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Article: Value of clinical assessment in the diagnostic evaluation of Global Developmental Delay (GDD) using a Likelihood Ratio Model

TitleValue of clinical assessment in the diagnostic evaluation of Global Developmental Delay (GDD) using a Likelihood Ratio Model
Authors
KeywordsChildren
Clinical assessment
Global Developmental Delay
Likelihood Ratio Model
Issue Date2011
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/braindev
Citation
Brain And Development, 2011, v. 33 n. 7, p. 548-557 How to Cite?
AbstractObjective: A selective approach is recommended for investigating children with GDD. Our objective is to identify clinical markers to improve the diagnostic yield of evaluation of children with GDD. Method: Children with GDD (delay > 2 S.D. in > 1 domain) followed up in our centre were reviewed retrospectively. We selected nine clinical markers (sex, severity of GDD, parental consanguinity, family history, behavioral problems, head size, facial dysmorphism, non-facial anomalies and neurological deficits) and looked into the likelihood of finding an underlying etiology during follow-up. Results: There were 577 children with 63%, 33% and 4% having mild, moderate and severe grade GDD. An identifiable etiology is detected in 53%. Genetic disease (25%) was the commonest cause identified. We have found that severity of GDD (severe and moderate versus mild grade [LR+ = 1.92 (95% C.I. = 1.49-2.48); LR- = 0.72(0.64-0.81)], behavioral problems [LR+ = 0.24 (95% C.I. = 0.17-0.34); LR- = 1.67 (1.48-1.88)], facial dysmorphism [LR+ = 2.66 (95% C.I. = 1.10-3.54); LR- = 0.65 (0.58-0.73)] and neurological deficits [LR+ = 2.85 (95% C.I. = 2.32-3.50); LR- = 0.31(0.25-0.39)] were clinical markers associated with increased chance of identifying an underlying etiology by multivariate analysis. Conclusion: These four clinical markers are useful in selecting patients with GDD for further diagnostic tests. Using the LR model, clinical markers in the first clinical evaluation of any child with GDD can potentially improve the etiological yield using targeted investigations. © 2010 The Japanese Society of Child Neurology.
Persistent Identifierhttp://hdl.handle.net/10722/129333
ISSN
2015 Impact Factor: 1.785
2015 SCImago Journal Rankings: 0.840
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWong, VCNen_HK
dc.contributor.authorChung, Ben_HK
dc.date.accessioned2010-12-23T08:35:25Z-
dc.date.available2010-12-23T08:35:25Z-
dc.date.issued2011en_HK
dc.identifier.citationBrain And Development, 2011, v. 33 n. 7, p. 548-557en_HK
dc.identifier.issn0387-7604en_HK
dc.identifier.urihttp://hdl.handle.net/10722/129333-
dc.description.abstractObjective: A selective approach is recommended for investigating children with GDD. Our objective is to identify clinical markers to improve the diagnostic yield of evaluation of children with GDD. Method: Children with GDD (delay > 2 S.D. in > 1 domain) followed up in our centre were reviewed retrospectively. We selected nine clinical markers (sex, severity of GDD, parental consanguinity, family history, behavioral problems, head size, facial dysmorphism, non-facial anomalies and neurological deficits) and looked into the likelihood of finding an underlying etiology during follow-up. Results: There were 577 children with 63%, 33% and 4% having mild, moderate and severe grade GDD. An identifiable etiology is detected in 53%. Genetic disease (25%) was the commonest cause identified. We have found that severity of GDD (severe and moderate versus mild grade [LR+ = 1.92 (95% C.I. = 1.49-2.48); LR- = 0.72(0.64-0.81)], behavioral problems [LR+ = 0.24 (95% C.I. = 0.17-0.34); LR- = 1.67 (1.48-1.88)], facial dysmorphism [LR+ = 2.66 (95% C.I. = 1.10-3.54); LR- = 0.65 (0.58-0.73)] and neurological deficits [LR+ = 2.85 (95% C.I. = 2.32-3.50); LR- = 0.31(0.25-0.39)] were clinical markers associated with increased chance of identifying an underlying etiology by multivariate analysis. Conclusion: These four clinical markers are useful in selecting patients with GDD for further diagnostic tests. Using the LR model, clinical markers in the first clinical evaluation of any child with GDD can potentially improve the etiological yield using targeted investigations. © 2010 The Japanese Society of Child Neurology.en_HK
dc.languageengen_US
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/braindeven_HK
dc.relation.ispartofBrain and Developmenten_HK
dc.subjectChildrenen_HK
dc.subjectClinical assessmenten_HK
dc.subjectGlobal Developmental Delayen_HK
dc.subjectLikelihood Ratio Modelen_HK
dc.titleValue of clinical assessment in the diagnostic evaluation of Global Developmental Delay (GDD) using a Likelihood Ratio Modelen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0387-7604&volume=33&issue=7&spage=548&epage=557&date=2011&atitle=Value+of+clinical+assessment+in+the+diagnostic+evaluation+of+Global+Developmental+Delay+(GDD)+using+a+Likelihood+Ratio+Model-
dc.identifier.emailWong, VCN:vcnwong@hku.hken_HK
dc.identifier.emailChung, B:bhychung@hku.hken_HK
dc.identifier.authorityWong, VCN=rp00334en_HK
dc.identifier.authorityChung, B=rp00473en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.braindev.2010.09.009en_HK
dc.identifier.pmid20965674-
dc.identifier.scopuseid_2-s2.0-79959844935en_HK
dc.identifier.hkuros189179en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79959844935&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume33en_HK
dc.identifier.issue7en_HK
dc.identifier.spage548en_HK
dc.identifier.epage557en_HK
dc.identifier.isiWOS:000293158600003-
dc.publisher.placeNetherlandsen_HK
dc.identifier.scopusauthoridWong, VCN=7202525632en_HK
dc.identifier.scopusauthoridChung, B=7203043997en_HK
dc.identifier.citeulike8121013-

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