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Inter-observer agreement of the General Movements Assessment with infants following surgery
Cathryn Crowle1, Claire Galea2, Catherine Morgan3
1Grace Centre for Newborn Care, The Children's Hospital Westmead, Sydney, Australia; University of Sydney, Sydney, Australia.
Insights
The General Movements Assessment (GMA) shows high inter-observer agreement in infants post-surgery. This makes the GMA a reliable tool for assessing neurodevelopmental outcomes in surgical infants.
Area of Science:
- Neonatal care
- Neurodevelopmental pediatrics
- Surgical outcomes
Background:
- The General Movements Assessment (GMA) is a validated method for identifying infants at risk of adverse neurodevelopmental outcomes.
- Limited data exists on GMA's utility in infants following surgical procedures.
Purpose of the Study:
- To evaluate the inter-observer agreement of the General Movements Assessment (GMA) in infants who have undergone neonatal surgery.
- To establish the reliability of GMA as an assessment tool in this specific pediatric population.
Main Methods:
- Prospective cohort study involving 190 term infants undergoing cardiac and/or non-cardiac surgery.
- General Movements Assessment (GMA) performed in the Neonatal Intensive Care Unit (NICU) and repeated at three months of age.
- Independent assessment of all GMA videos by three advanced trained clinicians, with agreement and reliability statistics calculated.
Main Results:
- Moderate to substantial agreement was observed for writhing general movements (66-77%, AC1=0.53-0.69).
- Almost perfect agreement was found for fidgety general movements (86-89%, AC1=0.84-0.88).
Conclusions:
- The General Movements Assessment (GMA) demonstrates high inter-observer agreement in infants post-neonatal surgery.
- GMA is a valid and complementary assessment tool for this population.
- Further research is ongoing to assess GMA's predictive ability for neurodevelopmental outcomes.
Background:
The General Movements Assessment (GMA) is a validated and reliable method of identifying infants at risk of adverse neurodevelopmental outcomes, however there is minimal data available on the use of the GMA with infants following surgery.
Aims:
The aim of this study was to investigate the inter-observer agreement for the GMA with this infant population.
Study Design:
Reliability and agreement study.
Subjects:
This was a prospective cohort study of 190 infants (male n=112) born at term (mean 38weeks, SD 2weeks).
Outcome Measures:
A GMA was conducted in the Neonatal Intensive Care Unit (NICU) following either cardiac surgery (n=92), non-cardiac surgery (n=93) or both types of surgery (n=5), and then again at three months of age. All videos were independently assessed by three advanced trained clinicians. Agreement and reliability statistics were calculated between each pair.
Results:
We found moderate to substantial levels of agreement in the writhing period (66-77%, AC1=0.53-0.69). For fidgety general movements, agreement was classified as almost perfect, ranging from 86 to 89% (AC1=0.84-0.88).
Conclusions:
The GMA has high levels of inter-observer agreement when used with infants who have undergone surgery in the neonatal period, making it a valid, complementary assessment tool. Research is now underway to determine the ability of the GMA to predict neurodevelopmental outcomes in this population.
