Abstract: Objective To explore and analyze the consistency of the subjective and objective evaluation scale-Ages and Stages Questionnaire-Third Edition (ASQ-3) and Denver Development Screening Test (DDST),in order to provide reference for the clinical assessment of children's developmental disorders. Methods A total of 355 children in Children's Health Clinic of Chongqing Youyou Baobei Children and Women's Hospital from April 1st,2019 to April 30th,2020 were selected in this study. Their record of ASQ-3 and DDST evaluation results was retrospectively collected. The screening positive rates of two assessment tools were compared,and the consistency of the two tools in gross motor function,fine motor function,language and personal-social function was analyzed. Results The screening positive rate of ASQ-3 was higher than that of DDST. Except for the motor function,the differences on the screening positive rate of fine motor,language,and personal-social function between the two tools were significant (χ²=28.942,6.424,60.634,P＜0.05). The consistency of the two screening methods was analyzed by the Kappa test. All Kappa values of the four function zones were lower than 0.4,suggesting very low consistency between ASQ-3 and DDST. The Kappa value of the motor function was relatively high compared with other zones(Kappa=0.317,P<0.001). Conclusions The consistency between ASQ-3 and DDST is low in developmental screening of children aged 3—60 months. Further researches are warranted to improve the accuracy and consistency of the infant development screening scale.

Key words: developmental screening, subjective assessment tool, objective assessment tool, consistency analysis

摘要： 目的 分析年龄与发育进程问卷(ASQ-3)中文版和丹佛尔发育筛查测验(DDST)两种常用婴幼儿发育筛查量表在临床应用的结果一致性,为临床评估婴幼儿发育不良选择合适量表提供依据。方法 回顾性分析2019年4月1日—2020年4月30日期间在重庆佑佑宝贝妇儿医院儿童保健门诊就诊的355名儿童的ASQ-3中文版问卷和DDST筛查评估结果。比较两种筛查方法的阳性率,分析大运动能区、精细运动能区、语言能区和个人-社会能区4个能区发育筛查结果的一致性。结果 ASQ-3量表筛查阳性率高于DDST量表,除大运动能区外,在精细运动能区、语言沟通能区、个人-社会能区差异具有统计学意义(χ²＝28.942、6.424、60.634,P<0.05或<0.01)。Kappa检验对两种筛查方法进行一致性分析,4个能区Kappa值均在0.4以下,提示这两种发育评价筛查量表在4个能区的一致性均较低,大运动能区的Kappa值相对较高(Kappa=0.317,P<0.001)。结论 ASQ-3中文版和DDST两种婴幼儿发育筛查量表临床应用于筛查3~60月龄的婴幼儿神经发育行为,筛查结果一致性低,亟需进一步研究指导临床应用,提高婴幼儿发育筛查量表的准确性和一致性。

关键词: 发育筛查, 主观评估工具, 客观评估工具, 一致性分析