title: [Evaluation of the Babylotse-Plus screening form : Evaluation of a simple instrument to systematically identify parents of newborns with severe psychosocial stress at Charité Berlin].
abstract: BACKGROUND
  The well-being and healthy development of children are at risk in families with severe psychosocial stress. In Germany, simple and valid screening instruments are lacking to identify families in need of early support.
  
  
  OBJECTIVE
  We aimed to examine the diagnostic accuracy of a simple perinatal screening form to identify families at high psychosocial risk.
  
  
  METHODS
  For every mother giving birth at Charité Berlin between January and August 2013 the short Babylotse-Plus screening form with 27 items was filled out by medical staff. Completing the form took about 5 min. After calculating a sum score, values of ≥3 were defined as "likely at risk". A one-hour comprehensive standardized interview with the parents after birth served as the reference standard for assessing family resources and stress factors.
  
  
  RESULTS
  Among the 279 participants included in the analyses, 215 were "likely at risk" and 64 had a low or no risk, the latter were randomly selected among all families with scores <3. The screening form had an excellent sensitivity (98.9 %; 95 % confidence interval 93.4-99.9 %) to detect families likely at risk, whereas its specificity was only low (33.0 %; 95 % confidence interval 30.5-33.5 %). This resulted in a rather poor positive likelihood ratio of 1.5 but a very good negative likelihood ratio of 0.03.
  
  
  CONCLUSIONS
  The screening form identified families with psychosocial risks well, but many families with low or no risk were falsely defined as being at risk. Before recommending the screening instrument for clinical practice, further studies are needed in different settings to improve the specificity without reducing its high sensitivity.
authors.affiliation: Kinderklinik m. S. Pneumologie, Immunologie und Intensivmedizin inkl. Rettungsstelle, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland. silvia.fisch@charite.de.
authors.forename: Silvia
authors.initials: S
authors.lastname: Fisch
authors.affiliation: Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
authors.forename: Theresa
authors.initials: T
authors.lastname: Keller
authors.affiliation: Klinik für Geburtsmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
authors.forename: Nurina
authors.initials: N
authors.lastname: Nazmy
authors.affiliation: Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Stasun
authors.affiliation: Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.|Institut für Klinische Epidemiologie und Biometrie, Universität Würzburg, Würzburg, Deutschland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Keil
authors.affiliation: Klinik für Geburtsmedizin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
authors.forename: Christine
authors.initials: C
authors.lastname: Klapp
mesh_terms: D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening / Q000379:methods*; D010290:Parents / Q000523:psychology*; D015995:Prevalence; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D013315:Stress, Psychological / Q000175:diagnosis* / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Babylotse-Plus; Child welfare; Diagnostic accuracy; Early prevention program; Screening