Developmental screening at 18 months using the Nipissing District Developmental Screen
Bibliographic record
Abstract
Objectives: The Canadian Paediatric Society recommends an enhanced 18-month visit, including the use of a developmental screening tool to stimulate discussion with parents about their child's development, and notes the Nipissing District Developmental Screen (NDDS) is a widely used tool. We examined the predictive validity of the NDDS in children at average-risk for developmental delay and the association between positive screening and health care utilization (HCU). Methods: Using a prospective design, parents completed the NDDS at the 18-month primary care visit in Toronto, Canada. Child health insurance number was used to link with health administrative databases to collect HCU data. We calculated screening test properties using later neurodevelopmental consultation as the criterion measure and used multivariable negative binomial regression to estimate adjusted rate ratios (aRR) for each HCU type. Results: Of 802 children (mean age 18 months), 35.5% screened NDDS positive. Mean age at follow-up was 8 years, 20 (2.5%) had a neurodevelopmental consultation, and 94 (11.7%) had a special paediatric consultation/assessment, including developmental and/or behavioural care. Screening test properties were: 50% sensitivity (95% CI 27%, 73%), 65% specificity (95% CI 61%, 68%), 35% false positive rate (95% CI 31%, 40%). A positive NDDS was associated with only 1 of 7 HCU types. Conclusions: The sensitivity and specificity of the NDDS is inadequate for a developmental screening tool at 18 months, and the false positive rate is unacceptably high. The screening test properties of other widely used developmental screening tools is discussed, noting their low sensitivity, higher specificity, and lower false positive rates. Trial registration: Clinicaltrials.gov (NCT01869530).
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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 | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".