Inter-observer agreement of the General Movements Assessment with infants following surgery

Cathryn Crowle; Claire Galea; Catherine Morgan; Iona Novak; Karen Walker; Nadia Badawi

doi:10.1016/j.earlhumdev.2016.11.001

Inter-observer agreement of the General Movements Assessment with infants following surgery

Early Hum Dev. 2017 Jan:104:17-21. doi: 10.1016/j.earlhumdev.2016.11.001. Epub 2016 Nov 30.

Authors

Cathryn Crowle¹, Claire Galea², Catherine Morgan³, Iona Novak⁴, Karen Walker⁵, Nadia Badawi⁶

Affiliations

¹ Grace Centre for Newborn Care, The Children's Hospital Westmead, Sydney, Australia; University of Sydney, Sydney, Australia. Electronic address: Cathryn.crowle@health.nsw.gov.au.
² Cerebral Palsy Alliance Research Institute, Sydney, Australia. Electronic address: cgalea@cerebralpalsy.org.au.
³ University of Sydney, Sydney, Australia; Cerebral Palsy Alliance Research Institute, Sydney, Australia. Electronic address: cmorgan@cerebralpalsy.org.au.
⁴ University of Sydney, Sydney, Australia; Cerebral Palsy Alliance Research Institute, Sydney, Australia. Electronic address: inovak@cerebralpalsy.org.au.
⁵ Grace Centre for Newborn Care, The Children's Hospital Westmead, Sydney, Australia; University of Sydney, Sydney, Australia; Cerebral Palsy Alliance Research Institute, Sydney, Australia. Electronic address: Karen.walker@health.nsw.gov.au.
⁶ Grace Centre for Newborn Care, The Children's Hospital Westmead, Sydney, Australia; University of Sydney, Sydney, Australia; Cerebral Palsy Alliance Research Institute, Sydney, Australia. Electronic address: nadia.badawi@health.nsw.gov.au.

PMID: 27914275
DOI: 10.1016/j.earlhumdev.2016.11.001

Abstract

Background: The General Movements Assessment (GMA) is a validated and reliable method of identifying infants at risk of adverse neurodevelopmental outcomes, however there is minimal data available on the use of the GMA with infants following surgery.

Aims: The aim of this study was to investigate the inter-observer agreement for the GMA with this infant population.

Study design: Reliability and agreement study.

Subjects: This was a prospective cohort study of 190 infants (male n=112) born at term (mean 38weeks, SD 2weeks).

Outcome measures: A GMA was conducted in the Neonatal Intensive Care Unit (NICU) following either cardiac surgery (n=92), non-cardiac surgery (n=93) or both types of surgery (n=5), and then again at three months of age. All videos were independently assessed by three advanced trained clinicians. Agreement and reliability statistics were calculated between each pair.

Results: We found moderate to substantial levels of agreement in the writhing period (66-77%, AC₁=0.53-0.69). For fidgety general movements, agreement was classified as almost perfect, ranging from 86 to 89% (AC₁=0.84-0.88).

Conclusions: The GMA has high levels of inter-observer agreement when used with infants who have undergone surgery in the neonatal period, making it a valid, complementary assessment tool. Research is now underway to determine the ability of the GMA to predict neurodevelopmental outcomes in this population.

Keywords: General Movements Assessment; Infant; Inter-observer agreement; Prechtl; Reliability.

Publication types

Evaluation Study

MeSH terms

Cardiovascular Surgical Procedures / adverse effects*
Female
Humans
Infant, Newborn
Male
Movement*
Neurologic Examination / methods
Neurologic Examination / standards*
Observer Variation
Postoperative Complications / diagnosis*
Postoperative Period