Internal and inter-rater reliability of the ASQ-3 in Mexican preschoolers / Confiabilidad interna e interevaluador del ASQ-3 en preescolares mexicanos

Abstract: Introduction: Monitoring child development includes the promotion of development in the healthy child and the detection of delays and early indicators of disorders that begin in the first five years of life through easy-to-use, easy to mark, and low-cost screening tests. Objective: To evaluate the internal reliability and inter-rater reliability of the ASQ-3 in Mexican preschool children. Method: The ASQ-3 was applied to parents and/or teachers of 33 - 60 month old children who attended the Centros de Desarrollo Infantil (Child Development Centers-CENDIS) in the public and private sectors of Mexico City. Results: A total of n = 1052 questionnaires were obtained, grouped into six age groups (33, 36, 42, 48, 54, and 60 months of age) according to the Ages and Stages Questionnaire-3 (ASQ-3). The levels of reliability of the ASQ-3 for each of the age groups were acceptable, with a range of α = .77 to α = .88. Regarding inter-rater reliability (parents vs. teachers), moderate correlation levels were observed. Discussion and conclusion: The results obtained suggest that this is a screening instrument that reliably evaluates the five areas of development that make up the ASQ-3 in pre-school children. This represents an opportunity to continue studying the psychometric characteristics of validity of this instrument in representative samples of Mexican children to optimize the process of early childhood development monitoring.

Resumen: Introducción: La vigilancia del desarrollo infantil contempla la promoción del desarrollo en el niño sano y la detección de retrasos e indicadores tempranos de trastornos que se inician en los primeros cinco años de vida por medio de pruebas de tamizaje de fácil aplicación, calificación y de bajo costo. Objetivo: Evaluar la fiabilidad interna y confiabilidad interevaluador del Cuestionario de Edades y Etapas-3 (ASQ-3) en preescolares mexicanos. Método: Se aplicó el ASQ-3 a padres y/o tutores de niños de edades entre 33 y 60 meses que asistían a Estancias de Desarrollo Infantil (CENDIS) del sector público y privado de la Ciudad de México. Resultados: Se obtuvieron un total de n = 1052 cuestionarios, agrupados en seis grupos de edad (33, 36, 42, 48, 54 y 60 meses de edad) de acuerdo con el ASQ-3. Los niveles de confiabilidad de los ASQ-3 para cada uno de los grupos de edad fueron aceptables con un rango de α =. 77 a α =. 88. Respecto a la confiabilidad interevaluador (padres vs. maestros), se observaron niveles de correlación moderados. Discusión y conclusión: Los resultados obtenidos sugieren que es un instrumento de tamizaje que evalúa de forma fidedigna las cinco áreas del desarrollo que conforman el ASQ-3 en los preescolares. Ello representa una oportunidad para seguir estudiando las características psicométricas de validez de este instrumento en muestras representativas de niños mexicanos con la finalidad de optimizar el proceso de vigilancia del desarrollo en edades tempranas.

Prevalence of rheumatoid cachexia assessed by bioelectrical impedance vector analysis and its relation with physical function.

Rheumatoid arthritis (RA) patients frequently have changes in their body composition, with a decrease in muscle mass and an increase in fat mass, a syndrome that is termed rheumatoid cachexia (RC). The prevalence of this nutritional alteration is not well known; there is as yet no consensus, seeing as it depends on the methods, techniques, and cutoff points that are used for its diagnosis. The main aim of this study was to identify RC through assessment by bioelectrical impedance vector analysis (BIVA) and its association with metabolic causes, physical function, and the main disease status, among others. The prevalence of RC was identified in those subjects who fell outside the right lower quadrant of the reference curve of RXc graph of BIVA. Clinical, anthropometric, biochemical and physical activity, emotional status, and diet markers were also evaluated. Ninety-four patients were included (92.55% women). The prevalence of RC assessed by BIVA was 21.28%. BIVA-cachexia patients had a lesser value of handgrip strength vs. patients without BIVA-cachexia 10.2 kg (7.2-13.4) vs. 14.7 kg (9.6-19), p = 0.0062. Disability and folic acid with methotrexate consumption are related to BIVA-cachexia ((OR 4.69, 95% CI 1.33, 16.54, p = 0.016) and (OR 0.19, 95%CI 0.058, 0.651, p = 0.008), respectively). BIVA could represent a valuable tool to assess presence of RC. It is important that RA patients have physical therapy to improve their nutritional status.