“兒童健康手冊”發展監測項目之信效度研究

The Reliability and Validity of the Developmental Items of "Child Health Pamphlet" (DICHP)

廖華芳(Hua-Fang Liao) ； 鄭玲宜(Ling-Yee Cheng) ； 謝武勳(Wu-Shien Hsieh) ； 楊銘欽(Ming-Ching Yang) ； 鄒國蘇(Kou-Su Tsou) ； 蔡昆瀛(Kuen-Ying Tsai)

《台灣醫學》 12卷5期 (2008/09) Pp. 502-512

https://doi.org/10.6320/FJM.2008.12(5).02

摘要

The developmental surveillance used for the early detection of developmental delay for children has been conducted for many years in Taiwan. However, the information of reliability and validity of the developmental surveillance items in the Child Health Pamphlet (DICHP) edited by the National Health Bureau of the Department of Health were still not very clear. The purpose of this study was to investigate the reliability and validity of the DICHP. The methodology research was used for reliability study, and the case-control study was used for validity study. A convenient sampling method was used to recruit 395 children (developing typically: children with developmental delay =1-3:1) in 3 age groups from 12-to 36-month-of-age, among them 194 children tested 2 times within 1 week for test-retest reliability. Before data collection, the developmental items were inspected by the research group, and a wording revised DICHP (6 items for each age group) was used in this study. The parents or caregivers filled the 6 items according the child's performance. Then the area under the receiver operating characteristic (ROC) curve, multi-level LRs, and the known-groups validities were analyzed. The results showed that the revised DICHP have acceptable internal consistency (α=0.74-0.86) and test-retest reliabilities (rs=0.72-1.00, p＜0.001). The screening accuracy were with area under ROC of 0.82-0.86 (p＜0.001). The sensitivities were 0.69-0.80, specificities were 0.76-0.89. The LRs of the DICHP scores of 5-6 were less than 1, of ≤ 2-4 were infinity, meeting the SpPin rule. It has acceptable known group validity. The authors concluded that for children aged 1-3 years, the DICHP had acceptable reliabilities and validities, and could be used as the first tool for multi-phasic surveillance. From the ROC and multi-level LRs of the DICHP, authors proposed that further diagnosis test was recommended for children with more than 2-4 failure items, second screening test for children with 1-3 failure items, and no intervention for children with 0-1 failure item.

關鍵字

發展遲緩 ； 篩選測試 ； 信效度 ； 概率比 ； 兒童

並列摘要

The developmental surveillance used for the early detection of developmental delay for children has been conducted for many years in Taiwan. However, the information of reliability and validity of the developmental surveillance items in the Child Health Pamphlet (DICHP) edited by the National Health Bureau of the Department of Health were still not very clear. The purpose of this study was to investigate the reliability and validity of the DICHP. The methodology research was used for reliability study, and the case-control study was used for validity study. A convenient sampling method was used to recruit 395 children (developing typically: children with developmental delay =1-3:1) in 3 age groups from 12-to 36-month-of-age, among them 194 children tested 2 times within 1 week for test-retest reliability. Before data collection, the developmental items were inspected by the research group, and a wording revised DICHP (6 items for each age group) was used in this study. The parents or caregivers filled the 6 items according the child's performance. Then the area under the receiver operating characteristic (ROC) curve, multi-level LRs, and the known-groups validities were analyzed. The results showed that the revised DICHP have acceptable internal consistency (α=0.74-0.86) and test-retest reliabilities (rs=0.72-1.00, p＜0.001). The screening accuracy were with area under ROC of 0.82-0.86 (p＜0.001). The sensitivities were 0.69-0.80, specificities were 0.76-0.89. The LRs of the DICHP scores of 5-6 were less than 1, of ≤ 2-4 were infinity, meeting the SpPin rule. It has acceptable known group validity. The authors concluded that for children aged 1-3 years, the DICHP had acceptable reliabilities and validities, and could be used as the first tool for multi-phasic surveillance. From the ROC and multi-level LRs of the DICHP, authors proposed that further diagnosis test was recommended for children with more than 2-4 failure items, second screening test for children with 1-3 failure items, and no intervention for children with 0-1 failure item.

並列關鍵字

developmental delay ； screening test ； reliability and validity ； likelihood ratio ； child