{
  "abstract": "Objective To determine the predictive accuracy of an early high risk of cerebral palsy (CP) classification for CP diagnosed by 2 years’ corrected age within an implementation study of international clinical CP guidelines.Design Implementation cohort study.Setting Eleven Australian neonatal intensive care units.Patients 453 infants born 2019–21 <28 weeks’ gestation, or ≥28 weeks with other newborn-detectable risk factors for CP.Interventions Implementation included providing professional development for clinicians, technology (smartphone app) and health network peer support. Infants were classified as high risk of CP if they had abnormal findings on at least two of the following three assessments: neonatal neuroimaging, General Movements Assessment at 3–4 months or Hammersmith Infant Neurological Examination.Main outcome measures Baseline perinatal data and 2-year outcome data were collected from medical record review. Any parent-report of CP at the 2-year interview was confirmed by medical records and/or a paediatrician’s report. We calculated predictive values for high risk of CP classification for confirmed CP at 2 years.Results We obtained 2-year outcomes from 425 infants (95%). High risk of CP was classified in 105 (25%) of these infants at a mean age of 3.5 months (SD 2.5). This classification demonstrated 91% sensitivity (95% CI 82% to 96%), 90% specificity (95% CI 86% to 93%) and 90% accuracy (95% CI 87% to 93%) for predicting CP, with a mean age of diagnosis of 10.8 months (SD 6.3).Conclusion Being classified as high risk of CP using a combination of neuroimaging, General Movements Assessment and/or Hammersmith Infant Neurological Examination can predict CP by 2 years of age with high accuracy.",
  "authors": [
    {
      "affiliations": [
        "Department of Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia",
        "Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia",
        "Newborn Research, Royal Women’s Hospital, Parkville, Victoria, Australia"
      ],
      "name": "Amanda KL Kwong"
    },
    {
      "affiliations": [
        "Department of Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia",
        "Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia",
        "Newborn Research, Royal Women’s Hospital, Parkville, Victoria, Australia"
      ],
      "name": "Abbey L Eeles"
    },
    {
      "affiliations": [
        "Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia",
        "Department of Pediatrics, University of California Irvine, Irvine, California, USA",
        "School of Psychological Sciences, Monash University, Clayton, Victoria, Australia",
        "Center of Newborn Research, Children's Hospital of Orange County, Orange, California, USA"
      ],
      "name": "Peter J Anderson"
    },
    {
      "affiliations": [
        "Newborn Care, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia"
      ],
      "name": "Shankari Arunanthy"
    },
    {
      "affiliations": [
        "Cerebral Palsy Alliance Research institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia",
        "Sydney Children's Hospital Network, Sydney, New South Wales, Australia"
      ],
      "name": "Nadia Badawi"
    },
    {
      "affiliations": [
        "Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Health, Medicine, and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia"
      ],
      "name": "Roslyn N Boyd, PhD"
    },
    {
      "affiliations": [
        "Department of Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia",
        "Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia"
      ],
      "name": "Kate LC Cameron"
    },
    {
      "affiliations": [
        "UQ Centre for Clinical Research, Faculty of Health, Medicine, and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia"
      ],
      "name": "Paul B Colditz"
    },
    {
      "affiliations": [
        "Sydney Children's Hospital Network, Sydney, New South Wales, Australia",
        "Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Cathryn Crowle"
    },
    {
      "affiliations": [
        "Kids Neuroscience Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Russell Dale"
    },
    {
      "affiliations": [
        "Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia",
        "Newborn Research, Royal Women’s Hospital, Parkville, Victoria, Australia",
        "Department of Obstetrics, Gynaecology, and Newborn Health, The University of Melbourne, Parkville, Victoria, Australia"
      ],
      "name": "Lex W Doyle"
    },
    {
      "affiliations": [
        "Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Health, Medicine, and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia",
        "Physiotherapy Department, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia"
      ],
      "name": "Joanne M George"
    },
    {
      "affiliations": [
        "Neonatology, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia"
      ],
      "name": "Pieter J Koorts"
    },
    {
      "affiliations": [
        "Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia",
        "Clinical and Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Parkville, Victoria, Australia"
      ],
      "name": "Katherine J Lee"
    },
    {
      "affiliations": [
        "Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Health, Medicine, and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia"
      ],
      "name": "Carly R Luke"
    },
    {
      "affiliations": [
        "Department of Physiotherapy, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia"
      ],
      "name": "Lynda McNamara"
    },
    {
      "affiliations": [
        "Cerebral Palsy Alliance Research institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Catherine Morgan"
    },
    {
      "affiliations": [
        "Cerebral Palsy Alliance Research institute, Specialty of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia",
        "Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "Iona Novak"
    },
    {
      "affiliations": [
        "Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia",
        "Newborn Research, Royal Women’s Hospital, Parkville, Victoria, Australia"
      ],
      "name": "Joy E Olsen"
    },
    {
      "affiliations": [
        "Department of Physiotherapy, Sydney Children’s Hospital, Randwick, New South Wales, Australia",
        "Division of Newborn Services, Royal Hospital for Women, Sydney, New South Wales, Australia"
      ],
      "name": "Nadia G Reid"
    },
    {
      "affiliations": [
        "School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia"
      ],
      "name": "Paul Scuffham"
    },
    {
      "affiliations": [
        "Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Health, Medicine, and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia"
      ],
      "name": "Koa Whittingham"
    },
    {
      "affiliations": [
        "Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia",
        "Newborn Research, Royal Women’s Hospital, Parkville, Victoria, Australia",
        "Department of Obstetrics, Gynaecology, and Newborn Health, The University of Melbourne, Parkville, Victoria, Australia",
        "Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia"
      ],
      "name": "Jeanie LY Cheong"
    },
    {
      "affiliations": [
        "Department of Physiotherapy, The University of Melbourne, Parkville, Victoria, Australia",
        "Clinical Sciences, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia",
        "Newborn Research, Royal Women’s Hospital, Parkville, Victoria, Australia"
      ],
      "name": "Alicia J Spittle"
    }
  ],
  "title": "Early high risk of cerebral palsy classification is predictive of cerebral palsy at 2 years: an implementation cohort study",
  "uid": "217af2ae-018a-598f-8463-a97c70f0d0ea"
}