MMBGR protocol - diagnostic accuracy of clinical examination in infants

MMBGR方案——婴儿临床检查的诊断准确性

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Abstract

PURPOSE: To present the diagnostic accuracy of the clinical examination with scores, the Orofacial Myofunctional Evaluation Protocol MMBGR for Infants and Preschoolers, for the age group of six to 23 months. METHODS: Diagnostic accuracy validation using a convenience sample. Images from 76 participants were analyzed by groups of three speech-language pathologists, who individually and separately assessed the images, with agreement between two of them considered valid. An electronic form was used to assess the domains of the orofacial myofunctional evaluation, Orofacial Myofunctional Disorder (OMD), and the need for referrals. The responses of speech-language pathologists who provided opinions based on clinical experience, without using the protocol (gold standard), were compared with those provided by speech-language pathologists who used the protocol (index test). The Receiver Operating Characteristic Curve (ROC) method was employed, and cut-off points were assigned using the R Core Team (2022) software, yielding sensitivity and specificity values. RESULTS: For infants aged six to 11 months, diagnostic accuracy was not ideal for orofacial structures, orofacial functions, and Orofacial Myofunctional Disorder (OMD), but reasonable for tone (70%). For infants aged 12 to 23 months, accuracy was reasonable for most domains- orofacial structures, orofacial functions, tone-and ideal for OMD (88.9%). The OMD cut-off point is 9 (for ages 6 to 11 months) and 14 (for ages 12 to 23 months). Accuracy was reasonable for multidisciplinary referrals but not ideal for speech-language pathology referrals. CONCLUSION: The Orofacial Myofunctional Evaluation Protocol MMBGR for Infants and Preschoolers, when analyzed through photos and videos, is accurate for assessing infants aged six to 11 months only in terms of tone; and for infants aged 12 to 23 months, it is accurate across all exam domains, being ideal for diagnosing OMD. The instrument is reasonable for determining the need for multidisciplinary referrals in infants.

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