SCREENING FOR DEVELOPMENTAL DELAY IN THE SETTING OF AN AMBULATORY PEDIATRIC CLINIC
Bibliographic record
Abstract
Objectives: The goal was to prospectively test a developmental screening protocol, which could be used to screen children with possible developmental delay. Specific objectives included: 1) the feasibility of using parent-report instruments in the setting of a pediatric clinic; 2) the accuracy of two available screening tests-the Ages and Stages Questionnaire (ASQ), and the Child Developmental Inventory (CDI); 3 whether the pediatrician's clinical judgment could be used as a potential modifier. Methods: Subjects were recruited over an 11 month period from the patient population of a pediatric clinic incorporating seven pediatricians and providing comprehensive primary pediatric care. Subjects without prior developmental delay or concerns were contacted at the time of their routine 18-month old visit. Those subjects who agreed were randomized to one of two groups and completed either the ASQ or CDI. The pediatrician completed a brief questionnaire regarding his/her opinion of the child's development. Those children for whom concerns were identified by the screening instrument or the pediatrician underwent detailed testing by the Battelle Development Inventory (BDI), the gold standard for the purposed of this study. An equal number of children scoring within the norms of the screening measures also underwent BDI testing. Psychometric values were calculated from the data collected. Results: Of the 397 parents whom we contacted, 354 parents (89%) agreed to participate. Most parents correctly completed the ASQ (82%) and the CDI (74%). The following psychometric variables were calculated for ASQ, the CDI and pediatrician's opinion respectively: for sensitivity 0.67, 0.50 and 0.46; for specificity 0.37, 0.86 and 0.87; for positive predictive value 0.37, 0.50 and 0.59 and finally for negative predictive value 0.70, 0.86, and 0.79. Incorporating the physician's opinion regarding the developmental status of the child did not improve the accuracy of the screening questionnaires. Conclusion: These questionnaires can be feasibly used in the setting of a pediatric clinic. Since neither test had psychometric values indicating consistent accuracy, a single screening instrument at one point in time may not be sufficient to accurately estimate the developmental status of a child. This study does raise important questions about how developmental screening can be performed and suggests that screening should occur over time.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.032 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".