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A total of 104 infants born preterm at less than 31\u2009weeks gestational age (males\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a061; mean\u00a0=\u00a028\u2009weeks 1\u2009day [SD 1\u2009week 6\u2009days], range 23\u2009weeks 1\u2009day\u201330\u2009weeks 6\u2009days) underwent HNNE early and at TEA, which were scored by comparison with term data. Motor outcomes at 12\u2009months corrected age were determined using the Bayley Scales of Infant and Toddler Development, Third Edition (scores \u226485). Cut\u2010off points were determined using receiver operating characteristic curves.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixteen (15%) infants born preterm had motor impairment at 12\u2009months corrected age. The HNNE total score cut\u2010off points with the best combination of sensitivity and specificity at early and TEA assessments were 15.2 or lower (sensitivity 77%, 95% confidence interval [CI]\u00a0=\u00a046%\u201395%; specificity 74%, 95% CI\u00a0=\u00a063%\u201383%) and 23.5 or lower (sensitivity 67%, 95% CI\u00a0=\u00a038%\u201388%; specificity 66%, 95% CI\u00a0=\u00a054%\u201376%) respectively. The most predictive subscale at the early assessment was reflexes (sensitivity 86%, 95% CI\u00a0=\u00a057%\u201398%; specificity 62%, 95% CI\u00a0=\u00a051%\u201372%; cut\u2010off point \u22643); at TEA, it was spontaneous movements (sensitivity 73%, 95% CI\u00a0=\u00a045%\u201392%; specificity 60%, 95% CI\u00a0=\u00a048%\u201370%; cut\u2010off point \u22642).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>The HNNE provides moderate predictive accuracy for motor outcome at 12\u2009months corrected age in infants born very preterm. Although modest at both time points, early assessment had stronger predictive ability for motor outcomes than TEA when scored using term data, highlighting the value of performing the HNNE earlier in the neonatal period. Performing HNNE earlier may assist risk stratification when planning follow\u2010up services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dmcn.15512","type":"journal-article","created":{"date-parts":[[2023,1,22]],"date-time":"2023-01-22T23:03:51Z","timestamp":1674428631000},"page":"1061-1072","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Diagnostic accuracy of the Hammersmith Neonatal Neurological Examination in predicting motor outcome at 12\u2009months for infants born very preterm"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8218-1690","authenticated-orcid":false,"given":"Grace T.","family":"Howard","sequence":"first","affiliation":[{"name":"School of Health Sciences and Social Work Griffith University  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9659-5859","authenticated-orcid":false,"given":"Emmah","family":"Baque","sequence":"additional","affiliation":[{"name":"School of Health Sciences and Social Work Griffith University  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6408-8238","authenticated-orcid":false,"given":"Paul B.","family":"Colditz","sequence":"additional","affiliation":[{"name":"University of Queensland Centre for Clinical Research The University of Queensland  Brisbane Australia"},{"name":"Perinatal Research Centre Royal Brisbane and Women's Hospital  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0004-6274","authenticated-orcid":false,"given":"Mark D.","family":"Chatfield","sequence":"additional","affiliation":[{"name":"Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine The University of Queensland  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6129-6736","authenticated-orcid":false,"given":"Robert S.","family":"Ware","sequence":"additional","affiliation":[{"name":"Menzies Health Institute Queensland Griffith University  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4919-5975","authenticated-orcid":false,"given":"Roslyn N.","family":"Boyd","sequence":"additional","affiliation":[{"name":"Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine The University of Queensland  Brisbane Australia"},{"name":"Australasian Cerebral Palsy Clinical Trials Network CRE The University of Queensland  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4893-6564","authenticated-orcid":false,"given":"Joanne M.","family":"George","sequence":"additional","affiliation":[{"name":"Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, Faculty of Medicine The University of Queensland  Brisbane Australia"},{"name":"Physiotherapy Department Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,22]]},"reference":[{"issue":"3","key":"e_1_2_9_2_1","first-page":"510","article-title":"Evaluation of neonatal intensive care for extremely low birth weight infants in Victoria over two decades: II","volume":"113","author":"Doyle LW, Victorian Infant Collaborative Study G","year":"2004","journal-title":"Efficiency. 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