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Neurodevelopmental outcomes of children born preterm: analyses into the validity of data collection and outcome reports

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Title: Neurodevelopmental outcomes of children born preterm: analyses into the validity of data collection and outcome reports
Authors: Wong, Sze Ying
Item Type: Thesis or dissertation
Abstract: Background and aims: Information on the neurodevelopmental outcomes of children born very preterm is required for multiple purposes. Reliable and up-to-date data sources are lacking. The overall aim of this thesis is to evaluate the validity and usability of the neurodevelopmental outcome data of very preterm children available from current data sources. The specific objectives were: 1) to examine the validity of outcome data recorded during routine follow-up assessment 2) to explore early childhood social-communication difficulties exhibited by very preterm children 3) to assess the stability over time of neurodevelopmental diagnoses made in early childhood. Methods: Three studies were conducted to meet the objectives. For studies 1 and 2, I recruited children born at <30 weeks’ gestation at 2 years corrected age (age corrected for prematurity) from 13 participating study sites. In study 1, I compared the agreement between the neurodevelopmental outcomes of 190 children recorded at their routine NHS assessments and data obtained by a research assessment using the Bayley Scales of Infant Development, 3rd edition. In study 2, the social-communication skills of 141 children were determined using the parent-completed Quantitative Checklist of Autism in Toddlers (Q-CHAT) questionnaire and compared to published results from the general population. In study 3, I conducted a systematic review and using meta-analytic methods, I calculated the pooled sensitivity and specificity of early developmental assessment in identifying school-age cognitive deficit from 24 studies. Conclusions: 1) Compared with research assessment, routine NHS follow-up assessment had a low sensitivity but high specificity for identifying children with neurodevelopmental impairment. 2) Very preterm children display greater early childhood social-communication difficulties and autistic behaviour than the general population as measured by their parents on the Q-CHAT. 3) Early neurodevelopmental assessment has high specificity but low sensitivity for identifying later school-age cognitive deficits.
Content Version: Open Access
Issue Date: Jan-2015
Date Awarded: Oct-2015
URI: http://hdl.handle.net/10044/1/45429
DOI: https://doi.org/10.25560/45429
Supervisor: Cowan, Frances
Modi, Neena
Sponsor/Funder: National Institute for Health Research (Great Britain)
Funder's Grant Number: RP-PG-0707-10010
Department: Department of Medicine
Publisher: Imperial College London
Qualification Level: Doctoral
Qualification Name: Doctor of Philosophy (PhD)
Appears in Collections:Medicine PhD theses



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