INCLEN Diagnostic Tool for Neuromotor Impairments (INDT-NMI) for Primary Care Physician: Development and Validation.
Indian Pediatr
;
2014 Aug; 51(8): 613-619
Article
in English
| IMSEAR
| ID: sea-170720
ABSTRACT
Objectives:
To develop and validate a diagnostic tool for use by primary care physicians for diagnosing neuro-motor impairment among 2-9 year old children in primary care settings. Studydesign:
Modified Delphi technique involving national (n=49) and international (n=6) experts was used for development of INDT-NMI. The tool was then validated through a cross sectional study.Setting:
Neurology specialty clinics of three tertiary care pediatric centers in New Delhi, India.Participants:
454 children aged 2-9 years [mean (SD) age 60.4 (23.7) mo], selected through systematic random sampling, underwent assessment for identification and classification of neuromotor impairments (NMI). Intervention All study subjects were first administered INDTNMI (candidate test) by a trained physician followed by expert assessment for NMI and other neurodevelopment disorders (NDD) by team of two pediatric neurologists (Gold standard).Results:
According to expert evaluation, 171 (37.8%) children had neuromotor impairments. There were four categories ofsubjects:
NMI alone (n=66); NMI+other NDDs (n=105); Other NDDs without NMI (n=225) and ‘Normal’ group (n=58). Using expert evaluation as gold standard, overall sensitivity of the INDTNMI was 75.4% and specificity was 86.8%. INDT-NMI helped graduate physicians to correctly classify 86.6% (112/129) children with NMI into different types (cerebral palsy, neuromotor diseases and other NMI). Graduate physicians assigned 40 children (8.8%) as ‘indeterminate’, 38 (95%) of whom had either NDD and/or NMI and thus merited referral. Misclassification of NMI occurred in those with mild changes in muscle tone, dystonia, or ataxia and associated NDDs.Conclusion:
Graduate primary care physicians with a structured short training can administer the new tool and diagnose NMI in 2-9 year old children with high validity. INDT-NMI requires further evaluation in actual primary care settings.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Type of study:
Diagnostic study
/
Observational study
Language:
English
Journal:
Indian Pediatr
Year:
2014
Type:
Article
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