TY  - JOUR
AU  - Denis, Fabrice
AU  - Le Goff, Florian
AU  - Desbois, Madhu
AU  - Gepner, Agnes
AU  - Feliciano, Guillaume
AU  - Silber, Denise
AU  - Zeitoun, Jean-David
AU  - Assuied, Guedalia Peretz
PY  - 2024
DA  - 2024/6/18
TI  - Early Detection of 5 Neurodevelopmental Disorders of Children and Prevention of Postnatal Depression With a Mobile Health App: Observational Cross-Sectional Study
JO  - JMIR Public Health Surveill
SP  - e58565
VL  - 10
KW  - mobile phone
KW  - pediatric
KW  - infant
KW  - baby
KW  - neonate
KW  - newborn
KW  - toddler
KW  - child
KW  - early detection
KW  - app
KW  - application
KW  - screening
KW  - algorithm
KW  - NDD
KW  - neurodevelopmental disorder
KW  - autism
KW  - ASD
KW  - autism spectrum disorder
KW  - attention deficit/hyperactivity disorder
KW  - ADHD
KW  - attention deficit
KW  - PND
KW  - postnatal depression
KW  - mHealth
KW  - mobile health
KW  - real-world study
KW  - smartphone
KW  - dyspraxia
KW  - delayed
KW  - language
KW  - dyslexia
KW  - incidence
KW  - prevalence
AB  - Background: Delay in the diagnosis of neurodevelopmental disorders (NDDs) in toddlers and postnatal depression (PND) is a major public health issue. In both cases, early intervention is crucial but too rarely implemented in practice. Objective: Our goal was to determine if a dedicated mobile app can improve screening of 5 NDDs (autism spectrum disorder [ASD], language delay, dyspraxia, dyslexia, and attention-deficit/hyperactivity disorder [ADHD]) and reduce PND incidence. Methods: We performed an observational, cross-sectional, data-based study in a population of young parents in France with at least 1 child aged <10 years at the time of inclusion and regularly using Malo, an “all-in-one” multidomain digital health record electronic patient-reported outcome (PRO) app for smartphones. We included the first 50,000 users matching the criteria and agreeing to participate between May 1, 2022, and February 8, 2024. Parents received periodic questionnaires assessing skills in neurodevelopment domains via the app. Mothers accessed a support program to prevent PND and were requested to answer regular PND questionnaires. When any PROs matched predefined criteria, an in-app recommendation was sent to book an appointment with a family physician or pediatrician. The main outcomes were the median age of the infant at the time of notification for possible NDD and the incidence of PND detection after childbirth. One secondary outcome was the relevance of the NDD notification by consultation as assessed by health professionals. Results: Among 55,618 children median age 4 months (IQR 9), 439 (0.8%) had at least 1 disorder for which consultation was critically necessary. The median ages of notification for probable ASD, language delay, dyspraxia, dyslexia, and ADHD were 32.5 (IQR 12.8), 16 (IQR 13), 36 (IQR 22.5), 80 (IQR 5), and 61 (IQR 15.5) months, respectively. The rate of probable ADHD, ASD, dyslexia, language delay, and dyspraxia in the population of children of the age included between the detection limits of each alert was 1.48%, 0.21%, 1.52%, 0.91%, and 0.37%, respectively. Sensitivity of alert notifications for suspected NDDs as assessed by the physicians was 78.6% and specificity was 98.2%. Among 8243 mothers who completed a PND questionnaire, highly probable PND was detected in 938 (11.4%), corresponding to a reduction of –31% versus our previous study without a support program. Suspected PND was detected a median 96 days (IQR 86) after childbirth. Among 130 users who filled in the satisfaction survey, 99.2% (129/130) found the app easy to use and 70% (91/130) reported that the app improved follow-up of their child. The app was rated 4.8/5 on Apple’s App Store. Conclusions: Algorithm-based early alerts suggesting NDDs were highly specific with good sensitivity as assessed by real-life practitioners. Early detection of 5 NDDs and PNDs was efficient and led to a possible 31% reduction in PND incidence. Trial Registration: ClinicalTrials.gov NCT06301087; https://www.clinicaltrials.gov/study/NCT06301087 
SN  - 2369-2960
UR  - https://publichealth.jmir.org/2024/1/e58565
UR  - https://doi.org/10.2196/58565
UR  - http://www.ncbi.nlm.nih.gov/pubmed/38888952
DO  - 10.2196/58565
ID  - info:doi/10.2196/58565
ER  -