title: Developmental Assessments in Preterm Children: A Meta-analysis.
abstract: Developmental outcomes of very preterm (gestational age ≤32 weeks) or very low birth weight (<1500 g) children are commonly reported before age 3 years although the predictive validity for later outcomes are uncertain.
  
  
  
  To determine the validity of early developmental assessments in predicting school-age cognitive deficits.
  
  
  
  PubMed.
  
  
  
  English-language studies reporting at least 2 serial developmental/cognitive assessments on the same population, 1 between ages 1 and 3 years and 1 at ≥5 years.
  
  
  
  For each study, we calculated the sensitivity, specificity, and positive and negative predictive values of early assessment for cognitive deficit (defined as test scores 1 SD below the population mean). Pooled meta-analytic sensitivity and specificity were estimated by using a hierarchical summary receiver operator characteristic curve.
  
  
  
  We included 24 studies (n = 3133 children). Early assessments were conducted at 18 to 40 months and generally involved the Bayley Scales of Infant Development or the Griffiths Mental Development Scales; 11 different cognitive tests were used at school-age assessments at 5 to 18 years. Positive predictive values ranged from 20.0% to 88.9%, and negative predictive vales ranged from 47.8% to 95.5%. The pooled sensitivity (95% confidence interval) of early assessment for identifying school-age cognitive deficit was 55.0% (45.7%-63.9%) and specificity was 84.1% (77.5%-89.1%). Gestational age, birth weight, age at assessment, and time between assessments did not explain between-study heterogeneity.
  
  
  
  The accuracy of aggregated data could not be verified. Many assessment tools have been superseded by newer editions.
  
  
  
  Early developmental assessment has poor sensitivity but good specificity and negative predictive value for school-age cognitive deficit.
authors.affiliation: Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom; and.
authors.forename: Hilary S
authors.initials: HS
authors.lastname: Wong
authors.affiliation: Imperial College Clinical Trials Unit and.
authors.forename: Shalini
authors.initials: S
authors.lastname: Santhakumaran
authors.affiliation: Section of Neonatal Medicine, Imperial College London, London, United Kingdom.
authors.forename: Frances M
authors.initials: FM
authors.lastname: Cowan
authors.affiliation: Section of Neonatal Medicine, Imperial College London, London, United Kingdom n.modi@imperial.ac.uk.
authors.forename: Neena
authors.initials: N
authors.lastname: Modi
mesh_terms: D002657:Child Development; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D007234:Infant, Premature; D011237:Predictive Value of Tests; D015203:Reproducibility of Results