Evaluating developmental screening in clinical practice

SAGE Open Medicine
Peter Dawson, B W Camp

Abstract

To demonstrate a method of evaluating accuracy of developmental screening modeled on the evidence-based medical literature. A retrospective review was performed on 418 children screened with the Denver II by a trained technician. Two models for analyzing screening data were examined, using predictive values and likelihood ratios (LR+ and LR-). The technician, working at 20% time, screened 44% of eligible children. There were 129/418 (31%) children with Suspect Denver II results, 115/418 who were referred, 81/115 (70%) who were evaluated by Early Intervention, and 64/81 (79%) who qualified for services. The uncorrected positive predictive value for the Denver II alone (44%) was insufficient to meet the preset standard of 60%, but the LR+ of 4.16 indicated a significant contribution of test information to improving predictive value. Combining test results with information from the parent-technician conference to achieve a referral decision resulted in an uncorrected predictive value of 56%, which rose with correction for children referred but not evaluated to 72% (LR+ 10.33). Negative predictive values and likelihood ratios of a negative test and a non-referral decision achieved recommended levels. Parents who expressed concern w...Continue Reading

References

Jun 1, 1987·Statistics in Medicine·C B Begg
Jul 9, 1994·BMJ : British Medical Journal·D G Altman, J M Bland
Apr 1, 1993·The Journal of Pediatrics·A S BatesA T Evans
Nov 14, 1997·Journal of Developmental and Behavioral Pediatrics : JDBP·G P Aylward
May 10, 2005·BMJ : British Medical Journal·Christopher J GillChristopher H Schmid
Dec 10, 2009·Journal of Developmental and Behavioral Pediatrics : JDBP·Bonnie W Camp
Dec 19, 2012·Pediatrics·James P GuevaraSusmita Pati
Sep 3, 2014·Pediatrics·Ayelet TalmiStephen Berman

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Citations

Jan 6, 2016·Pediatrics·Peter Dawson

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Methods Mentioned

BETA
X-ray

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