ASQ3 and/or the Bayley-III to support clinicians' decision making

Abstract

BackgroundAppropriate tools are essential to support a clinician’s decision to refer very preterm infants to developmental resources. Streamlining the use of developmental assessment or screening tools to make clinical decisions offers an alternative methodology to help to choose the most effective way to assess this very high-risk population.ObjectiveTo examine the influence of the Ages and Stages Questionnaire-3rd edition (ASQ3) and the Bayley Scales of Infant Development-3rd edition (Bayley-III) scores within a clinically-based decision-making process.MethodsThis retrospective cohort study includes children born at less than 29 weeks gestation who had completed both psychologist-administered Bayley-III and physician-observed ASQ3 assessments at 18 months corrected age. Theoretical referral decisions (TRDs) based on each assessment results were formulated, using cut-off scores between the lower first and second standard deviation values and below the lower second standard deviation values. TRDs to refer to developmental resources were evaluated in light of the multidisciplinary team’s actual final integrated decisions (FID).ResultsComplete data was available for 67 children. The ASQ3 and the Bayley-III had similar predictive value for the FID, with comparable kappa values. Comparisons of the physicians’ and psychologists’ TRDs with the FIDs demonstrated that the ASQ3 in conjunction with the medical and socio-familial findings predicted 93% of referral decisions.ConclusionTaking into consideration potential methodological biases, the results suggest that either ASQ3 or Bayley-III, along with socio-environmental, medical and neurological assessment, are sufficient to guide the majority of clinicians’ decisions regarding referral for specialty services. This retrospective study suggests that the physician-supervised ASQ3 may be sufficient to assess children who had been extremely preterm infants for referral purposes. The findings need to be confirmed in a larger, well-designed prospective study to minimize and account for potential sources of bias.

Parent participation in the neonatal intensive care unit: Predictors and relationships to neurobehavior and developmental outcomes

“…The ASQ-3 was chosen for follow-up, because it could be sent out to parents for completion without the need for infants to return for standardized testing. In addition, it has been shown to provide comparable results to the Bayley Scales of Infant and Toddler Development, 3 rd edition [38].…”

Screening for Neurodevelopmental Delay for Preterm Very Low Birth Weight Infants at Tertiary Care Center in Saudi Arabia

“…Furthermore, ASQ3-A had a kappa score of (k = 1.00). As a result, ASQ3 scores seemed satisfactory in conducting multidisciplinary team referral decisions and general proficiency in all situations [ 28 ]. As seen in this study, all 61 preterm infants initially recruited had complete demographic data with all morbidities, which is an excellent source to record the prevalence of common morbidities known to be associated with less than 32 weeks or VLBW preterm infants.…”

Study protocol for a randomized trial on timely delivery versus expectant management in late preterm small for gestational age pregnancies with an abnormal umbilicocerebral ratio (UCR): the DRIGITAT study

“…The time horizon of data collection for the economic evaluation will be 24 months, corresponding to the follow-up time and covering the neonatal care period and possible events following the neonatal period. As the intervention will mainly have a large impact on cost-effectiveness by a lifelong increase in quality-adjusted life years (QALYs) and saving of costs through improved neurological development, as measured by the Bailey-III score, we will estimate this by linking this improvement to use of healthcare resources and utility of these infants in later life by using medical literature [ 26 , 27 ]. Similarly, women who have undergone a cesarean section may experience disutilities and additional costs in later life due to repeat cesarean sections.…”

“…However, it should be considered that this is a dominant strategy, and the largest impact will be on the cost savings for these newborns in later life. Estimates for cost savings presented in the anticipated cost-effectiveness are very conservative as for the infants clinically improved Bayley-III score, corresponding to improved neurologic development, will require less resource use concerning, e.g., motor therapy [ 26 , 29 ]. While the incidence of more severe neurodevelopmental morbidities, such as cerebral palsy, will be low, their health care burden is expected to be very large, partially due to their life span.…”