학술논문
Preliminary results on validity and reliability from two prospective cohort studies on a new Neonatal Coma Score.
Document Type
Academic Journal
Author
Hart AR; Department of Paediatric Neurology, King's College Hospital NHS Foundation Trust, London, UK anthony.hart@kcl.ac.uk.; King's College London, Division of Health and Social Care Research, London, UK.; Kieran M; Medical School, The University of Sheffield, Sheffield, UK.; Matthews E; Medical School, The University of Sheffield, Sheffield, UK.; Mandefield L; York Trials Unit, Department of Health Sciences, University of York, York, UK.; Williams T; Deparment of Neonatology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.; Johnson K; Department of Neonatology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.; English S; Department of Neonatology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.; Evans D; Neonatal Education, Yorkshire and Humber Neonatal Operational Delivery Network, Sheffield, UK.; Cutsey L; Department of Paediatric Neurology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.; Goodden J; Department of Paediatric Neurosurgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Source
Publisher: British Medical Association Country of Publication: England NLM ID: 9501297 Publication Model: Electronic Cited Medium: Internet ISSN: 1468-2052 (Electronic) Linking ISSN: 13592998 NLM ISO Abbreviation: Arch Dis Child Fetal Neonatal Ed Subsets: MEDLINE
Subject
Language
English
Abstract
Objective: To collect data on content/face validity and interobserver agreement for a Neonatal Coma Score (NCS) in well full-term neonates and on construct validity in unwell and preterm babies, specifically how the NCS changed with gestational age and illness.
Design: Prospective cohort studies.
Setting: Two UK tertiary neonatal units (Sheffield and Leeds).
Patients: 151 well full-term (≥37 weeks gestational age) newborn babies recruited between January and February 2020 in Sheffield and April and May 2021 in Leeds; 101 sick preterm and full-term babies admitted to Sheffield neonatal unit between January 2021 and May 2022.
Intervention: A new NCS.
Main Outcome Measures: Determination of normal values in well babies born ≥37 weeks gestational age; data on how the NCS changes with gestational age and illness.
Results: Face validity was demonstrated during development of the NCS. The median NCS of well, full-term newborn babies was 15 and the intraclass correlation coefficient was 0.78 (95% CI 0.70 to 0.84). In the 'well' preterm population, 95% <28 weeks had a score ≥11; 28-31 weeks ≥11; 32-36 weeks ≥13 and 37-44 weeks 14-15. The NCS dropped during periods of deterioration, demonstrating evidence of construct validity. Criterion validity was not assessed.
Conclusions: The NCS has good intraobserver agreement in well full-term babies, with a normal NCS 14-15. The NCS in preterm neonates depended on gestational age, and deterioration from baseline was associated with illness. Further work is needed to determine normal scores each gestational age, reliability at lower levels, how early the NCS identifies deterioration and comparison with other assessment tools to demonstrate criterion validity.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Design: Prospective cohort studies.
Setting: Two UK tertiary neonatal units (Sheffield and Leeds).
Patients: 151 well full-term (≥37 weeks gestational age) newborn babies recruited between January and February 2020 in Sheffield and April and May 2021 in Leeds; 101 sick preterm and full-term babies admitted to Sheffield neonatal unit between January 2021 and May 2022.
Intervention: A new NCS.
Main Outcome Measures: Determination of normal values in well babies born ≥37 weeks gestational age; data on how the NCS changes with gestational age and illness.
Results: Face validity was demonstrated during development of the NCS. The median NCS of well, full-term newborn babies was 15 and the intraclass correlation coefficient was 0.78 (95% CI 0.70 to 0.84). In the 'well' preterm population, 95% <28 weeks had a score ≥11; 28-31 weeks ≥11; 32-36 weeks ≥13 and 37-44 weeks 14-15. The NCS dropped during periods of deterioration, demonstrating evidence of construct validity. Criterion validity was not assessed.
Conclusions: The NCS has good intraobserver agreement in well full-term babies, with a normal NCS 14-15. The NCS in preterm neonates depended on gestational age, and deterioration from baseline was associated with illness. Further work is needed to determine normal scores each gestational age, reliability at lower levels, how early the NCS identifies deterioration and comparison with other assessment tools to demonstrate criterion validity.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)