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    Diagnostic accuracy of early magnetic resonance imaging to determine motor outcomes in infants born preterm: A systematic review and meta-analysis

    Access Status
    Fulltext not available
    Authors
    George, J.
    Pannek, K.
    Rose, S.
    Ware, R.
    Colditz, P.
    Boyd, Roslyn
    Date
    2017
    Type
    Journal Article
    
    Metadata
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    Citation
    George, J. and Pannek, K. and Rose, S. and Ware, R. and Colditz, P. and Boyd, R. 2017. Diagnostic accuracy of early magnetic resonance imaging to determine motor outcomes in infants born preterm: A systematic review and meta-analysis. Developmental Medicine and Child Neurology. 60 (2): pp. 134-146.
    Source Title
    Developmental Medicine and Child Neurology
    DOI
    10.1111/dmcn.13611
    ISSN
    0012-1622
    School
    School of Occupational Therapy, Social Work and Speech Pathology
    URI
    http://hdl.handle.net/20.500.11937/60790
    Collection
    • Curtin Research Publications
    Abstract

    Aim: To examine the diagnostic ability of early magnetic resonance imaging (MRI; < 36wks postmenstrual age) to detect later adverse motor outcomes or cerebral palsy (CP) in infants born preterm. Method: Studies of infants born preterm with MRI earlier than 36 weeks postmenstrual age and quantitative motor data or a diagnosis of CP at or beyond 1 year corrected age were identified. Study details were extracted and meta-analyses performed where possible. Quality of included studies was evaluated with the QUADAS-2 (a revised tool for the quality assessment of diagnostic accuracy studies). Results: Thirty-one articles met the inclusion criteria, five of which reported diagnostic accuracy and five reported data sufficient for calculation of diagnostic accuracy. Early structural MRI global scores detected a later diagnosis of CP with a pooled sensitivity of 100% (95% confidence interval [CI] 86-100) and a specificity of 93% (95% CI 59-100). Global structural MRI scores determined adverse motor outcomes with a pooled sensitivity of 89% (95% CI 44-100) and a specificity of 98% (95% CI 90-100). White matter scores determined adverse motor outcomes with a pooled sensitivity of 33% (95% CI 20-48) and a specificity of 83% (95% CI 78-88). Interpretation: Early structural MRI has reasonable sensitivity and specificity to determine adverse motor outcomes and CP in infants born preterm. Greater reporting of diagnostic accuracy in studies examining relationships with motor outcomes and CP is required to facilitate clinical utility of early MRI. What this paper adds: Early magnetic resonance imaging (MRI) has reasonable sensitivity and specificity to determine later adverse motor outcomes and cerebral palsy (CP). Detection of infants who progressed to CP was stronger than motor outcomes. Global MRI scores determined adverse motor outcomes more accurately than white matter scores. Few studies report diagnostic accuracy of early MRI findings. Diagnostic accuracy is required to draw clinically meaningful conclusions from early MRI studies.

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