Concurrent Validity and Inter-Rater Reliability of the Motor Optimality Score-Revised in a Neonatal Surgical...

Area of Science:

• Pediatric Surgery
• Developmental Pediatrics
• Neonatal Care

Background:

• Infants undergoing major neonatal surgery require careful neurodevelopmental monitoring.
• The Motor Optimality Score-Revised (MOS-R) is a tool used to assess motor development.
• Evaluating the MOS-R's validity and reliability in this high-risk population is crucial.

Purpose of the Study:

• To assess the concurrent validity of the MOS-R against established developmental scales (Bayley III, HINE) in infants post-neonatal surgery.
• To determine the inter-rater reliability and agreement of the MOS-R in this cohort.
• To evaluate the MOS-R's utility in identifying potential adverse neurodevelopmental outcomes.

Main Methods:

• A cross-sectional study included 211 term infants with congenital anomalies requiring neonatal surgery.
• Concurrent validity was assessed by comparing MOS-R scores with Bayley III and HINE at 3 months corrected age.
• Inter-rater reliability and agreement were quantified using Gwet's AC1, ICC, and percentage agreement.

Main Results:

• The MOS-R demonstrated very weak correlations with Bayley III (cognition, expressive communication, gross motor) and HINE total scores.
• Categorizing the MOS-R based on optimality showed associations primarily with gross motor function.
• Inter-rater reliability for the total MOS-R was substantial (AC1 = 0.72), with good agreement for optimality categories (AC1 = 0.76) and excellent agreement for a predictive cut-off score (AC1 = 1.00).

Conclusions:

• The MOS-R exhibits limited concurrent validity with the Bayley III and HINE at 3 months corrected age in infants post-neonatal surgery.
• Despite limited concurrent validity, the MOS-R demonstrates strong inter-rater reliability, particularly when used with a predictive cut-off score for adverse outcomes.
• The MOS-R provides valuable clinical insights and reliable categorization of motor optimality in this vulnerable infant population.