TY - JOUR
KW - Child
KW - Child Behavior Disorders/diagnosis/epidemiology/therapy
KW - Developmental Disabilities/diagnosis/epidemiology/therapy
KW - Humans
KW - Mass Screening/methods
KW - Primary Health Care/methods
AU - R. C. Sheldrick
AU - S. Merchant
AU - E. C. Perrin
A1 - 
AB - CONTEXT: Recent mandates and recommendations for formal screening programs are based on the claim that pediatric care providers underidentify children with developmental-behavioral disorders, yet the research to support this claim has not been systematically reviewed. OBJECTIVE: To review research literature for studies regarding pediatric primary care providers' identification of developmental-behavioral problems in children. METHODS: On the basis of a Medline search conducted on September 22, 2010, using relevant key words, we identified 539 articles for review. We included studies that (1) were conducted in the United States, (2) were published in peer-reviewed journals, (3) included data that addressed pediatric care providers' identification of developmental-behavioral problems in individual patients, (4) included an independent assessment of patients' developmental-behavioral problems, such as diagnostic interviews or validated screening instruments, and (5) reported data sufficient to calculate sensitivity and specificity. Studies were not limited by sample size. Eleven articles met these criteria. We used Quality Assessment of Diagnostic Accuracy Studies (QUADAS) criteria to evaluate study quality. Although the studies were similar in many ways, heterogeneous methodology precluded a meta-analysis. RESULTS: Sensitivities for pediatric care providers ranged from 14% to 54%, and specificities ranged from 69% to 100%. The authors of 1 outlier study reported a sensitivity of 85% and a specificity of 61%. CONCLUSIONS: Pediatricians are often the first point of entry into developmental and mental health systems. Knowing their accuracy in identifying children with developmental-behavioral disabilities is essential for implementing optimal evaluation programs and achieving timely identification. Moreover, these statistics are important to consider when planning large-scale screening programs.
BT - Pediatrics
C5 - General Literature
CP - 2
CY - United States
DO - 10.1542/peds.2010-3261
IS - 2
JF - Pediatrics
N2 - CONTEXT: Recent mandates and recommendations for formal screening programs are based on the claim that pediatric care providers underidentify children with developmental-behavioral disorders, yet the research to support this claim has not been systematically reviewed. OBJECTIVE: To review research literature for studies regarding pediatric primary care providers' identification of developmental-behavioral problems in children. METHODS: On the basis of a Medline search conducted on September 22, 2010, using relevant key words, we identified 539 articles for review. We included studies that (1) were conducted in the United States, (2) were published in peer-reviewed journals, (3) included data that addressed pediatric care providers' identification of developmental-behavioral problems in individual patients, (4) included an independent assessment of patients' developmental-behavioral problems, such as diagnostic interviews or validated screening instruments, and (5) reported data sufficient to calculate sensitivity and specificity. Studies were not limited by sample size. Eleven articles met these criteria. We used Quality Assessment of Diagnostic Accuracy Studies (QUADAS) criteria to evaluate study quality. Although the studies were similar in many ways, heterogeneous methodology precluded a meta-analysis. RESULTS: Sensitivities for pediatric care providers ranged from 14% to 54%, and specificities ranged from 69% to 100%. The authors of 1 outlier study reported a sensitivity of 85% and a specificity of 61%. CONCLUSIONS: Pediatricians are often the first point of entry into developmental and mental health systems. Knowing their accuracy in identifying children with developmental-behavioral disabilities is essential for implementing optimal evaluation programs and achieving timely identification. Moreover, these statistics are important to consider when planning large-scale screening programs.
PP - United States
PY - 2011
SN - 1098-4275; 0031-4005
SP - 356
EP - 363
EP - 
T1 - Identification of developmental-behavioral problems in primary care: a systematic review
T2 - Pediatrics
TI - Identification of developmental-behavioral problems in primary care: a systematic review
U1 - General Literature
U2 - 21727101
U3 - 10.1542/peds.2010-3261
VL - 128
VO - 1098-4275; 0031-4005
Y1 - 2011
ER -