硕士研究生英文文献汇报实例.ppt

AgesandStagesQuestionnaireat3YearsforPredictingIQat5 6Years幼儿3岁时的发育情况 年龄和发育阶段问卷结果 能预测其5 6岁时的IQ PEDIATRICSVolume139 number4 April2017IF 6 476Yaoxing 2017 11 07 Contens BackgroundObjectivesMethodsResultsDiscussionStrengthsandlimitationsConclusionsImplications Abbreviations ASQ Ages StagesQuestionnaires 年龄与发育阶段问卷 CI ConfidenceInterval 可信区间 EDEN EtudedesDeterminantsPre etPost natalsduDeveloppementdel Enfant 伊甸园队列 IQR InterquartileRange 四分位数间距 ROC ReceiverOperatingCharacteristic 受试者 接受者工作特征 SDQ StrengthsandDifficultiesQuestionnaire 长处与困难问卷 WPPSI III WechslerPreschoolandPrimaryScaleofIntelligence ThirdEdition 韦氏学龄前儿童智力量表 第3版 EDEN EtudedesDeterminantsPre etPost natalsduDeveloppementdel Enfant TheEDENmother childcohortstudyaimstoexamineprenatalandpostnataldeterminantsofchilddevelopment growth andhealth Participantswererecruitedbetween2003and2006amongpregnantwomenfollowedinPoitiersandNancyuniversitymaternities Exclusioncriteriaweremultiplepregnancies 多胎妊娠 aknownhistoryofdiabetes non Frenchspeakersorreaders orplanstomoveoutofthestudyregioninthenext3years Background 1 Theidentificationofyoungchildrenatriskforlatersuboptimaldevelopmentiskeytothedesignandimplementationofearlypreventiveorinterventionalstrategies 2 Parentalreportinstrumentsaredesignedtobeusedinprimarycareforfirstlineclinicalscreeningofinfantandpreschoolchilddevelopment 3 TheAges StagesQuestionnaires ASQ arethemostcommonlyusedquestionnairestoidentifyyoungchildrenatriskfordevelopmentaldelay 4 Previousevidencefromapopulationofchildrenbornpretermshowedthatthe36 monthASQpredictedschooldifficultiesatage5 5 ThereisagapinknowledgeaboutthepredictivevalueofearlyASQscoresforlatercognitivefunctioning suchasIQ inthegeneralpediatricpopulation Objectives 1 Toinvestigatethepredictivevalueofthe36 monthASQscoreforIQatage5to6yearsinalargepopulation basedcohortstudy 2 Tosearchforotherchild maternal andfamily relatedfactorsassociatedwithlowIQoncethe36 monthASQscoreistakenintoaccountandtodeterminewhethersuchfactorscouldinteractintherelationshipbetweenthe36 monthASQscoreandlaterIQ Methods 1 Measuresofchilddevelopment 2 136 MonthASQScore FrenchSecondEdition Parentsanswer6questionsineachof5domainsofdevelopment communication 沟通 grossmotor 粗大动作 finemotor 精细动作 problem solvingskills 解决问题能力 andadaptiveskills 适应能力 USnormsareavailableforeachdomain andanydomainscreened 2SDsbelowthemeanisconsideredapositivescreening Thisstudyusedthesumorthe5domainscores producingascorebetween0and300 1 Measuresofchilddevelopment 2 2IQWiththeWechslerPreschoolandPrimaryScaleofIntelligence ThirdEditionatAge5to6YearsWhenthechildwas5to6yearsold cognitiveassessmentwasperformedbytrainedpsychologists TheWPPSI IIIincludes7subtestsusedtocomputeaverbalIQ aperformanceIQ andafull scaleIQ IQwasconsideredlowifitwas 85 Whenthechildrenwere3yearsold mothersfilledoutaquestionnairereportingsociodemographicstatusforthefamilyandspecificdataoncurrentmaternalhealth togetherwiththeASQ Whenthechildrenwere5to6yearsold acognitiveassessmentwasconductedbytrainedpsychologists 1 Measuresofchilddevelopment 2 Factorsincludedintheanalysis 1 Child scharacteristics gender whetherthechildwasafirstbornchild behavioralproblemsatage3 ratedviatheStrengthsandDifficultiesQuestionnaire SDQ andwhetherthechildhadstartedpreschoolatage3 2 Maternalcharacteristics maternaleducationallevel occupation anddepressivesymptomsassessedwiththeCenterforEpidemiologicStudies Depressionscale 3 Familycharacteristics parents occupationandfinancialdifficultiesreportedbytheparentswhenthechildwas3 3 Statisticalanalysis 1 ChildrenincludedinthecurrentanalysiswerefirstcomparedwiththeotherchildrenintheEDENcohortwhowerenotincluded 2 Resultsforthe36 monthASQscoreandthe5 to6 yearWPPSI IIIevaluationweredescribedasmeans SDsandmedianwithinterquartileranges IQRs 3 Thereceiveroperatingcharacteristic ROC curvelinkinglowIQ 85 andASQscorewasusedtodeterminetheoptimalcutoffvaluefortheASQscore 4 A3 stepanalysiswasthenconductedwithlogisticregression 5 StatisticalanalyseswereperformedinSASsoftwareversion9 3 Results ASQscoresweredeterminedatameanageof37 3 0 8months Themean36 monthASQscorewas270 30 withamedianof280 IQR260 290 IQwasmeasuredatameanageof67 2 1 8months TheMeanIQwas103 13 and69children 7 3 hadanIQ 85 Allchild maternal andfamilyfactorsstudied exceptgenderandmaternaldepressivesymptoms weresignificantlyassociatedwithASQscore 1 CharacteristicsoftheStudypopulation andcomparedwithchildrenintheEDENCohortbutnotincludedinthestudy ChildrennotincludedweremoreoftenfromNancyCenter werelessoftenfirstborn hadmotherswithlowereducationallevels andhadparentswithloweroccupationallevelsthanchildrenincluded 2 IQatage5to6yearsaccordingto36 monthASQscore ROCcurve Theareaunderthecurvewas0 78 95 confidenceinterval CI 0 72 0 84 即IQ 85的幼儿ASQ值小于正常组的概率为0 78 TheoptimalcutoffvalueforpredictinglowIQwas270 sensitivitywas0 77 specificitywas0 68 Positivepredictivevaluewas0 16 thenegativepredictivevaluewas0 97 提示3岁时ASQ得分 270的幼儿5 6岁时IQ 85的可能性小 ROC曲线下面积与工具诊断准确度高低高0 90 1 00 excellent A 中0 80 0 90 good B 0 70 0 80 fair C 低0 60 0 70 poor D 0 50 0 60 fail F 3 FactorsassociatedwithIQ 85onceASQistakenintoaccount 单变量 多变量 TherisksoflowIQwassignificantlyhigherinchildrenwithanASQscore 270andamaternaleducationallevelathighschoolorbelow Discussion 1 TheprevalenceoflowIQwasprobablyunderestimatedinthestudy Aprevalenceof16 couldhavebeenexpected consideringthedistributionofIQ mean 100 SD 15 Theprevalenceinthisstudywas7 3 whichwasalsointhelowerrangeoftheprevalenceobservedinthegeneralpediatricpopulationexhibitingsometypeofdevelopmentaldelayordisabilitybeforeenteringschool 5 15 2 ThetotalASQscoreusedinthestudy Asreportedinseveralpreviousstudies totalASQscoresprovideaglobalevaluationofachild sfunctioning whichseemsrelevantforpredictinglaterglobalcognitivefunctioning Usingthetotalscoreinsteadofthecutoffpointsbydomain 能区 couldmisslesssevereproblemsrestrictedto1domain OtherresearchersfoundthatinthegeneralpopulationtheuseofASQtotalscorecouldberecommendedbecauseofthelowprevalenceofdifficulties UsingtheASQatage3couldleadtodecisionstoperformmoredetaileddevelopmentalassessmentsforchildrenwithlowerscores Thegoalwouldbetosetupearlyinterventionsdesignedtohelpthechildachievehisorherfulldevelopmentalpotential 3 FactorsassociatedwithIQatage5to6yearsonceASQscorewastakenintoaccount Theobjectiveofthisstudywastoidentifythefactorsstillhavinganimpactbetweenage3and5to6years onceabilitiesatage3weretakenintoaccount Interventionsconductedbetweenage3and5to6years suchasspeechtherapy werenotstudied LowermaternaleducationallevelwasassociatedwithlowerASQscore Thisassociationunderlinesthefactthatsocioeconomicbackgroundplaysacrucialroleinchilddevelopmentthroughoutearlychildhood ChildrenwhosemothershadnooccupationalactivityhadagreaterriskoflowIQonceASQscorewastakenintoaccountandafteradjustmentfortheirmothers educationallevel Itispossiblethatmaternaloccupationalactivityservesasaproxy 代表 forvariousaspectsofsocioculturalandeconomicbackground Strengths 1 Largesamplesize madeitpossibletostudynumerousfactors 2 TheASQscorewasstudiedinrelationtothegoldstandardevaluationofcognitiveabilityatage5to6years WPPSI III 3 ThepsychologistsperformingtheWPPSI IIIwereblindedtotheASQscore Limitations 1 TheIQat5to6yearsitselfalsohaslimitsandisnotaperfectpredictoroflonger termoutcomes 2 Only69childrenhadanIQ 85 leadingtoalackofpowerforstudyingassociatedfactors 3 959childrenwerelosttofollow upbetweenbirthandage5to6years 4 Childrennotincludedhadalowersocioeconomicbackgroundthanch