评估儿童健康和福祉风险评估工具的预测有效性:一个元分析
Ning Zhu1,2, Xiaoqing Pan1, Fang Zhao1
1School of Social Development and Public Policy, Fudan University, Shanghai 200433, China.
Children (Basel, Switzerland)
|May 1, 2025
概括
儿童风险评估工具显示中等的预测有效性. 结构化临床判断工具比精算或基于共识的工具更准确地识别有风险的儿童. 建议进行进一步的研究和培训.
科学领域:
- 儿童福利研究儿童福利研究
- 风险评估方法 风险评估方法
- 公共卫生干预措施 公共卫生干预
背景情况:
- 虐待和伤害儿童是全球重大问题,每年影响超过10亿名儿童.
- 风险评估工具对于早期识别和干预至关重要,但它们的预测准确性仍有争议.
- 现有工具的有效性和影响因素需要进行系统的评估.
研究的目的:
- 系统地评估国际儿童风险评估工具的预测有效性.
- 检查工具特性如何影响其在预测儿童伤害方面的有效性.
- 为改善全球儿童保护系统提供基于证据的指导.
主要方法:
- 对28项涉及27项工具和136700名参与者的研究进行了全面的元分析.
- 使用三级元分析模型计算聚合效应大小 (AUC) 并评估异质性.
- 测试了工具类型,长度,出版年份,评估者类型和目标人群的调节效应;评估了出版偏差.
主要成果:
- 儿童风险评估工具显示整体预测有效性中等 (AUC = 0.686).
- 与精算 (AUC = 0.662) 和基于共识的工具 (AUC = 0.580) 相比,结构化临床判断 (SCJ) 工具的预测有效性更高 (AUC = 0.662).
- 工具的特性,如长度或出版年份,并没有显著调节预测有效性.
结论:
- SCJ工具为风险评估提供了结构和专业判断的宝贵平衡.
- 所有当前的工具都有局限性,需要仔细的上下文应用和与需求评估的整合.
- 调查结果支持开发动态工具和加强从业人员培训,以有效实施儿童保护.
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