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中国循证儿科杂志

中国循证儿科杂志 ›› 2016, Vol. 11 ›› Issue (6): 436-440.

• 论著 • 上一篇    下一篇

《年龄与发育进程问卷》中文版在高危儿童发育筛查中效度验证

刘仕祺,武元,边旸,李明   

  1. 北京大学第一医院儿科 北京，100034
  • 收稿日期:2016-11-29 修回日期:2016-12-15 出版日期:2016-12-25 发布日期:2016-12-25
  • 通讯作者: 李明

The validity of the Chinese version of ASQ in high risk children

LIU Shi-qi, WU Yuan, BIAN Yang, LI Ming   

  1. Department of Pediatrics, Peking University First Hospital, Beijing 100034, China
  • Received:2016-11-29 Revised:2016-12-15 Online:2016-12-25 Published:2016-12-25
  • Contact: LI Ming

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1854

被引次数

3

摘要：

目的 在高危儿童中行中文版《年龄与发育进程问卷》（ASQ-C）的进一步验证。 方法 以Gesell发育量表为效度标准，对儿童发育迟缓门诊就诊的2~60月龄的儿童同时实施Gesell发育量表和ASQ-C评测，分析ASQ-C及其不同领域在不同年龄组及不同筛查界值时的诊断参数。 结果 符合本文纳入标准的高危儿130例进入本文分析，男94例，女36例，年龄（19.9±16.4）个月，早产26例。≥18和＜18个月组分别为52例和78例。ASQ-C量表以2 s为筛查界值，其诊断一致率73％，敏感度72.5％（95%CI：63%~82%），特异度74.3%（95%CI：61%~88%），阳性预测值86.8%（95%CI：79%~94%），阴性预测值53.7%（95%CI：40%~67%）。ASQ-C以1 s为筛查界值，其诊断一致率75％，敏感度92.5%（95%CI：87%~98%），特异度32.4%（95%CI：17%~48%），阳性预测值77.5%（95%CI：70%~85%），阴性预测值632%（95%CI：41%~85%）。≥18个月组儿童中诊断一致率90％~92％、敏感度95.6％~100%；＜18个月组儿童中诊断一致率64％~68％、敏感度59.6%~85.1%。ASQ-C在适应性能区、粗大运动能区、精细动作能区、语言能区和个人社会能区与Gesell发育量表相应领域的诊断一致率68％~80％，敏感度46.6%~85%，特异度64.3%~93.7%，语言能区的敏感度（63.3%~85%）高于精细运动能区（47%~68.2%）。 结论 ASQ-C与北京Gesell发育量表对应领域的一致性好。ASQ-C作为发育筛查量表用于高危儿临床效度虽在可接受范围内，但达不到理想筛查量表的参数水平。对＜18个月的高危儿童，以1 s为界值的敏感度显著提高，可降低漏诊。

Abstract:

Objective ASQ-C is a newly introduced and standardized questionnaire for children's development in China. The validity of ASQ-C was not fully tested .In this study, the Gesell developmental scale was used as a diagnostic scale to test the validity of the ASQ-C in high risk children. Methods The 130 samples were selected in the outpatient of children development, who were evaluated by both ASQ-C and Gesell development scale. Cutoff points for all ASQ-3 age-versions were calculated in two ways and the samples were divided into 2 groups according to the age. The sensitivity, specificity, positive and negative predictive values were calculated. The subscales of ASQ-C were analyzed according to the corresponding scales of Gesell development scale. Results In generally, the coincidence rate was 0.73， sensitivity and specificity were 72.5% (95%CI:63% to 82%)and 74.3%(95%CI:61% to 88%),the PPV and NPV were 86.8%(95%CI:79% to 94%)and 53.7%(95%CI:40% to 67%).Using 1 s as the cutoff, the sensitivity and specificity were 92.5% and 32.4%, the PPV and NPV were 77.5%(95%CI:70% to 85%)and 63.2%(95%CI:41% to 85%).Sensitivity and specificity values were higher for the older age-cohort than for the younger age-cohort. The sensitivity and specificity of the subscale were 46.6% to 85% and 64.3% to 93.7%. Conclusion The ASQ-C was a developmental screening scale, its validity was within acceptable range, but failed to reach the ideal screening scale level. For less than 18 months of high-risk children, using 1s as the cutoff may significantly improve the sensitivity and reduce missed diagnosis.