scholarly journals The assessment of general movements in term and late-preterm infants diagnosed with neonatal encephalopathy, as a predictive tool of cerebral palsy by 2 years of age—a scoping review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Judy Seesahai ◽  
Maureen Luther ◽  
Paige Terrien Church ◽  
Patricia Maddalena ◽  
Elizabeth Asztalos ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Late Preterm ◽  
Neonatal Encephalopathy ◽  
Predictive Values ◽  
Late Preterm Infants ◽  
High Negative Predictive Value ◽  
General Movements ◽  
Sensitivity Specificity

Abstract Background The General Movements Assessment is a non-invasive and cost-effective tool with demonstrated reliability for identifying infants at risk for cerebral palsy. Early detection of cerebral palsy allows for the implementation of early intervention and is associated with better functional outcomes. No review to date has summarized the utility of the General Movements Assessment to predict cerebral palsy in term and late-preterm infants diagnosed with neonatal encephalopathy. Methods We conducted a scoping review involving infants born greater than or equal to 34 weeks gestational age to identify all available evidence and delineate research gaps. We extracted data on sensitivity, specificity, and positive and negative predictive values and described the strengths and limitations of the results. We searched five databases (MEDLINE, Embase, PsychINFO, Scopus, and CINAHL) and the General Movements Trust website. Two reviewers conducted all screening and data extraction independently. The articles were categorized according to key findings, and a critical appraisal was performed. Results Only three studies, a cohort and two case series, met all of the inclusion criteria. The total number of participants was 118. None of the final eligible studies included late-preterm neonates. All three studies reported on sensitivity, specificity, and positive predictive and negative predictive values. An abnormal General Movement Assessment at 3–5 months has a high specificity (84.6–98%) for cerebral palsy with a similarly high negative predictive value (84.6–98%) when it was normal. Absent fidgety movements, in particular, are highly specific (96%) for moderate to severe cerebral palsy and carry a high negative predictive value (98%) when normal. In the time period between term and 4–5 months post-term, any cramped synchronized movements had results of 100% sensitivity and variable results for specificity, positive predictive value, and negative predictive value. Conclusions A normal General Movements Assessment at 3 months in a term high-risk infant is likely associated with a low risk for moderate/severe cerebral palsy. The finding of cramped synchronized General Movements is a strong predictor for the diagnosis of cerebral palsy by 2 years of age in the term population with neonatal encephalopathy. The deficit of high-quality research limits the applicability, and so the General Movements Assessment should not be used in isolation when assessing this population. Systematic review registration Title registration with Joanna Briggs Institute. URL: http://joannabriggswebdev.org/research/registered_titles.aspx.

scholarly journals The Assessment of General Movements in Term and Late-Preterm Infants Diagnosed with Neonatal Encephalopathy, As a Predictive Tool of Cerebral Palsy by Two Years of Age - A Scoping Review.

2020 ◽  
Author(s):  
Judy Seesahai ◽  
Thomas Rotter ◽  
Maureen Luther ◽  
Patricia Maddalena ◽  
Paige Terrien Church ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Late Preterm ◽  
Neonatal Encephalopathy ◽  
Late Preterm Infants ◽  
Spontaneous Movements ◽  
Time Period ◽  
General Movements ◽  
Sensitivity Specificity

Abstract BACKGROUND The General Movements Assessment is a non-invasive and cost-effective tool with demonstrated reliability for identifying infants at risk for cerebral palsy. Early detection of cerebral palsy allows for implementation of early intervention, and is associated with better functional outcomes. No review to date has summarized the utility of the General Movements Assessment to predict cerebral palsy in term and late-preterm infants diagnosed with neonatal encephalopathy and so detect the research gaps. METHODS We conducted a systematic scoping review for data on sensitivity, specificity, positive and negative predictive value and described the strengths and limitations of the results. We searched five databases (MEDLINE, Embase, PsychINFO, Scopus and CINAHL). Two reviewers conducted all screening and data extraction independently. The articles were categorized according key findings and a critical appraisal performed.RESULTS From the electronic database search, only two studies, case series, met all of the inclusion criteria. The total number of participants were 60. Neither of the final eligible studies included late-preterm neonates. Both studies reported on sensitivity, specificity, positive predictive and negative predictive value. The newer study reported that in the time period between term and 4-5 months post-term, that any cramped synchronized movements in this time period had results of 100% sensitivity and variable results for specificity, positive predictive value and negative predictive value. Neither of the studies had infants that received therapeutic hypothermia for Neonatal Encephalopathy. CONCLUSIONS The finding of cramped synchronized General Movements is a strong predictor of cerebral palsy by two years of age in the term population. Neonatal encephalopathy has an effect on spontaneous movements in term infants, be it transient or persistent. The predictive ability of spontaneous movements is very accurate when assessed early but improves when done later (at 15-22 weeks of age). A deficit of research exists with regards to cerebral palsy prediction using general movements in term and late-preterm infant with encephalopathy, especially when therapeutic hypothermia is instituted. Systematic review registration Title registration with Joanna Briggs Institute. URL: http://joannabriggs-webdev.org/research/registered_titles.aspx

scholarly journals The assessment of general movements in term and late-preterm infants diagnosed with neonatal encephalopathy, as a predictive tool of cerebral palsy by two years of age - A scoping review.

2021 ◽  
Author(s):  
Judy Seesahai ◽  
Thomas Rotter ◽  
Maureen Luther ◽  
Patricia Maddalena ◽  
Paige Terrien Church ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Negative Predictive Value ◽  
Scoping Review ◽  
Predictive Value ◽  
Late Preterm ◽  
Neonatal Encephalopathy ◽  
Late Preterm Infants ◽  
Time Period ◽  
General Movements ◽  
Sensitivity Specificity

Abstract BACKGROUND The General Movements Assessment is a non-invasive and cost-effective tool with demonstrated reliability for identifying infants at risk for cerebral palsy. Early detection of cerebral palsy allows for implementation of early intervention, and is associated with better functional outcomes. No review to date has summarized the utility of the General Movements Assessment to predict cerebral palsy in term and late-preterm infants diagnosed with neonatal encephalopathy.METHODS We conducted a scoping review involving infants born greater than or equal to 34 weeks gestational age to identify all available evidence and delineate research gaps. We extracted data on sensitivity, specificity, positive and negative predictive value and described the strengths and limitations of the results. We searched five databases (MEDLINE, Embase, PsychINFO, Scopus and CINAHL). Two reviewers conducted all screening and data extraction independently. The articles were categorized according to key findings and a critical appraisal performed.RESULTS From the electronic database search, only two studies, case series, met all of the inclusion criteria. The total number of participants were 60. Neither of the final eligible studies included late-preterm neonates. Both studies reported on sensitivity, specificity, positive predictive and negative predictive value. The newer study reported that in the time period between term and 4-5 months post-term, that any cramped synchronized movements in this time period had results of 100% sensitivity and variable results for specificity, positive predictive value and negative predictive value. Neither of the studies had infants that received therapeutic hypothermia for Neonatal Encephalopathy.CONCLUSIONS The finding of cramped synchronized General Movements is a strong predictor for the diagnosis of cerebral palsy by two years of age in the term population with neonatal encephalopathy. The deficit of high quality research limits the applicability and so the general movements assessment should not be used in isolation when assessing this population.Systematic review registrationTitle registration with Joanna Briggs Institute. URL: http://joannabriggswebdev.org/research/registered_titles.aspx

scholarly journals The general movements assessment in term and late-preterm newborns diagnosed with neonatal encephalopathy, as a predictive tool of cerebral palsy by two years of age: a scoping review protocol.

2020 ◽  
Author(s):  
Judy Seesahai ◽  
Maureen Luther ◽  
Carmen Cindy Rhoden ◽  
Paige Terrien Church ◽  
Elizabeth Asztalos ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Randomized Controlled Trials ◽  
Preterm Infants ◽  
Scoping Review ◽  
Late Preterm ◽  
Controlled Trials ◽  
Neonatal Encephalopathy ◽  
Late Preterm Infants ◽  
Randomized Controlled ◽  
General Movements

Abstract Background Prediction of long-term neurodevelopmental outcomes remains an elusive goal for neonatology. Clinical and socioeconomic markers have not proven to be adequately reliable. The limitation in prognostication includes those term and late-preterm infants born with neonatal encephalopathy. The General Movements Assessment tool by Prechtl has demonstrated reliability for identifying infants at risk for neuromotor impairment. This tool is non-invasive and cost-effective. The purpose of this study is to identify the published literature on how this tool applies to the prediction of cerebral palsy in term and late-preterm infants diagnosed with neonatal encephalopathy and so detect the research gaps. Methods We will conduct a systematic scoping review for data on sensitivity, specificity, positive and negative predictive value and describe the strengths and limitations of the results. This review will consider studies that included neonates more than or equal to 34+0 weeks gestational age, diagnosed with neonatal encephalopathy, with a General Movements Assessment done between birth to six months of life and an assessment for cerebral palsy by at least two years of age. Experimental and quasi-experimental study designs including randomized controlled trials, non-randomized controlled trials, before and after studies, interrupted time-series studies and systematic reviews will be considered. Text and opinion papers will not be considered for inclusion in this scoping review as this is a highly specific and medical topic. Studies in the English language only will be considered. Studies published from at least 1970 will be included as this is around the time when the General Movements Assessment was first introduced in neonatology as a potential predictor of neuromotor outcomes. We will search five databases (MEDLINE, Embase, PsychINFO, Scopus and CINAHL). Two reviewers will conduct all screening and data extraction independently. The articles will be categorized according key findings and a critical appraisal performed.Discussion The results of this review will guide future research to improve early identification and timely intervention in neonates with neonatal encephalopathy at risk of neuromotor impairment.Systematic review registration Title registration with Joanna Briggs Institute.

scholarly journals The general movements assessment in term and late-preterm infants diagnosed with neonatal encephalopathy, as a predictive tool of cerebral palsy by two years of age: a scoping review protocol.

2020 ◽  
Author(s):  
Judy Seesahai ◽  
Maureen Luther ◽  
Carmen Cindy Rhoden ◽  
Paige Terrien Church ◽  
Elizabeth Asztalos ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Randomized Controlled Trials ◽  
Preterm Infants ◽  
Scoping Review ◽  
Late Preterm ◽  
Controlled Trials ◽  
Neonatal Encephalopathy ◽  
Late Preterm Infants ◽  
Randomized Controlled ◽  
General Movements

Abstract Background Prediction of long-term neurodevelopmental outcomes remains an elusive goal for neonatology. Clinical and socioeconomic markers have not proven to be adequately reliable. The limitation in prognostication includes those term and late-preterm infants born with neonatal encephalopathy. The General Movements Assessment tool by Prechtl has demonstrated reliability for identifying infants at risk for neuromotor impairment. This tool is non-invasive and cost-effective. The purpose of this study is to identify the published literature on how this tool applies to the prediction of cerebral palsy in term and late-preterm infants diagnosed with neonatal encephalopathy and so detect the research gaps. Methods We will conduct a systematic scoping review for data on sensitivity, specificity, positive and negative predictive value and describe the strengths and limitations of the results. This review will consider studies that included infants more than or equal to 34+0 weeks gestational age, diagnosed with neonatal encephalopathy, with a General Movements Assessment done between birth to six months of life and an assessment for cerebral palsy by at least two years of age. Experimental and quasi-experimental study designs including randomized controlled trials, non-randomized controlled trials, before and after studies, interrupted time-series studies and systematic reviews will be considered. Case reports, case series, case control and cross-sectional studies will be included. Text, opinion papers and animal studies will not be considered for inclusion in this scoping review as this is a highly specific and medical topic. Studies in the English language only will be considered. Studies published from at least 1970 will be included as this is around the time when the General Movements Assessment was first introduced in neonatology as a potential predictor of neuromotor outcomes. We will search five databases (MEDLINE, Embase, PsychINFO, Scopus and CINAHL). Two reviewers will conduct all screening and data extraction independently. The articles will be categorized according key findings and a critical appraisal performed. Discussion The results of this review will guide future research to improve early identification and timely intervention in infants with neonatal encephalopathy at risk of neuromotor impairment.

scholarly journals Foundational Statistical Principles in Medical Research: Sensitivity, Specificity, Positive Predictive Value, and Negative Predictive Value

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 503
Author(s):  
Thomas F. Monaghan ◽  
Syed N. Rahman ◽  
Christina W. Agudelo ◽  
Alan J. Wein ◽  
Jason M. Lazar ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Medical Literature ◽  
Disease Prevalence ◽  
Positive Test Result ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Test Result ◽  
Test Probability

Sensitivity, which denotes the proportion of subjects correctly given a positive assignment out of all subjects who are actually positive for the outcome, indicates how well a test can classify subjects who truly have the outcome of interest. Specificity, which denotes the proportion of subjects correctly given a negative assignment out of all subjects who are actually negative for the outcome, indicates how well a test can classify subjects who truly do not have the outcome of interest. Positive predictive value reflects the proportion of subjects with a positive test result who truly have the outcome of interest. Negative predictive value reflects the proportion of subjects with a negative test result who truly do not have the outcome of interest. Sensitivity and specificity are inversely related, wherein one increases as the other decreases, but are generally considered stable for a given test, whereas positive and negative predictive values do inherently vary with pre-test probability (e.g., changes in population disease prevalence). This article will further detail the concepts of sensitivity, specificity, and predictive values using a recent real-world example from the medical literature.

scholarly journals Clinical Performance of the Spot Vision Photo Screener before and after Induction of Cycloplegia in Children

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Konuralp Yakar
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Clinical Performance ◽  
High Specificity ◽  
Screening Criteria ◽  
Predictive Values ◽  
Before And After ◽  
Sensitivity Specificity ◽  
Vision Screener

Aim. To compare the clinical performance of the Spot Vision Screener used to detect amblyopia risk factors (ARFs) in children before and after induction of cycloplegia; the children were referred because they met the screening criteria of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS). Methods. The Spot Vision Screener and a standard autorefractometer were used to examine 200 eyes of 100 children aged 3–10 years, before and after cycloplegia induction, in terms of ARFs. Sensitivity, specificity, and positive and negative predictive values for the detection of significant refractive errors were measured using the AAPOS referral criteria. It was explored that Spot Screener data were affected by cycloplegia. The extent of agreement between cycloplegic/noncycloplegic photoscreening data and cycloplegic autorefraction measurements was assessed using Wilcoxon and Spearman correlation analyses. Results. The Spot’s sensitivity was improved from 60.9% to 85.3% and specificity from 94.9% to 87.4% with cycloplegia compared to cycloplegic standard autorefractometer results. The positive predictive value of Spot was 75.7%, and the negative predictive value was 90.4% without cycloplegia. With cycloplegia, the positive predictive value of Spot was 63.6% and the negative predictive value was 95.8%. Conclusions. The Spot Screener afforded moderate sensitivity and high specificity prior to cycloplegia. The sensitivity and negative predictive value improved after induction of cycloplegia. Examiners should be aware of the effects of cycloplegia on their findings.

Isolated demyelinating syndromes: comparison of CSF oligoclonal bands and different MR imaging criteria to predict conversion to CDMS

2001 ◽  
Vol 7 (6) ◽  
pp. 359-363 ◽  
Author(s):  
M Tintoré ◽  
A Rovira ◽  
L Brieva ◽  
E Grivé ◽  
R Jardí ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
High Sensitivity ◽  
Oligoclonal Bands ◽  
High Negative Predictive Value ◽  
Csf Oligoclonal Bands ◽  
Sensitivity Specificity

Aim of the study: To evaluate and compare the capacity of oligoclonal bands (OB) and three sets of MR imaging criteria to predict the conversion of clinically isolated syndromes (CIS) to clinically definite multiple sclerosis (CDMS). Patients and methods: One hundred and twelve patients with CIS were prospectively studied with MR imaging and determination of OB. Based on the clinical follow-up (conversion or not conversion to CDMS), we calculated the sensitivity, specificity accuracy, positive and negative predictive value of the OB, and MR imaging criteria proposed by Paty et al, Fazekas et al and Barkhof et al. Results: CDMS developed in 26 (23.2%) patients after a mean follow-up of 31 months (range 12-62). OB were positive in 70 (62.5%) patients and were associated with a higher risk of developing CDMS. OB showed a sensitivity of 81%, specificity of 43%, accuracy of 52%, positive predictive value (PPV) of 30% and negative predictive value (NPV) of 88%. Paty and Fazekas criteria showed the same results with a sensitivity of 77%, specificity of 51%, accuracy of 57%, positive predictive value of 32% and negative predictive value of 88%. Barkhof criteria showed a sensitivity of 65%, specificity of 70%, accuracy of 69%, PPV of 40% and NPV of 87%. The greatest accuracy was achieved when patients with positive OB and three or four Barkhof's criteria were selected. Conclusions: We observed a high prevalence of OB in CIS. OB and MR imaging (Paty's and Fazekas' criteria) have high sensitivity. Barkhof's criteria have a higher specificity. Both OB and MR imaging criteria have a high negative predictive value.

scholarly journals Sensitivity, Specificity and Predictive Values of Cytological and Microbiological Findings of Endometrial Biopsy, Cytobrush and Low Volume Uterine Lavage in Relation to Endometrial Histology in Barren Mares

2020 ◽  
Vol 15 (04) ◽  
pp. 75-79
Author(s):  
Agnus Mathew ◽  
DM Patel ◽  
KK Hadiya
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Endometrial Biopsy ◽  
Microbial Culture ◽  
K Value ◽  
Predictive Values ◽  
Low Volume ◽  
Sensitivity Specificity ◽  
Uterine Lavage

This study was carried out on 10 infertile barren mares to evaluate the sensitivity, specificity, predictive values and agreement (kappa value) of cytological and microbiological findings of three diagnosing techniques of endometritis, viz., endometrial biopsy (EB), cytobrush (CB) and low volume uterine lavage (LVL) in relation to endometrial histology. When histological examinations from EB were used as “the best standard,” the sensitivity of cytology from EB, CB and LVL technique was 0.33, 0.50 and 0.50; specificity 0.75, 1.00 and 0.75; positive predictive value 0.66, 1.00 and 0.75, and negative predictive value was 0.42, 0.57 and 0.50, respectively. The sensitivity of bacteriology from EB, CB and LVL technique was 0.83, 0.83 and 1.00; the specificity was 0.75, 0.75 and 0.50; positive predictive value 0.83, 0.83 and 0.75, and the negative predictive value was 0.75, 0.75 and 1.00, respectively. In all the cases, the sensitivity of the bacteriology was found to be higher than the sensitivity of cytology. When the results of cytological and bacteriological examinations were combined, no any increase in the sensitivity was found. Bacteriology and cytology from CB showed the highest positive predictive value demonstrating that a positive result is an accurate indication of endometritis. Sensitivity values were always higher if smears were evaluated according to PMNs to epithelial cell ratio, and the highest values were observed in specimens collected from CB and LVL. The evaluation of cytological smears based on counting PMNs in relation to epithelial cells was a better method for diagnosis of endometritis than counting the number of PMNs per high power microscopic field (k value 0.07-0.47 vs. 0.00). The agreement of the diagnosis of endometritis between the three techniques of the collection was from fair to poor and between the different criteria adopted to evaluate smears was always poor. However, the agreement of the diagnosis of endometritis by the microbial culture was moderate between the three techniques of the collection (k value 0.55-0.58).

scholarly journals False negativity rate of ultrasonography with mammography in women with palpable breast lumps

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 1800-1804
Author(s):  
Sudha M ◽  
Prashant Moorthy
Keyword(s):  
Negative Predictive Value ◽  
Predictive Value ◽  
Breast Imaging ◽  
False Negative ◽  
False Negative Rate ◽  
Predictive Values ◽  
High Negative Predictive Value ◽  
Study Population ◽  
Palpable Breast ◽  
Breast Lumps

This study was performed to determine the false negativity rates of ultrasonography with mammography in the assessment of women with palpable breast lumps. The relevant data on 202 female patients aged above 14 years of age, who had presented to our institution with a breast lump, had been retrospectively reviewed from our hospital database. Out of these, 155 patients for whom mammography with sonography imaging (MSI) was done were included in the study population. It consisted of tissue-positive cases, tissue-negative cases, and false-negative MSI confirmed on pathology. All cancer cases and false-negative cases using MSI were identified. Cancer rates, false-negative rates, and negative predictive values were calculated based on MSI breast imaging reporting and BI-RADS categories. Among patients who had undergone MSI, 73.55 % (114/155) of patients had BI-RADS 1–2. Despite a benign result, 10.5% (12/114) of them had gone ahead with a tissue diagnosis, whereas BI-RADS 4 and 5 had a 100% biopsy rate (28/28, 4/4, respectively). Out of the seventeen cancers detected in toto, only one belonged to BI-RADS 1–2. The false-negative rate of MSI (i.e., BI-RADS 1–2) was found to be 1.75% (1/114). As none of the remaining cases had progressed into malignancy post-follow-up (Median: 9 months, Range: 2 – 13 months), The negative predictive value (NPV) and cancer rate were estimated to be 99.12% and 0.88% respectively. Therefore, low false negativity and high negative predictive value of mammography with ultrasonography imaging for breast lumps were established.

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