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Symptomatic asymmetry in very young infants: a Delphi study on the development of a screening instrument.

机译：年轻婴儿的症状不对称：Delphi研究筛查仪器的发展。

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摘要

The objective of this study was to develop a screening instrument for pediatric physiotherapists to distinguish a symptomatic asymmetry in the clinical evaluation of young infants (age <6 months) with an asymmetric head posture. We chose two consensus methods, a two-round Delphi design and an expert meeting using nominal group technique, for reaching agreement about classification of diagnoses and clinical diagnostic criteria (CDC). Seventeen diagnoses with an expression of asymmetry with 69 matching CDC were assessed. In two Delphi rounds, six medical specialists and seven pediatric physiotherapists were polled anonymously on the classification, completeness, and relevance of the diagnoses and the CDC. Panel consistency in round 2, expressed as Cronbach's-alpha, was 0.89. In round 3, a face-to-face meeting with eight therapists, the previously selected diagnoses and CDC were prioritised, reduced to 10 diagnoses and 21 CDC, and completed with eight hard clinical signs (red flags). Finally, a differential diagnostic screening instrument, containing a classification scheme, the CDC for differential diagnostics, and a list of "red flags" was established on the basis of literature search and expert consensus. Cross-validity and reliability of the instrument will be investigated in future research.
机译：这项研究的目的是为儿科理疗师开发一种筛查仪器，以在头部姿势不对称的婴儿（年龄<6个月）的临床评估中区分症状不对称。我们选择了两种共识方法，即两轮Delphi设计和使用名义组技术的专家会议，以就诊断分类和临床诊断标准（CDC）达成共识。评估了17个诊断为不对称表达的69个匹配CDC。在两轮德尔菲回合中，匿名对六名医学专家和七名儿科物理治疗师进行了民意测验，以诊断和CDC的分类，完整性和相关性。第二轮的小组一致性为Cronbach's-α，为0.89。在第3轮中，与8位治疗师进行了面对面的会议，对先前选择的诊断和CDC进行了优先排序，减少到10位诊断和21位CDC，并完成了8个硬性临床体征（危险信号）。最后，在文献检索和专家共识的基础上，建立了包含分类方案，用于鉴别诊断的CDC和“危险信号”列表的鉴别诊断筛选工具。该仪器的交叉有效性和可靠性将在未来的研究中进行研究。

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