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Predictive value and ranking of writhing and fidgety movements for cerebral palsy: A meta-analysis based on the
Taotao Wang1, Bo Zheng2, Hong Yang3
1Xi'an Daxing Hospital, Xi'an, China.
Background:
This meta-analysis assessed the diagnostic value of writhing and fidgety general movements (GMs) for predicting cerebral palsy.
Methods:
We searched PubMed, EMBASE, Cochrane Library, CINAHL, and Web of Science for cohort or case-control studies evaluating GMs. We calculated the superiority index (S), sensitivity, specificity, likelihood ratios, diagnostic odds ratio (DOR), and area under the curve (AUC) using STATA.
Results:
Eight studies were included. For writhing movements, S = 1, sensitivity = 0.99, specificity = 0.69, AUC = 0.91, and DOR = 166. For fidgety movements, S = 3, sensitivity = 0.95, specificity = 0.87, AUC = 0.97, and DOR = 144. Subgroup analyses by study design, risk population, and sample size consistently showed better predictive performance of fidgety movements. For example, in high-risk children, AUC was 0.98 for both periods, but DOR was higher for fidgety (169 vs 302 for writhing). Across subgroups, the Superiority Index of fidgety remained stable at 3.
Conclusion:
Fidgety GMs have significantly greater predictive value for cerebral palsy than writhing GMs. This advantage remains consistent across study types, populations, and sample sizes.
