摘要
目的在高危儿童中行中文版《年龄与发育进程问卷》（ASQ-C）的进一步验证。方法以Gesell发育量表为效度标准,对儿童发育迟缓门诊就诊的2-60月龄的儿童同时实施Gesell发育量表和ASQ-C评测,分析ASQ-C及其不同领域在不同年龄组及不同筛查界值时的诊断参数。结果符合本文纳入标准的高危儿130例进入本文分析,男94例,女36例,年龄（19.9±16.4）个月,早产26例。≥18和〈18个月组分别为52例和78例。ASQ-C量表以2 s为筛查界值,其诊断一致率73%,敏感度72.5%（95%CI：63%-82%）,特异度74.3%（95%CI：61%-88%）,阳性预测值86.8%（95%CI：79%-94%）,阴性预测值53.7%（95%CI：40%-67%）。ASQ-C以1 s为筛查界值,其诊断一致率75%,敏感度92.5%（95%CI：87%-98%）,特异度32.4%（95%CI：17%-48%）,阳性预测值77.5%（95%CI：70%-85%）,阴性预测值63.2%（95%CI：41%-85%）。≥18个月组儿童中诊断一致率90%-92%、敏感度95.6%-100%;〈18个月组儿童中诊断一致率64%-68%、敏感度59.6%-85.1%。ASQ-C在适应性能区、粗大运动能区、精细动作能区、语言能区和个人社会能区与Gesell发育量表相应领域的诊断一致率68%-80%,敏感度46.6%-85%,特异度64.3%-93.7%,语言能区的敏感度（63.3%-85%）高于精细运动能区（47%-68.2%）。结论 ASQ-C与北京Gesell发育量表对应领域的一致性好。ASQ-C作为发育筛查量表用于高危儿临床效度虽在可接受范围内,但达不到理想筛查量表的参数水平。对〈18个月的高危儿童,以1 s为界值的敏感度显著提高,可降低漏诊。
Objective ASQ-C is a newly introduced and standardized questionnaire for children ＇ s development in China.The validity of ASQ-C was not fully tested.In this study,the Gesell developmental scale was used as a diagnostic scale to test the validity of the ASQ-C in high risk children.Methods The 130 samples were selected in the outpatient of children development,who were evaluated by both ASQ-C and Gesell development scale.Cutoff points for all ASQ-3 age-versions were calculated in two ways and the samples were divided into 2 groups according to the age.The sensitivity,specificity,positive and negative predictive values were calculated.The subscales of ASQ-C were analyzed according to the corresponding scales of Gesell development scale.Results In generally,the coincidence rate was 0.73,sensitivity and specificity were 72.5%（95% CI：63% to 82%） and 74.3%（95%CI：61% to 88%）,the PPV and NPV were 86.8%（95%CI：79% to 94%） and 53.7%（95%CI：40% to 67%）.Using 1 s as the cutoff,the sensitivity and specificity were 92.5% and 32.4%,the PPV and NPV were 77.5%（95% CI：70% to 85%） and 63.2%（95%CI：41% to 85%）.Sensitivity and specificity values were higher for the older age-cohort than for the younger age-cohort.The sensitivity and specificity of the subscale were 46.6% to 85% and 64.3% to 93.7%.Conclusion The ASQ-C was a developmental screening scale,its validity was within acceptable range,but failed to reach the ideal screening scale level.For less than 18 months of high-risk children,using 1s as the cutoff may significantly improve the sensitivity and reduce missed diagnosis.
出处
《中国循证儿科杂志》
CSCD
北大核心
2016年第6期436-440,共5页
Chinese Journal of Evidence Based Pediatrics
