半。结果发现,两阶段的DDST-S和DDST程序比单独使用任何一种形式都具有更高的预测价值(76%;如果将临界病例[得分70至80分]视为阳性,则为100%)。