原创力文档the test characteristics of head circumference measurements for pathology associated with head enlargement a retrospective cohort study头围测量的测试特点与头扩大相关的病理回顾性队列研究.pdfVIP
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the test characteristics of head circumference measurements for pathology associated with head enlargement a retrospective cohort study头围测量的测试特点与头扩大相关的病理回顾性队列研究
Daymont et al. BMC Pediatrics 2012, 12:9
/1471-2431/12/9
RESEARCH ARTICLE Open Access
The test characteristics of head circumference
measurements for pathology associated with
head enlargement: a retrospective cohort study
Carrie Daymont1,2,3,4*, Moira Zabel3,4, Chris Feudtner3,5,6 and David M Rubin3,5,6
Abstract
Background: The test characteristics of head circumference (HC) measurement percentile criteria for the
identification of previously undetected pathology associated with head enlargement in primary care are unknown.
Methods: Electronic patient records were reviewed to identify children age 3 days to 3 years with new diagnoses
of intracranial expansive conditions (IEC) and metabolic and genetic conditions associated with macrocephaly
(MGCM). We tested the following HC percentile threshold criteria: ever above the 95th, 97th, or 99.6th percentile and
ever crossing 2, 4, or 6 increasing major percentile lines. The Centers for Disease Control and World Health
Organization growth curves were used, as well as the primary care network (PCN) curves previously derived from
this cohort.
Results: Among 74,428 subjects, 85 (0.11%) had a new diagnosis of IEC (n = 56) or MGCM (n = 29), and between
these 2 groups, 24 received intervention. The 99.6th percentile of the PCN curve was the only threshold with a PPV
over 1% (PPV 1.8%); the sensitivity of this threshold was only 15%. Test characteristics for the 95th percentiles were:
sensitivity (CDC: 46%; WHO: 55%; PCN: 40%), positive predictive value (PPV: CDC: 0.3%; WHO: 0.3%; PCN: 0.4%), and
likelihood ratios positive (LR+: CDC: 2.8; WHO: 2.2; PCN: 3.9). Test characteristics for the 97th percentiles were:
sensitivity (CDC: 40%; WHO: 48%; PCN: 34%), PPV (CDC: 0.4%; WHO: 0.3%; PCN: 0.6%), and LR+ (CDC: 3.6; WHO: 2.7;
PCN: 5.6). Test characteris
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