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PREDICT-CP: study protocol of implementation of comprehensive surveillance to predict outcomes for school-aged
Roslyn N Boyd1,2, Peter Sw Davies3, Jenny Ziviani2,4
1Queensland Cerebral Palsy and Rehabilitation Research Centre (QCPRRC), The University of Queensland, Brisbane, Queensland, Australia.
Insights
PREDICT-CP investigates how brain structure and other factors impact outcomes for children with cerebral palsy (CP). This study aims to predict long-term needs and tailor interventions for improved quality of life.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) is the leading cause of childhood physical disability globally, incurring substantial care costs and impacting well-being.
- Existing research highlights the need for comprehensive surveillance to predict long-term outcomes and healthcare needs in children with CP.
- The PREDICT-CP study builds upon previous cohorts, extending follow-up to provide a deeper understanding of CP's trajectory from early childhood to school age.
Purpose of the Study:
- To investigate the influence of brain structure, body composition, diet, physical activity, and musculoskeletal development on motor, cognitive, and functional outcomes in children with CP.
- To predict motor attainment, cognition, communication, participation, and quality of life in school-aged children with CP.
- To analyze the relationship between brain lesion severity and clinical outcomes, informing tailored interventions and healthcare utilization projections.
Main Methods:
- A population-based cohort study involving state-wide surveillance of 245 children with CP born in Queensland (2006-2009).
- Classification using Gross Motor Function Classification System, Manual Ability Classification System, Communication Function Classification System, and Eating and Drinking Ability Classification System.
- Detailed phenotypical data collection including motor function, musculoskeletal development, upper limb function, communication, swallowing, nutrition, body composition, quality of life, and healthcare resource use, correlated with 3 Tesla MRI brain imaging.
Main Results:
- The study is designed to provide detailed phenotypic data and correlate it with brain macrostructure and microstructure.
- Multilevel mixed-effects models will be used to analyze relationships between brain lesion severity and various outcomes.
- Longitudinal data from 1.5-5 years and 8-12 years will enable prediction of outcomes and healthcare needs.
Conclusions:
- The PREDICT-CP study protocol is prospectively registered and ethically approved.
- Combining clinical assessments with advanced neuroimaging will enable prediction of outcomes and healthcare needs for children with CP.
- Findings will be essential for tailoring interventions, including rehabilitation, surgery, and nutritional support, to optimize outcomes and manage healthcare utilization.
Objectives:
Cerebral palsy (CP) remains the world's most common childhood physical disability with total annual costs of care and lost well-being of $A3.87b. The PREDICT-CP (NHMRC 1077257 Partnership Project: Comprehensive surveillance to PREDICT outcomes for school age children with CP) study will investigate the influence of brain structure, body composition, dietary intake, oropharyngeal function, habitual physical activity, musculoskeletal development (hip status, bone health) and muscle performance on motor attainment, cognition, executive function, communication, participation, quality of life and related health resource use costs. The PREDICT-CP cohort provides further follow-up at 8-12 years of two overlapping preschool-age cohorts examined from 1.5 to 5 years (NHMRC 465128 motor and brain development; NHMRC 569605 growth, nutrition and physical activity).
Methods And Analyses:
This population-based cohort study undertakes state-wide surveillance of 245 children with CP born in Queensland (birth years 2006-2009). Children will be classified for Gross Motor Function Classification System; Manual Ability Classification System, Communication Function Classification System and Eating and Drinking Ability Classification System. Outcomes include gross motor function, musculoskeletal development (hip displacement, spasticity, muscle contracture), upper limb function, communication difficulties, oropharyngeal dysphagia, dietary intake and body composition, participation, parent-reported and child-reported quality of life and medical and allied health resource use. These detailed phenotypical data will be compared with brain macrostructure and microstructure using 3 Tesla MRI (3T MRI). Relationships between brain lesion severity and outcomes will be analysed using multilevel mixed-effects models.
Ethics And Dissemination:
The PREDICT-CP protocol is a prospectively registered and ethically accepted study protocol. The study combines data at 1.5-5 then 8-12 years of direct clinical assessment to enable prediction of outcomes and healthcare needs essential for tailoring interventions (eg, rehabilitation, orthopaedic surgery and nutritional supplements) and the projected healthcare utilisation.
Trial Registration Number:
ACTRN: 12616001488493.
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