Impact of a National Follow-Up Program on the Age at Diagnosis for Cerebral Palsy
Rebecca Alison Fabricius1, Mads Langager Larsen2, Nanette Mol Debes3
1Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; Department of Orthopedic Surgery, Hospital South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark.
Insights
The Danish National Cerebral Palsy Follow-up Program did not change the diagnostic age for cerebral palsy (CP). However, the program did lead to a significant decrease in severe motor disabilities among children with CP.
Area of Science:
- Pediatrics
- Neurology
- Public Health
Background:
- The Danish National Cerebral Palsy Follow-up Program (CPOP) was implemented nationwide in 2004 to provide standardized treatment for children with cerebral palsy (CP).
- The study aimed to assess the impact of CPOP on the age of CP diagnosis.
Purpose of the Study:
- To determine if the nationwide implementation of standardized cerebral palsy (CP) follow-up care influenced the age of diagnosis.
- To analyze changes in clinical features and diagnostic practices associated with CP over time.
Main Methods:
- Children with confirmed CP diagnoses were identified from the Danish Cerebral Palsy Registry and CPOP.
- A comparative analysis was conducted on children born between 2000-2003 and 2010-2013.
- Log-rank tests were used to compare differences in time to diagnosis.
Main Results:
- The median age at diagnosis for cerebral palsy remained consistent at 13.0 months between the two study periods (P = 0.23).
- A significant reduction in severe motor disability was observed, decreasing from 47.5% to 32.0% (P < 0.001).
- Increased utilization of cerebral magnetic resonance imaging did not correlate with an earlier diagnostic age.
Conclusions:
- The nationwide standardized follow-up program for cerebral palsy (CP) did not alter the diagnostic age.
- Significant shifts in central clinical aspects occurred between the comparison periods, potentially influencing diagnostic timelines.
- Despite no change in diagnostic age, the program was associated with improved outcomes regarding motor disability severity.
Background:
The Danish National Cerebral Palsy Follow-up Program (CPOP) is a nationwide program offering standardized treatment to all children with cerebral palsy (CP) since 2004. We aimed to establish if its implementation had a positive impact on the diagnostic age of CP.
Methods:
Children with validated CP diagnoses were identified from the Danish Cerebral Palsy Registry and the CPOP. We then compared the age at diagnosis and the clinical features of children with CP born in 2000 to 2003 with those born in 2010 to 2013. Differences in time to diagnosis were compared using log-rank test.
Results:
The age at diagnosis was not different in the two periods (P = 0.23), with identical overall median diagnostic ages at 13.0 months. The number of children with severe motor disability decreased markedly from 47.5% in 2000 to 2003 to 32.0% in 2010 to 2013 (P < 0.001). There was increased usage of cerebral magnetic resonance imaging; however, this was not associated with lower diagnostic age.
Conclusions:
The diagnostic age of CP did not change after the implementation of a nationwide follow-up program, offering standardized and early assessments. However, central clinical aspects also changed significantly between the periods compared, which possibly affected the diagnostic age.
