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MMBGR protocol - diagnostic accuracy of clinical examination in preschoolers
Anna Luiza Dos Santos Matos1, Giédre Berretin-Felix2, Katia Flores Genaro2
1Programa de Pós-graduação em Ciências da Saúde, Universidade Federal de Sergipe - UFS - Aracaju (SE), Brasil.
Insights
The MMBGR Protocol accurately assesses orofacial structures and functions in preschool children. This diagnostic tool shows reasonable accuracy for identifying orofacial myofunctional disorders (OMD) and guiding referrals.
Area of Science:
- Pediatric Speech-Language Pathology
- Orofacial Myology
- Diagnostic Accuracy Studies
Background:
- Orofacial Myofunctional Disorders (OMD) impact speech and oral functions in children.
- Accurate diagnosis is crucial for timely intervention and appropriate referrals.
- The MMBGR Orofacial Myofunctional Assessment Protocol requires validation for preschool-aged children.
Purpose of the Study:
- To evaluate the diagnostic accuracy of the scored Clinical Examination of the MMBGR Orofacial Myofunctional Assessment Protocol.
- To assess the protocol's effectiveness in children aged 24 to 71 months.
Main Methods:
- A diagnostic accuracy validation study involved 132 children aged 24-71 months, divided into two age groups.
- Speech-language pathologists independently analyzed images using the MMBGR Protocol and compared results to their clinical judgment (gold standard).
- Receiver Operating Characteristic (ROC) curve analysis determined sensitivity, specificity, and optimal cutoff points for Orofacial Myofunctional Disorder (OMD) diagnosis.
Main Results:
- The MMBGR Protocol demonstrated ideal diagnostic accuracy for orofacial structures and functions in younger preschoolers (24-35 months) and reasonable accuracy in older preschoolers (36-71 months).
- Accuracy for diagnosing OMD was reasonable across both age groups, with specific cutoff points identified (15 for 24-35 months, 22 for 36-71 months).
- The protocol showed reasonable accuracy in predicting the need for multidisciplinary and speech-language pathology referrals.
Conclusions:
- The MMBGR Protocol is a valid tool for assessing orofacial structures and functions in preschool children.
- It provides adequate diagnostic accuracy for OMD and effectively guides referral decisions for specialized care.
Purpose:
To present the diagnostic accuracy of the scored Clinical Examination of the MMBGR Orofacial Myofunctional Assessment Protocol for the age range of 24 to 71 months.
Methods:
Diagnostic accuracy validation study with a convenience sample. Fourteen speech-language pathologists analyzed images of 132 participants from the database of previous validation stages, divided into two groups (G1 = 24 to 35 months and 29 days; G2 = 36 to 71 months and 29 days). Each image was analyzed individually and independently by a panel of three expert speech-language pathologists, with agreement between at least two evaluators considered valid. Opinions regarding domains of the orofacial myofunctional examination, Orofacial Myofunctional Disorder (OMD), and referral needs were recorded using an electronic form. The speech-language pathologists' responses based on clinical experience, without using the protocol (gold standard), were compared with those obtained using the Protocol (index test). Receiver Operating Characteristic (ROC) curve analysis was applied, cutoff points were established, and sensitivity and specificity values were obtained using R Core Team software (2022).
Results:
Diagnostic accuracy in preschool children in G1 was ideal and in G2 was reasonable for orofacial structures. For orofacial functions, accuracy was ideal in G1 and reasonable in G2; for tone, accuracy was reasonable in both groups. For OMD, accuracy was reasonable for both G1 and G2. The cutoff point for OMD was 15 (24-35 months) and 22 (36-71 months). Accuracy was reasonable for predicting multidisciplinary and speech-language pathology referrals.
Conclusion:
The MMBGR Protocol demonstrated adequate diagnostic accuracy for orofacial structures and functions in preschool children. It showed reasonable accuracy for diagnosing OMD and for predicting multidisciplinary and speech-language pathology referrals.
