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MMBGR protocol - diagnostic accuracy of clinical examination in infants
Anna Luiza Dos Santos Matos1, Giédre Berretin-Felix2, Íkaro Daniel de Carvalho Barreto3
1Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe - UFS - Aracaju (SE), Brasil.
Insights
The Orofacial Myofunctional Evaluation Protocol MMBGR is accurate for diagnosing Orofacial Myofunctional Disorder (OMD) in infants 12-23 months old. For younger infants (6-11 months), it
Area of Science:
- Speech-language pathology
- Pediatric diagnostics
- Orofacial myofunctional disorders
Background:
- Orofacial Myofunctional Disorders (OMDs) can impact infant development.
- Accurate diagnostic tools are crucial for early intervention.
- The Orofacial Myofunctional Evaluation Protocol MMBGR for Infants and Preschoolers is a clinical assessment tool.
Purpose of the Study:
- To evaluate the diagnostic accuracy of the Orofacial Myofunctional Evaluation Protocol MMBGR for Infants and Preschoolers.
- To assess the protocol's effectiveness in the 6-23 month age group.
- To determine accuracy for orofacial structures, functions, OMD diagnosis, and referral needs.
Main Methods:
- Diagnostic accuracy validation using video analysis of 76 infants.
- Three speech-language pathologists assessed images individually.
- Comparison of protocol use (index test) versus clinical experience (gold standard) via ROC curve analysis.
Main Results:
- For infants 6-11 months: reasonable accuracy for tone (70%), but not ideal for other domains.
- For infants 12-23 months: reasonable accuracy for structures and functions, ideal for OMD diagnosis (88.9%).
- Protocol showed reasonable accuracy for multidisciplinary referrals but not speech-language pathology referrals.
Conclusions:
- The MMBGR protocol is accurate for diagnosing OMD in infants 12-23 months.
- For infants 6-11 months, accuracy is limited to assessing tone.
- The protocol is reasonably effective for identifying the need for multidisciplinary referrals in infants.
Purpose:
To present the diagnostic accuracy of the clinical examination with scores, the Orofacial Myofunctional Evaluation Protocol MMBGR for Infants and Preschoolers, for the age group of six to 23 months.
Methods:
Diagnostic accuracy validation using a convenience sample. Images from 76 participants were analyzed by groups of three speech-language pathologists, who individually and separately assessed the images, with agreement between two of them considered valid. An electronic form was used to assess the domains of the orofacial myofunctional evaluation, Orofacial Myofunctional Disorder (OMD), and the need for referrals. The responses of speech-language pathologists who provided opinions based on clinical experience, without using the protocol (gold standard), were compared with those provided by speech-language pathologists who used the protocol (index test). The Receiver Operating Characteristic Curve (ROC) method was employed, and cut-off points were assigned using the R Core Team (2022) software, yielding sensitivity and specificity values.
Results:
For infants aged six to 11 months, diagnostic accuracy was not ideal for orofacial structures, orofacial functions, and Orofacial Myofunctional Disorder (OMD), but reasonable for tone (70%). For infants aged 12 to 23 months, accuracy was reasonable for most domains- orofacial structures, orofacial functions, tone-and ideal for OMD (88.9%). The OMD cut-off point is 9 (for ages 6 to 11 months) and 14 (for ages 12 to 23 months). Accuracy was reasonable for multidisciplinary referrals but not ideal for speech-language pathology referrals.
Conclusion:
The Orofacial Myofunctional Evaluation Protocol MMBGR for Infants and Preschoolers, when analyzed through photos and videos, is accurate for assessing infants aged six to 11 months only in terms of tone; and for infants aged 12 to 23 months, it is accurate across all exam domains, being ideal for diagnosing OMD. The instrument is reasonable for determining the need for multidisciplinary referrals in infants.
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