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Reliability of classification of cerebral palsy in low-birthweight children in four countries

Published online by Cambridge University Press:  12 August 2003

Nigel Paneth
Affiliation:
Departments of Epidemiology, and Pediatrics and Human Development, College of Human Medicine, Michigan State University, MI, USA.
Hong Qiu
Affiliation:
Department of Epidemiology, College of Human Medicine, Michigan State University, MI, USA.
Peter Rosenbaum
Affiliation:
Department of Pediatrics, Faculty of Health Sciences, McMaster University College of Human Medicine, Hamilton, Ontario, Canada.
Saroj Saigal
Affiliation:
Department of Pediatrics, Faculty of Health Sciences, McMaster University College of Human Medicine, Hamilton, Ontario, Canada.
Sharif Bishai
Affiliation:
College of Osteopathic Medicine, Michigan State University, MI, USA.
James Jetton
Affiliation:
Department of Epidemiology, College of Human Medicine, Michigan State University, MI, USA.
Lya den Ouden
Affiliation:
TNO-Holland, Leiden, the Netherlands.
Sue Broyles
Affiliation:
Department of Pediatrics, University of Texas – Southwestern Medical School, Dallas, TX, USA.
Jon Tyson
Affiliation:
University of Texas – Houston, Houston, TX, USA.
Karl Kugler
Affiliation:
University of Munich Children's Hospital, Munich, Germany.
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Abstract

The reliability of classification of cerebral palsy (CP) in low-birthweight children was assessed by using clinical and research study records sampled from population-based cohort studies in the USA, the Netherlands, Canada, and Germany. Records of neurological examination findings and functional motor assessments were submitted to up to five pediatricians with expertize in CP diagnosis, who grouped children into categories referred to as ‘disabling’ CP, ‘non-disabling’ CP, and no CP. Each study provided between 31 and 51 records of children assessed between 2 and 8 years of age, approximately equally divided among the three groupings. The discrimination between ‘any CP’ and ‘no CP’ was only fair (mean Kappa coefficients 0.37 to 0.69). However, when more detailed information describing motor function was used, children with ‘disabling’ CP could be distinguished, on the basis of records, from those without CP or with ‘non-disabling’ CP with good to excellent reliability (mean Kappa coefficients 0.69 to 0.88). Because of the substantially higher agreement observed when these functional distinctions are made, we recommend that reports or comparisons of rates of CP should include levels of motor function of children with CP, and not simply total CP, among the outcomes of interest.

Type
Original Articles
Copyright
© 2003 Mac Keith Press

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