Interrater reliability of the <i>Saint-Anne Dargassies</i> Scale in assessing the neurological patterns of healthy preterm newborns

Alves, Carla Ismirna Santos; Medeiros, João Gonçalves de; Carriço, Luciana Arruda; Arraes, Nívia Maria; Alencar, Roselene Ferreira de; Melo, Aurea Nogueira de

doi:10.1590/1806-93042018000100005

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Revista Brasileira de Saúde Materno Infantil

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ORIGINAL ARTICLES • Rev. Bras. Saude Mater. Infant. 18 (1) • Jan-Mar 2018 • https://doi.org/10.1590/1806-93042018000100005 copy

Interrater reliability of the Saint-Anne Dargassies Scale in assessing the neurological patterns of healthy preterm newborns

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objectives:

to assess the interrater reliability of the Saint-Anne Dargassies Scale in assessing neurological patterns of healthy preterm newborns.

Methods:

twenty preterm newborns met the inclusion criteria for participation in this prospective study. The neurologic examination was performed using the Saint-Anne Dargassies Scale, showing normal serial cranial ultrasound examination. In order to test the reliability, the study was structured as follows: group I (rater 1/physiotherapist; rater 2/neonatologist); group II (rater 3/physiotherapist; rater 4/child neurologist) and the gold standard (expert and professor in pediatric neurology).

Results:

high interrater agreement was observed between groups I - II compared with the gold standard in assessing postural pattern (p<0.01). Regarding the assessment ofprimitive reflexes, greater agreement was observed in the evaluation of palmar grasp reflex and Moro reflex (p< 0.01) for group I compared with the gold standard. An analysis of tone demonstrated heterogeneous agreement, without compromising the reliability of the scale. The probability of equality between measurements of head circumference in the two groups, compared with the gold standard, was observed.

Conclusions:

the Saint-Anne Dargassies Scale demonstrated high reliability and homogeneity with significant power of reproducibility and may be capable to identify preterm newborns suspected of having neurological deficits.

Key words
Neonatal screening; Reliability; Infant; premature; Preterm; Evaluation

Type of assessment	Interrater agreement
	R1 and GS		R2 and GS
	Agreement (%)	p	Agreement (%)	p
PP 1SDS	100	<0.01	90	<0.01
PP 2SDS	100	<0.01	100	<0.01
PP 3SDS	100	<0.01	100	<0.01
PP 4SDS	100	<0.01	100	<0.01
	R3 with GS		R4 with GS
	Agreement (%)	p	Agreement (%)	p
PP 1SDS	100	<0.01	100	<0.01
PP 2SDS	100	<0.01	100	<0.01
PP 3SDS	100	<0.01	90	<0.01
PP 4SDS	100	<0.01	100	<0.01

Type of assessment	Interrater agreement
	R1 and GS	R2 and GS
	^p	^p
HC 1SDS	0.944	0.634
HC 2SDS	1.000	0.833
HC 3SDS	0.905	0.259
HC 4SDS	0.915	0.191

BA 1SDS	0.198	0.015
BA 2SDS	0.010	0.030
BA 3SDS	0.016	0.009
BA 4SDS	0.030	0.058

AP 1SDS	0.028	0.032
AP 2SDS	0.009	0.014
AP 3SDS	0.014	0.013
AP 4SDS	0.030	0.022

HC 1SDS	1.000	0.048
HC 2SDS	0.013	0.035
HC 3SDS	0.581	0.179
HC 4SDS	0.077	0.122

BA 1SDS	0.233	0.462
BA 2SDS	0.156	0.035
BA 3SDS	0.362	0.076
BA 4SDS	0.227	0.309

AP 1SDS	0.498	0.622
AP 2SDS	0.931	0.671
AP 3SDS	0.160	0.049
AP 4SDS	0.172	0.097

Type of assessment	Interrater agreement
	R1 and GS		R2 and GS
	Agreement (%)	p	Agreement (%)	p
CPR 1SDS	80	<0.01	80	<0.01
CPR 2SDS	100	<0.01	90	<0.01
CPR 3SDS	100	<0.01	100	<0.01
CPR 4SDS	90	<0.01	90	<0.01

PGR 1SDS	100	<0.01	100	<0.01
PGR 2SDS	100	<0.01	100	<0.01
PGR 3SDS	100	<0.01	100	<0.01
PGR 4SDS	100	<0.01	100	<0.01

MR 1 SDS	100	<0.01	100	<0.01
MR 2SDS	100	<0.01	100	<0.01
MR 3SDS	100	<0.01	100	<0.01
MR 4SDS	100	<0.01	100	<0.01

CER 1SDS	70	0.02	80	<0.01
CER 2SDS	90	<0.01	90	<0.01
CER 3SDS	100	<0.01	100	<0.01
CER 4SDS	100	<0.01	100	<0.01

AGR 1SDS	90	<0.01	90	<0.01
AGR 2SDS	90	<0.01	100	<0.01
AGR 3SDS	100	<0.01	100	<0.01
AGR 4SDS	100	<0.01	100	<0.01

Type of assessment	Interrater agreement
	R3 and GS		R4 and GS
	Agreement (%)	p	Agreement (%)	p
CPR 1SDS	50	0.213	60	0.076
CPR 2SDS	80	<0.01	90	<0.01
CPR 3SDS	90	<0.01	100	<0.01
CPR 4SDS	80	<0.01	100	<0.01

PGR 1SDS	100	<0.01	90	<0.01
PGR 2SDS	90	<0.01	80	<0.01
PGR 3SDS	100	<0.01	100	<0.01
PGR 4SDS	90	<0.01	90	<0.01

MR 1SDS	50	0.213	60	0.076
MR 2SDS	90	<0.01	100	<0.01
MR 3SDS	100	<0.01	100	<0.01
MR 4SDS	100	<0.01	100	<0.01

CER 1SDS	40	0.787	70	0.02
CER 2SDS	50	0.213	40	0.787
CER 3SDS	70	0.02	60	0.076
CER 4SDS	60	0.076	70	0.02

AGR 1SDS	80	<0.01	80	<0.01
AGR 2SDS	90	<0.01	90	<0.01
AGR 3SS	70	0.02	90	<0.01
AGR 4SDS	80	<0.01	80	<0.01

Type of assessment	Interrater agreement
	R1 and GS		R2 and GS
	Agreement (%)	p	Agreement (%)	p
PA 1SDS	70	0.02	80	<0.01
PA 2SDS	80	<0.01	80	<0.01
PA 3SDS	100	<0.01	100	<0.01
PA 4SDS	100	<0.01	100	<0.01

FLA 1SDS	50	0.213	60	0.787
FLA 2SDS	70	0.02	90	<0.01
FLA 3SDS	80	<0.01	70	0.02
FLA 4SDS	80	<0.01	80	<0.01

HEA 1SDS	90	<0.01	100	<0.01
HEA 2SDS	90	<0.01	80	<0.01
HEA 3SDS	70	0.02	70	0.02
HEA 4SDS	80	<0.01	80	<0.01

PA 1SDS	20	0.299	50	0.213
PA 2SDS	50	0.213	50	0.213
PA 3SDS	60	0.076	60	0.076
PA 4SDS	80	<0.01	90	<0.01

FLA 1SDS	60	0.076	70	0.02
FLA 2SDS	60	0.076	70	0.02
FLA 3SDS	80	<0.01	80	<0.01
FLA 4SDS	100	<0.01	100	<0.01

HEA 1SDS	80	<0.01	70	0.02
HEA 2SDS	60	0.076	70	0.02
HEA 3SDS	90	<0.01	70	0.02
HEA 4SDS	60	0.076	30	0.599

Instituto de Medicina Integral Prof. Fernando Figueira Rua dos Coelhos, 300. Boa Vista, 50070-550 Recife PE Brasil, Tel./Fax: +55 81 2122-4141 - Recife - PR - Brazil
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[TFN1] PP = postural pattern; R1 = rater/1; R2 = rater/2; R3 = rater/3; R4 = rater/4; GS = gold standard; SDS = Saint-Anne Dargassies Scale.