Predictive model for congenital muscular torticollis: analysis of 1021 infants with sonography

Arch Phys Med Rehabil. 2005 Nov;86(11):2199-203. doi: 10.1016/j.apmr.2005.05.010.

Abstract

Objective: To construct a predictive model to foretell congenital muscular torticollis (CMT) on the basis of clinical correlates.

Design: Correlation study.

Setting: Regional hospital.

Participants: A consecutive series of 1021 newborn infants.

Interventions: Not applicable.

Main outcome measure: Participants underwent portable ultrasonography to diagnose CMT. Significant clinical correlates were identified to construct a predictive model using the logistic regression model.

Results: Forty of 1021 infants were diagnosed with CMT using ultrasonography, yielding an overall incidence of 3.92%. Birth body length (odds ratio [OR]=1.38; 95% confidence interval [CI], 1.49-2.38), facial asymmetry (OR=21.75; 95% CI, 6.6-71.7), plagiocephaly (OR=22.3; 95% CI, 7.01-70.95), perineal trauma during delivery (OR=4.26; 95% CI, 1.25-14.52), and primiparity (OR=6.32; 95% CI, 2.34-17.04) were significant correlates. A predictive logistic regression model with the incorporation of these 4 correlates was developed. We used cross-validation with a receiver operating characteristic curve to validate the predictive model.

Conclusions: Our study successfully developed a quantitative predictive model for estimating the risk of CMT on the basis of clinical correlates only. This model has good discriminative ability for classifying CMT and non-CMT by yielding acceptable values of false-negative and false-positive cases.

MeSH terms

  • Female
  • Head Movements / physiology
  • Humans
  • Infant, Newborn
  • Logistic Models
  • Male
  • Neck / diagnostic imaging*
  • Neck Muscles / diagnostic imaging*
  • Neck Muscles / physiopathology*
  • Predictive Value of Tests
  • ROC Curve
  • Range of Motion, Articular / physiology
  • Risk Assessment / methods
  • Torticollis / congenital
  • Torticollis / diagnostic imaging*
  • Torticollis / physiopathology*
  • Ultrasonography