Development of a risk calculator to predict attention-deficit/hyperactivity disorder in very preterm/very low birth weight newborns / Adelar Pedro FRANZ in Journal of Child Psychology and Psychiatry, 63-8 (August 2022)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 63-8 (August 2022) . - p.929-938 Titre : Development of a risk calculator to predict attention-deficit/hyperactivity disorder in very preterm/very low birth weight newborns Type de document : Texte imprimé et/ou numérique Auteurs : Adelar Pedro FRANZ, Auteur ; Arthur CAYE, Auteur ; Barbara Calil LACERDA, Auteur ; Flavia WAGNER, Auteur ; Rita C. SILVEIRA, Auteur ; Renato Soibelmann PROCIANOY, Auteur ; Carlos Renato MOREIRA-MAIA, Auteur ; Luis Augusto ROHDE, Auteur Article en page(s) : p.929-938 Langues : Anglais (eng) Mots-clés : Attention Deficit Disorder with Hyperactivity/diagnosis/epidemiology  Child  Gestational Age  Humans  Infant  Infant, Extremely Premature  Infant, Newborn  Infant, Very Low Birth Weight/psychology  Retrospective Studies  Prematurity  attention-deficit/hyperactivity disorder  low birth weight  prediction Index. décimale : PER Périodiques Résumé : BACKGROUND: Very preterm/very low birth weight (VP/VLBW) newborns can have lifelong morbidities, as attention-deficit/hyperactivity disorder (ADHD). Clinicians have no markers to discriminate which among those individuals will develop later ADHD, based only on the clinical presentation at birth. Our aim was to develop an individualized risk calculator for ADHD in VP/VLBW newborns. METHODS: This retrospective prognostic study included a consecutive sample of all VP/VLBW children (gestational age<32weeks and/or birth weight<1.5kg) born between 2010 and 2012 from a clinical cohort in a Brazilian tertiary care hospital. Children were clinically assessed at 6years of age for ADHD using the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS). The least absolute shrinkage and selection operator (LASSO) method was used for model-building. RESULTS: Ninety-six VP/VLBW children were assessed at 6years of age (92% follow-up), of whom 32 (33%) were diagnosed with ADHD. The area under the ROC curve (AUC) for ADHD prediction based on seven parameters (late-onset sepsis confirmed by blood culture, necrotizing enterocolitis, neonatal seizures, periventricular leukomalacia, respiratory distress syndrome, length of hospital stay, and number of maternal ADHD symptoms) was .875 (CI, 0.800-0.942, p<.001; AUC corrected for optimism with bootstrapping: .806), a performance that is comparable to other medical risk calculators. Compared to approaches that would offer early intervention to all, or intervention to none, the risk calculator will be more useful in selecting VP/VLBW newborns, with statistically significant net benefits at cost:benefits of around 1:2 to around 10:6 (range of ADHD risk thresholds of 32%-62%, respectively). It also showed specificity for ADHD compared to other prevalent child psychopathologies. CONCLUSIONS: The risk calculator showed good performance for early identification of VP/VLBW newborns at high risk of future ADHD diagnosis. External validity in population-based samples is needed to extend clinical usefulness. En ligne : http://dx.doi.org/10.1111/jcpp.13546 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=486 [article] Development of a risk calculator to predict attention-deficit/hyperactivity disorder in very preterm/very low birth weight newborns [Texte imprimé et/ou numérique] / Adelar Pedro FRANZ, Auteur ; Arthur CAYE, Auteur ; Barbara Calil LACERDA, Auteur ; Flavia WAGNER, Auteur ; Rita C. SILVEIRA, Auteur ; Renato Soibelmann PROCIANOY, Auteur ; Carlos Renato MOREIRA-MAIA, Auteur ; Luis Augusto ROHDE, Auteur . - p.929-938. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 63-8 (August 2022) . - p.929-938 Mots-clés : Attention Deficit Disorder with Hyperactivity/diagnosis/epidemiology  Child  Gestational Age  Humans  Infant  Infant, Extremely Premature  Infant, Newborn  Infant, Very Low Birth Weight/psychology  Retrospective Studies  Prematurity  attention-deficit/hyperactivity disorder  low birth weight  prediction Index. décimale : PER Périodiques Résumé : BACKGROUND: Very preterm/very low birth weight (VP/VLBW) newborns can have lifelong morbidities, as attention-deficit/hyperactivity disorder (ADHD). Clinicians have no markers to discriminate which among those individuals will develop later ADHD, based only on the clinical presentation at birth. Our aim was to develop an individualized risk calculator for ADHD in VP/VLBW newborns. METHODS: This retrospective prognostic study included a consecutive sample of all VP/VLBW children (gestational age<32weeks and/or birth weight<1.5kg) born between 2010 and 2012 from a clinical cohort in a Brazilian tertiary care hospital. Children were clinically assessed at 6years of age for ADHD using the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS). The least absolute shrinkage and selection operator (LASSO) method was used for model-building. RESULTS: Ninety-six VP/VLBW children were assessed at 6years of age (92% follow-up), of whom 32 (33%) were diagnosed with ADHD. The area under the ROC curve (AUC) for ADHD prediction based on seven parameters (late-onset sepsis confirmed by blood culture, necrotizing enterocolitis, neonatal seizures, periventricular leukomalacia, respiratory distress syndrome, length of hospital stay, and number of maternal ADHD symptoms) was .875 (CI, 0.800-0.942, p<.001; AUC corrected for optimism with bootstrapping: .806), a performance that is comparable to other medical risk calculators. Compared to approaches that would offer early intervention to all, or intervention to none, the risk calculator will be more useful in selecting VP/VLBW newborns, with statistically significant net benefits at cost:benefits of around 1:2 to around 10:6 (range of ADHD risk thresholds of 32%-62%, respectively). It also showed specificity for ADHD compared to other prevalent child psychopathologies. CONCLUSIONS: The risk calculator showed good performance for early identification of VP/VLBW newborns at high risk of future ADHD diagnosis. External validity in population-based samples is needed to extend clinical usefulness. En ligne : http://dx.doi.org/10.1111/jcpp.13546 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=486

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