Validity of administering the child development evaluation test through telemedicine to children aged 18-72 months

Ilma R. Torres-Escobar, Servicio de Pediatría del Desarrollo y la Conducta, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
Miguel A. Villasís-Keever, Unidad de Investigación en Análisis y Síntesis de la Evidencia, Hospital de Pediatría Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social. Mexico City, Mexico
Martha M. Zapata-Tarrés, Coordinating Commission of the Institutos Nacionales de Salud y Hospitales de Alta Especialidad, Mexico City, Mexico
Laura A. Hernández-Trejo, Department of Clinical and Health Psychology Coordination, Facultad de Psicología, Universidad Nacional Autónoma de México, Mexico City, Mexico
Christian A. Delaflor-Wagner, Investigación Biomédica, Centro Médico Nacional 20 de Noviembre, Instituto de Servicios y Seguridad Social para los Trabajadores del Estado, Mexico City, Mexico
Antonio Rizzoli-Córdoba, Servicio de Pediatría del Desarrollo y la Conducta, Hospital Infantil de México Federico Gómez, Mexico City, Mexico

Background: Early childhood development is a complex process that requires reliable tools for the timely detection of alterations that may affect a child’s progress. The Child Development Evaluation test (EDI, in its Spanish acronym) is a screening test developed and validated in Mexico to be administered in person by a professional. The objective is to evaluate the validity of administering the EDI test through telemedicine in terms of its diagnostic concordance with the face-to-face modality. Methods: This analytical, prospective, and cross-sectional study included patients aged 18-72 months and was conducted at a tertiary care hospital in Mexico City. The test was administered through telemedicine and subsequently in person. In addition, sensitivity and specificity data were reported with confidence interval of 95% (95% CI). The face-to-face evaluator was blinded to the telemedicine results. Results: Fifty children with a median age of 47 months participated in the study. A sensitivity of 100% (95% CI, 91-100) and specificity of 100% (95% CI, 70-100) overall were obtained. Language was the higher area with a sensitivity of 100 (95% CI: 91-100) and specificity of 90 (59-98); the results for the other areas are shown. The lowest sensitivity was neurological examination (67; CI 95%: 30-90) but has the highest specificity (98; CI 95%: 88-99). Conclusion: The EDI test implemented through telemedicine shows high correlation with the face-to-face modality, maintaining high sensitivity and specificity. These results make it an appropriate method for screening children of this age, although further larger studies are needed to corroborate it.

Keywords: Child development. Telemedicine. Diagnostic agreement. Developmental assessment.