scholarly journals Preschool predictive value of abnormal general movements at 10-15 weeks corrected age in high-risk infants

2018 ◽  
Vol 60 ◽  
pp. 53-53
Keyword(s):  
High Risk ◽  
Predictive Value ◽  
General Movements ◽  
High Risk Infants

scholarly journals Predictive Value of General Movement Assessment for Cerebral Palsy in Routine Clinical Practice

2015 ◽  
Vol 95 (11) ◽  
pp. 1489-1495 ◽  
Author(s):  
Gunn Kristin Øberg ◽  
Bjarne Koster Jacobsen ◽  
Lone Jørgensen
Keyword(s):  
Cerebral Palsy ◽  
High Risk ◽  
Clinical Setting ◽  
Predictive Value ◽  
Normal Development ◽  
Likelihood Ratios ◽  
Motor Problems ◽  
Movement Assessment ◽  
General Movement ◽  
High Risk Infants

Background Early identification of children at high risk of future neurodevelopmental disability is important for the initiation of appropriate therapy. In research settings, the assessment of fidgety movements (FMs) at 3 months supports a general movement assessment (GMA) as a strong predictor for subsequent motor development, but there are few studies from routine clinical settings. Objective The study objective was to examine the relationship between FMs and neurodevelopmental outcome by the age of 2 years in high-risk infants in a routine hospital clinical setting. Design This was a prospective study. Methods A GMA was performed in 87 high-risk infants at 3 months after term age. The infants were clinically assessed for cerebral palsy (CP) at 2 years. Sensitivity, specificity, likelihood ratios, and positive and negative predictive values were computed. The relative risk of motor problems by the age of 2 years, according to the GMA, was estimated. Results Of the infants with normal FMs, 93% (50/54) had normal development and none was diagnosed with CP, whereas 75% (12/16) with abnormal or sporadic FMs had normal development. In contrast, 53% (9/17) of those without FMs had CP. When the GMA was considered to be a test for CP and absent FMs were considered to be a positive test result, the sensitivity was 90% and the specificity was 90%. The likelihood ratios for positive and negative test results were 8.7 and 0.1, respectively. The negative predictive value was 99%, and the positive predictive value was 53%. The risk of motor problems by the age of 2 years increased linearly with the extent of pathological results on the GMA and was 10 times higher when FMs were absent at 3 months than when FMs were normal. Limitations The relatively small study sample was a study limitation. Conclusions When applied in a routine clinical setting, the GMA strongly predicted neurodevelopmental impairments at 2 years in high-risk infants.

Prediction of Developmental Outcome Using a Perinatal Risk Inventory

PEDIATRICS ◽  
1991 ◽  
Vol 88 (6) ◽  
pp. 1135-1143
Author(s):  
Albert P. Schemer ◽  
Miriam E. Sexton
Keyword(s):  
High Risk ◽  
Predictive Value ◽  
Neonatal Intensive Care ◽  
Infant Development ◽  
Assessment Scale ◽  
Developmental Outcome ◽  
Family Status ◽  
Perinatal Risk ◽  
High Risk Infants ◽  
Status Index

An effective perinatal developmental screening that predicts developmental outcome of high-risk neonates is currently not available. One hundred twenty-five high-risk infants were evaluated prior to discharge from the neonatal intensive care unit using a newly developed perinatal risk inventory, family status index, and abbreviated neurobehavioral assessment scale. All infants had been evaluated using the Bayley Mental and Motor scales or the Stanford-Binet. They were also evaluated by a pediatrician, audiologist, and ophthalmologist. Fifteen infants had been evaluated using 9-month Bayley Scales of Infant Development, 74 had been evaluated using the Bayley at 9 and 18 months, and 36 children had been assessed using the Stanford-Binet at 36 months. The total score of the perinatal risk inventory demonstrated a significant correlation with the infants' last score on the Bayley and Stanford-Binet (r = -.55, P < .001). The abbreviated neurobehavioral assessment scale correlated with the infants' IQ and developmental quotient score (r = .3, P < .001); the family status index did not correlate well with the developmental outcome. Using a score of 10 on the perinatal risk inventory provided a sensitivity of 0.76, specificity of 0.79, positive predictive value of 0.475, and negative predictive value of 0.929. Twelve of the 13 infants with cerebral palsy were identified as being potentially developmentally abnormal prior to discharge. It appears that it is possible to predict the developmental outcome of high-risk neonates using a perinatal risk inventory.

scholarly journals The Pooled Diagnostic Accuracy of Neuroimaging, General Movements, and Neurological Examination for Diagnosing Cerebral Palsy Early in High-Risk Infants: A Case Control Study

2019 ◽  
Vol 8 (11) ◽  
pp. 1879 ◽  
Author(s):  
Catherine Morgan ◽  
Domenico M. Romeo ◽  
Olena Chorna ◽  
Iona Novak ◽  
Claire Galea ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
High Risk ◽  
Sensitivity And Specificity ◽  
Neurological Examination ◽  
Predictive Power ◽  
Case Control Study ◽  
Case Control ◽  
General Movements ◽  
High Risk Infants ◽  
Control Study

Introduction: Clinical guidelines recommend using neuroimaging, Prechtls’ General Movements Assessment (GMA), and Hammersmith Infant Neurological Examination (HINE) to diagnose cerebral palsy (CP) in infancy. Previous studies provided excellent sensitivity and specificity for each test in isolation, but no study has examined the pooled predictive power for early diagnosis. Methods: We performed a retrospective case-control study of 441 high-risk infants born between 2003 and 2014, from three Italian hospitals. Infants with either a normal outcome, mild disability, or CP at two years, were matched for birth year, gender, and gestational age. Three-month HINE, GMA, and neuroimaging were retrieved from medical records. Logistic regression was conducted with log-likelihood and used to determine the model fit and Area Under the Curve (AUC) for accuracy. Results: Sensitivity and specificity for detecting CP were 88% and 62% for three-month HINE, 95% and 97% for absent fidgety GMs, and 79% and 99% for neuroimaging. The combined predictive power of all three assessments gave sensitivity and specificity values of 97.86% and 99.22% (PPV 98.56%, NPV 98.84%). Conclusion: CP can be accurately detected in high-risk infants when these test findings triangulate. Clinical implementation of these tools is likely to reduce the average age when CP is diagnosed, and intervention is started.

scholarly journals Movement Recognition Technology as a Method of Assessing Spontaneous General Movements in High Risk Infants

2015 ◽  
Vol 5 ◽  
Author(s):  
Claire Marcroft ◽  
Aftab Khan ◽  
Nicholas D. Embleton ◽  
Michael Trenell ◽  
Thomas Plötz
Keyword(s):  
High Risk ◽  
Movement Recognition ◽  
General Movements ◽  
High Risk Infants

ACIP Backs Menhibrix for High-Risk Infants

2012 ◽  
Vol 5 (11) ◽  
pp. 24-25
Author(s):  
ELIZABETH MECHCATIE
Keyword(s):  
High Risk ◽  
High Risk Infants

Is Colour Doppler Ultrasound a Sensitive Screening Method in Diagnosing Deep Vein Thrombosis after Hip Surgery ?

1996 ◽  
Vol 75 (02) ◽  
pp. 242-245 ◽  
Author(s):  
Marie Magnusson ◽  
Bengt I Eriksson ◽  
Peter Kãlebo ◽  
Ramon Sivertsson
Keyword(s):  
Deep Vein Thrombosis ◽  
High Risk ◽  
Doppler Ultrasound ◽  
Predictive Value ◽  
Screening Method ◽  
Colour Doppler ◽  
Vein Thrombosis ◽  
Colour Doppler Ultrasound ◽  
Asymptomatic Patients ◽  
Deep Vein

SummaryPatients undergoing orthopedic surgery are at high risk of developing deep vein thrombosis. One hundred and thirty-eight consecutive patients undergoing total hip replacement or hip fracture surgery were included in this study. They were surveilled with colour Doppler ultrasound (CDU) and bilateral ascending contrast phlebography. The prevalence of proximal and distal DVT in this study was 5.8% and 20.3% respectively.CDU has a satisfactory sensitivity in patients with symptomatic deep vein thrombosis, especially in the proximal region. These results could not be confirmed in the present study of asymptomatic patients. The sensitivity was 62.5% (95% confidence interval: C.I. 24-91%) and the specificity 99.6% (C.I. 98-100%) for proximal DVT; 53.6% (C.I. 34-73%) and 98% (C.I. 96-99%) respectively for distal thrombi. The overall sensitivity was 58.1% (C.I. 39-75%) and the specificity 98% (C.I. 96-99%). The positive predictive value was 83.3% (C.I. 36-99%) and 75% (C.I. 51-91%) for proximal and distal DVT respectively. The negative predictive value was 98.9% (C.I. 98-100%) and 94.9% (C.I. 92-98%) for proximal and distal DVT respectively. The results of this study showed that even with a highly specialised and experienced investigator the sensitivity of CDU was too low to make it suitable for screening purposes in a high risk surgical population.

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