Risk-based approach to school entry examinations in Germany - a validation study.
BMC Pediatr
; 19(1): 448, 2019 11 19.
Article
in En
| MEDLINE
| ID: mdl-31744487
ABSTRACT
BACKGROUND:
In Germany, all preschoolers undergo a school entry examination (SEE). While most children are sufficiently served with standardized developmental tests only, for a small group of otherwise underserved children, the SEE should also include a subsidiary health checkup. The aim of the study was to validate selection criteria to differentiate these two groups of children.METHODS:
Secondary data from the SEEs of 2016 and 2017 that contained information on 3513 children were analyzed. Of these children, a subset was selected in which no severe developmental disorders were diagnosed prior to the SEE (n = 2744). The selection criteria identified in an earlier study (low or medium social status, missed the last pediatric routine check-up, migration background, three or more siblings, and raised by a single mother) were then applied to this subset to estimate their effectiveness in finding children at risk for a newly diagnosed severe developmental disorder. The sensitivity, specificity and positive and negative predictive values of the selection criteria were calculated.RESULTS:
The tested selection criteria identified children who would likely benefit from a subsidiary checkup in the context of SEEs with a sensitivity of 96% (95% CI 94.5-98.9%). The negative predictive value and specificity of the criteria were 99% (98.6-99.7%) and 34% (32.1-35.8%), respectively. By using this approach, the number of children seen by a physician could be reduced to 53% of the age cohorts.CONCLUSION:
The tested selection criteria are a viable way to differentiate children for whom SEEs should include a subsidiary health checkup from those who do not need it. Therefore, the time that physicians spend with SEEs could be reduced. Using the selection criteria to establish a stepped procedure in SEEs therefore offers a valid way to focus physicians' resources on the children who need them most.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Physical Examination
/
Schools
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Child
/
Child, preschool
/
Female
/
Humans
/
Male
Country/Region as subject:
Europa
Language:
En
Journal:
BMC Pediatr
Journal subject:
PEDIATRIA
Year:
2019
Document type:
Article
Affiliation country:
Germany