20 Developmental Outcomes of a Cohort of Preschool Children Requiring Craniosynostosis Surgery in Manitoba
Bibliographic record
Abstract
Abstract Background Historically in Manitoba, all children with craniosynostosis were referred to the Child Development Clinic (CDC) for neurodevelopmental evaluation, because craniosynostosis has been associated with developmental delay. However, due to heightened volume pressures, the CDC recently decided to limit the number of referrals accepted for evaluation of children with craniosynostosis. Objectives To inform best practices for neurodevelopmental screening, this study aims to describe the developmental outcomes of preschool children requiring craniosynostosis surgery in Manitoba. Design/Methods In this historical chart review of the CDC electronic medical record, the developmental outcomes of patients who were assessed at CDC for surgically managed craniosynostosis between July 1st, 2016 and December 1st, 2021 were described. Developmental quotients across Motor, Cognitive and Language domains were collected, and patients were categorized as Normal, Mild Delay in 1 Area or Delay in ≥2 Areas. Demographic and medical characteristics were collected, and descriptive statistics were used to describe and compare outcomes between groups. Results Out of a total of 67 children, 18% (n=12) demonstrated developmental delays in ≥2 areas, 23.9% (n=16) demonstrated mild developmental delays in one area, and 58.2% (n=39) were developmentally appropriate across all areas. Presence of genetic syndrome (p<0.001), suture type (p=0.011), and parental SES score (p=0.028) were significantly associated with developmental delay in ≥2 areas. Odds ratios for genetic syndrome and SES score were 218.352 (95% CI 6.843, 6967.766) and 0.857 (95% CI 0.766, 0.959) respectively. 11.9% (n=8) of children were referred to Children’s Disability Services, 5 of whom had syndrome involvement. Conclusion To target children at highest risk for developmental delay, we suggest that children with craniosynostosis be referred for neurodevelopmental evaluation if they have multisutural craniosynostosis, suspicion or confirmed genetic syndrome, or an identified developmental concern by primary care physician screening.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| 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".