Document Detail


The premie-neuro: opportunities and challenges for standardized neurologic assessment of the preterm infant.
MedLine Citation:
PMID:  22964608     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: : To determine the interrater and test-retest reliabilities and construct validity of the Premie-Neuro, a standardized neurologic assessment tool for preterm infants.
SUBJECTS: : Thirty-four preterm infants (mean gestational age at birth 29 ± 3.7 weeks, mean birth weight 1343.2 ± 696.3 g) participated in the study.
DESIGN: : A prospective repeated-measures design was used to assess the reliability and validity of the Premie-Neuro.
METHODS: : The Premie-Neuro was administered twice on consecutive days and then weekly through 37-weeks postmenstrual age or hospital discharge. At discharge, infants' medical histories were reviewed and a Neurobiologic Risk Score (NBRS) was used to determine risk for poor neurodevelopmental outcomes.
MAIN OUTCOME MEASURE: : Premie-Neuro raw scores and classifications were analyzed to determine the tool's reliability. Construct validity was measured by determining whether the Premie-Neuro could discriminate between infants identified as high-risk or low-risk for neurodevelopmental delays by using a NBRS of 5 as the cutoff for high- and low-risk infants.
RESULTS: : The intraclass correlation coefficients for interrater and test-retest reliability varied from 0.391 to 0.556 and from 0.493 to 0.592, respectively. Analysis of variance revealed that the Premie-Neuro raw scores for infants with NBRS > 5 were significantly worse than those for infants with NBRS < 5 (P = .000-.010).
CONCLUSIONS: : The Premie-Neuro is a valid assessment tool for discriminating between preterm infants at high and low risk for neurodevelopmental delay. Interrater reliability of the Premie-Neuro was poor, and test-retest reliability of the Premie-Neuro was fair to moderate. The Premie-Neuro may be acceptable for assessing groups of infants, but there is no evidence that reliability is sufficient for clinical decision-making for individual infants. More research needs to be done to improve the reliability of the Premie-Neuro and assess other facets of the Premie-Neuro's reliability.
Authors:
Kendra Gagnon; Susan Cannon; Kathleen B Weatherstone
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Advances in neonatal care : official journal of the National Association of Neonatal Nurses     Volume:  12     ISSN:  1536-0911     ISO Abbreviation:  Adv Neonatal Care     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101125644     Medline TA:  Adv Neonatal Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  310-7     Citation Subset:  IM    
Affiliation:
Department of Physical Therapy and Rehabilitation Science (Dr Gagnon) and Center for Child Health and Development (Ms Cannon), University of Kansas Medical Center, Kansas City; and Neonatal Intensive Care Services, Sunflower Neonatology Associates, Overland Park Regional Medical Center, Kansas (Dr Weatherstone).
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