title: Hospital and community validation of a screening instrument for detection of neurodisability in Indian children aged 6 months to 2 years.
abstract: OBJECTIVE
  To develop and validate a screening instrument for neurological disorders in children aged 6 months to 2 years in the community.
  
  
  METHODS
  A comprehensive parent-administered instrument was developed to screen for hearing, vision, seizures, motor deficits and development in Indian children aged 6-24 months. This was tested for reliability and validated in the hospital setting by comparing with pre-decided gold standards. It was then used in a community survey in a two-phase design in which all screen positives and a random sample of screen negatives were validated.
  
  
  RESULTS
  The screening instrument had overall sensitivity, specificity and positive predictive values of 95.8, 68.1 and 76.1%, respectively, in the hospital setting. In the field setting, these figures changed to 95.4, 51.8 and 20.6%, respectively. The reasons for this are discussed.
  
  
  CONCLUSIONS
  Community surveys must use a two-phase design to get the true prevalence. A falsely high prevalence will be computed if only a single-phase design or hospital validation is used.
authors: Department of Pediatrics, CSM Medical University, Lucknow, India.
authors: Anupama
authors: A
authors: Bhave
authors: Roli
authors: R
authors: Bhargava
authors: Anwar
authors: A
authors: Rizvi
authors: Talat
authors: T
authors: Rizvi
authors: Rashmi
authors: R
authors: Kumar
mesh_terms: D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D003625:Data Collection / Q000379:methods; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000453:epidemiology; D004827:Epilepsy / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006761:Hospitals; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D008403:Mass Screening; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000453:epidemiology; D011237:Predictive Value of Tests; D011596:Psychomotor Disorders / Q000175:diagnosis / Q000453:epidemiology; D015203:Reproducibility of Results; D012111:Residence Characteristics; D012678:Sensation Disorders / Q000175:diagnosis / Q000453:epidemiology; D012680:Sensitivity and Specificity