Quality-of-Care Indicators for the Neurodevelopmental Follow-up of Very Low Birth Weight Children: Results of an Expert Panel Process

Wang, C. Jason; McGlynn, Elizabeth A.; Brook, Robert H.; Leonard, Carol H.; Piecuch, Robert E.; Hsueh, Steven I.; Schuster, Mark A.

doi:10.1542/peds.2005-1904

Cited by 105 publications

(82 citation statements)

References 85 publications

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“…1 In 2006, the American Academy of Pediatrics published guidelines for the follow-up of preterm infants and recommended that all children with a very low birthweight (birthweight <1500g) should have a structured, age-appropriate neuromotor examination at least twice during the first year of life. 2 Infant neuromotor examinations are performed for a variety of purposes, including discriminating between infants who have motor dysfunction and those who are developing typically (discriminative tool), predicting which infants will have future motor problems from current performance (predictive tool), and evaluating changes over time (evaluative tool). 3 There is a growing body of evidence that the first year of an infant's life is a critical period of brain development.…”

mentioning

confidence: 99%

A systematic review of the clinimetric properties of neuromotor assessments for preterm infants during the first year of life

Spittle

Doyle

Boyd

2008

Develop Med Child Neuro

281

292

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This systematic review evaluates assessments used to discriminate, predict, or evaluate the motor development of preterm infants during the first year of life. Eighteen assessments were identified; nine met the inclusion criteria. The Alberta Infant Motor Scale (AIMS), Bayley Scale of Infant and Toddler Development ‐ Version III, Peabody Developmental Motor Scales ‐ Version 2, Test of Infant Motor Performance (TIMP), and Toddler and Infant Motor Examination have good discriminative validity when examined in large populations. The AIMS, Prechtl's Assessment of General Movements (GMs), Neuro Sensory Motor Development Assessment (NSMDA), and TIMP were designed for preterm infants and are able to detect more subtle changes in movement quality. The best predictive assessment tools are age dependent: GMs, the Movement Assessment of Infants, and TIMP are strongest in early infancy (age 4mo or less) and the AIMS and NSMDA are better at older ages (8‐12mo). The TIMP is the only tool that has demonstrated a difference between groups in response to intervention in two randomized controlled trials. The AIMS, TIMP, and GMs demonstrated the highest levels of overall reliability (interrater and intrarater intraclass correlation coefficient or κ>0.85). Selection of motor assessment tools during the first year of life for infants born preterm will depend on the intended purpose of their use for discrimination, prediction, and/or evaluation.

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mentioning

confidence: 99%

A systematic review of the clinimetric properties of neuromotor assessments for preterm infants during the first year of life

Spittle

Doyle

Boyd

2008

Develop Med Child Neuro

281

292

View full text Add to dashboard Cite

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“…5 Therefore, structured neuromotor assessments are recommended for very preterm children throughout early childhood so that timely referral to early intervention services can occur. 6 Motor assessments play an important role in clinical and research settings for identification, classification, and diagnosis of motor dysfunction, as well as in evaluating the effectiveness of interventions. 7 The first and second editions of the Bayley Scales of Infant Development (Bayley Scales; Bayley-II) 8,9 have been used extensively to document motor development in young children for several decades.…”

mentioning

confidence: 99%

Does the Bayley‐III Motor Scale at 2 years predict motor outcome at 4 years in very preterm children?

Spittle

Spencer‐Smith

Eeles

et al. 2012

Develop Med Child Neuro

107

109

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METHOD Ninety-six infants (49 males, 47 females) born at less than 30 weeks' gestation admitted to two tertiary hospitals in Melbourne, Australia, were assessed with the Bayley-III Motor Scale at 2 years' corrected age and were classified as suspect or definite motor impairment if they scored less than À1 or À2 standard deviations respectively, relative to the test mean. At 4 years' corrected age, children completed Movement Assessment Battery for Children -Second Edition (MABC-2); for the total motor score, cut-offs of not more than the 15th were used to classify motor development and cut-offs of not more than the 15th centile were classified as having a significant movement difficulty. RESULTSOf the 96 children assessed at both ages, at 2 years 9% had suspect and 4% had definite motor impairment; however, by 4 years, rates had increased to 22% and 19% respectively. The specificity of the Bayley-III for motor impairments for later motor outcome was excellent (ranging from 94 to 100% for cerebral palsy [CP] and 97 to 100% for motor impairment), although the sensitivity was low (ranging from 67 to 83% for CP and 18 to 37% for motor impairment); many children with later impairment were not identified by the Bayley-III.INTERPRETATION The Bayley-III Motor Scale at 2 years underestimates later rates of motor impairment, particularly in the absence of CP at 4 years on the MABC-2 total motor score in children born at less than 30 weeks' gestational age.Preterm infants are at risk of various motor, cognitive, and behavioural difficulties in early and later childhood.1 These children may present with a range of motor dysfunctions from clumsiness to cerebral palsy (CP), which can have significant functional implications.2 Movement and motor coordination are critical components of development, aiding functions such as learning to sit and eating in infancy, to playing with friends at kindergarten, and handwriting at school. 3Perinatal complications such as low birthweight, gestational age, brain injury, and postnatal corticosteroids have all been associated with poorer motor outcomes in very preterm infants. 4 However, these perinatal complications do not account for all of the variance in motor outcomes, and other methods for identifying those children most at risk are required. Early developmental intervention programmes have demonstrated that remediation and rehabilitation improve some developmental outcomes in preterm infants.5 Therefore, structured neuromotor assessments are recommended for very preterm children throughout early childhood so that timely referral to early intervention services can occur. 6 Motor assessments play an important role in clinical and research settings for identification, classification, and diagnosis of motor dysfunction, as well as in evaluating the effectiveness of interventions. 7 The first and second editions of the Bayley Scales of Infant Development (Bayley Scales; Bayley-II) 8,9 have been used extensively to document motor development in young children for several decades. These scal...

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“…Although identifying the specific indicators for each of these domains of quality might prove challenging, this framework provides a guide to practitioners and researchers in an ongoing effort to refine quality measurement. Evidence-based expert consensus 38,39 could be used to fill the matrix and to generate measures for qualitymonitoring or pay-for-performance initiatives.…”

Section: Framework For Measuring Qualitymentioning

confidence: 99%

Implementing Pay-for-Performance in the Neonatal Intensive Care Unit

et al. 2007

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Pay-for-performance initiatives in medicine are proliferating rapidly. Neonatal intensive care is a likely target for these efforts because of the high cost, available databases, and relative strength of evidence for at least some measures of quality. Pay-for-performance may improve patient care but requires valid measurements of quality to ensure that financial incentives truly support superior performance. Given the existing uncertainty with respect to both the effectiveness of pay-forperformance and the state of quality measurement science, experimentation with pay-forperformance initiatives should proceed with caution and in controlled settings. In this article, we describe approaches to measuring quality and implementing pay-for-performance in the NICU setting. Keywords pay-for-performance programs; quality improvementLarge deficits in quality of care remain more than half a decade after the Institute of Medicine (IOM) provided a blueprint for improvement. 1 In neonatology, there is persistent unexplained variation in health care delivery and outcomes. [2][3][4][5][6][7][8] To date, quality improvement (QI) efforts, either locally or as part of collaborative efforts, have had mixed results. 9-17 The broad-based improvement envisioned by health care payers and the IOM has not occurred. (In this article, we use the term "payer" to mean the broad group of employers, purchasers, insurers, and health care plans that pay for health care services directly or indirectly.)

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Quality-of-Care Indicators for the Neurodevelopmental Follow-up of Very Low Birth Weight Children: Results of an Expert Panel Process

Cited by 105 publications

References 85 publications

A systematic review of the clinimetric properties of neuromotor assessments for preterm infants during the first year of life

A systematic review of the clinimetric properties of neuromotor assessments for preterm infants during the first year of life

Does the Bayley‐III Motor Scale at 2 years predict motor outcome at 4 years in very preterm children?

Implementing Pay-for-Performance in the Neonatal Intensive Care Unit

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