An evidence-based approach to predicting low IQ in very preterm infants from the neurological examination: outcome data from the indomethacin Indomethacin Intraventricular Hemorrhage Prevention Trial.
We evaluated whether the degree of cerebral palsy (CP) at age 3 in very preterm children is predictive of full-scale intelligence quotient (FSIQ) <70 at age 8 by calculating likelihood ratios (LRs) for findings on the neurologic examination. Data from the follow-up phase of the Indomethacin Intraventricular Hemorrhage Prevention Trial, which includes periodic neurologic examination and neuropsychometric testing, were used. Information was available on 366 of 440 (83\%) children with birth weight of 600 to 1250 g who survived. Neurologic examination at age 3 was grouped by presence and type of CP, and the Weschler Intelligence Scale for Children-Third Edition FSIQ at age 8 was grouped dichotomously (<70 or > or =70). CP was identified in 35 of 366 3-year-olds (9.5\%). An FSIQ <70 was identified in 47 of 366 children at 8 years old (12.8\%). FSIQ <70 occurred in 14 of 17 children with tri- or quadriplegia (82\%), 8 of 18 children with di- or hemiplegia (44\%), and 25 of 331 children without CP (7.5\%). Useful LRs were calculated for tri- or quadriplegia (30), di- or hemiplegia (5.7), and children without CP (0.55). These LRs have greater impact on posttest odds for FSIQ <70 than those for birth weight <1000 g, history of bronchopulmonary dysplasia, and Stanford-Binet Intelligence Score <70 at age 3. We conclude that the neurologic examination at 3 years old predicts FSIQ <70 at age 8 with LRs that allow evidence-based parental counseling and intervention planning.
%0 Journal Article
%1 Pleacher2004
%A Pleacher, Michael D
%A Vohr, Betty R
%A Katz, Karol H
%A Ment, Laura R
%A Allan, Walter C
%D 2004
%J Pediatrics
%K Cerebral Palsy; Child; Child, Preschool; Evidence-Based Medicine; Follow-Up Studies; Humans; Infant, Newborn; Premature; Very Low Birth Weight; Intelligence Tests; Likelihood Functions; Mental Retardation; Neurologic Examination; Randomized Controlled Trials; Sensitivity and Specificity
%N 2
%P 416--419
%T An evidence-based approach to predicting low IQ in very preterm infants from the neurological examination: outcome data from the indomethacin Indomethacin Intraventricular Hemorrhage Prevention Trial.
%V 113
%X We evaluated whether the degree of cerebral palsy (CP) at age 3 in very preterm children is predictive of full-scale intelligence quotient (FSIQ) <70 at age 8 by calculating likelihood ratios (LRs) for findings on the neurologic examination. Data from the follow-up phase of the Indomethacin Intraventricular Hemorrhage Prevention Trial, which includes periodic neurologic examination and neuropsychometric testing, were used. Information was available on 366 of 440 (83\%) children with birth weight of 600 to 1250 g who survived. Neurologic examination at age 3 was grouped by presence and type of CP, and the Weschler Intelligence Scale for Children-Third Edition FSIQ at age 8 was grouped dichotomously (<70 or > or =70). CP was identified in 35 of 366 3-year-olds (9.5\%). An FSIQ <70 was identified in 47 of 366 children at 8 years old (12.8\%). FSIQ <70 occurred in 14 of 17 children with tri- or quadriplegia (82\%), 8 of 18 children with di- or hemiplegia (44\%), and 25 of 331 children without CP (7.5\%). Useful LRs were calculated for tri- or quadriplegia (30), di- or hemiplegia (5.7), and children without CP (0.55). These LRs have greater impact on posttest odds for FSIQ <70 than those for birth weight <1000 g, history of bronchopulmonary dysplasia, and Stanford-Binet Intelligence Score <70 at age 3. We conclude that the neurologic examination at 3 years old predicts FSIQ <70 at age 8 with LRs that allow evidence-based parental counseling and intervention planning.
@article{Pleacher2004,
abstract = {We evaluated whether the degree of cerebral palsy (CP) at age 3 in very preterm children is predictive of full-scale intelligence quotient (FSIQ) <70 at age 8 by calculating likelihood ratios (LRs) for findings on the neurologic examination. Data from the follow-up phase of the Indomethacin Intraventricular Hemorrhage Prevention Trial, which includes periodic neurologic examination and neuropsychometric testing, were used. Information was available on 366 of 440 (83\%) children with birth weight of 600 to 1250 g who survived. Neurologic examination at age 3 was grouped by presence and type of CP, and the Weschler Intelligence Scale for Children-Third Edition FSIQ at age 8 was grouped dichotomously (<70 or > or =70). CP was identified in 35 of 366 3-year-olds (9.5\%). An FSIQ <70 was identified in 47 of 366 children at 8 years old (12.8\%). FSIQ <70 occurred in 14 of 17 children with tri- or quadriplegia (82\%), 8 of 18 children with di- or hemiplegia (44\%), and 25 of 331 children without CP (7.5\%). Useful LRs were calculated for tri- or quadriplegia (30), di- or hemiplegia (5.7), and children without CP (0.55). These LRs have greater impact on posttest odds for FSIQ <70 than those for birth weight <1000 g, history of bronchopulmonary dysplasia, and Stanford-Binet Intelligence Score <70 at age 3. We conclude that the neurologic examination at 3 years old predicts FSIQ <70 at age 8 with LRs that allow evidence-based parental counseling and intervention planning.},
added-at = {2014-07-19T21:03:18.000+0200},
author = {Pleacher, Michael D and Vohr, Betty R and Katz, Karol H and Ment, Laura R and Allan, Walter C},
biburl = {https://www.bibsonomy.org/bibtex/2fbbac8410d35cdc626fcabcf1e4b2edd/ar0berts},
groups = {public},
interhash = {52bb8f09755d2511c4f9395a0d306d47},
intrahash = {fbbac8410d35cdc626fcabcf1e4b2edd},
journal = {Pediatrics},
keywords = {Cerebral Palsy; Child; Child, Preschool; Evidence-Based Medicine; Follow-Up Studies; Humans; Infant, Newborn; Premature; Very Low Birth Weight; Intelligence Tests; Likelihood Functions; Mental Retardation; Neurologic Examination; Randomized Controlled Trials; Sensitivity and Specificity},
month = Feb,
number = 2,
pages = {416--419},
pmid = {14754962},
timestamp = {2014-07-19T21:03:18.000+0200},
title = {An evidence-based approach to predicting low IQ in very preterm infants from the neurological examination: outcome data from the indomethacin Indomethacin Intraventricular Hemorrhage Prevention Trial.},
username = {ar0berts},
volume = 113,
year = 2004
}