For each question, any response category receiving 50% or more of the panel's votes was tested for a consensus by assuming that the DATTA panel is a sample from a broader population of experts. Using exact binomial probabilities, the likelihood of the observed vote was calculated if exactly 50% of the total population of experts support that response for that question. Hence, the null hypothesis is 50% of all experts support the response, and the alternative, one-tailed, hypothesis is that more than 50% of all experts support the response. Rejection of the null hypothesis, and acceptance of the alternative, is interpreted as evidence of a majority opinion in the total population of experts, and a consensus is achieved. If no consensus was found, the categories were reorganized and reanalyzed. The definitions of "promising" and "established" include the concept of "appropriate," while the "doubtful" and "unacceptable" definitions include the concept of "inappropriate." The original five categories were thus, if necessary, reorganized into three categories, "appropriate," "investigational," and "inappropriate"; an analysis of any category with 50% or more of the vote was performed. P values for the survey responses are as follows: questions 1A, 1B, and 2A, 18 "appropriate" responses out of 26, P =.0378; question 2B, 16 "appropriate" responses out of 26, P=.1635, no consensus. There were eight panelists who offered no opinion for questions 1A, 1B, and 2A, 2B.
Percy AK. Neonatal asphyxia and static encephalopathies . In: Fishman MA, ed. Pediatric Neurology . Orlando, Fla: Grune & Stratton; 1986;;57-70.
McDonald AD. Cerebral palsy in children of very low birthweight . Arch Dis Child. 1963;;38:579-588.
Nelson KB. Cerebral palsy: what is known regarding cause? Ann N Y Acad Sci. 1986;;477:22-26.
Volpe JJ. Neurology of the Newborn . Philadelphia, Pa: WB Saunders; 1981;:220-226,311-341.
Wigglesworth J. Brain development and its modification by adverse influences . Clin Dev Med. 1984;;87:12-26.
Kudrjavcev T, Schoenberg BS, Kurland LT, Groover RV. Cerebral palsy: survival rates, associated handicaps and distribution by clinical subtype (Rochester, MN, 1950-1976) . Neurology. 1985;;35:900-903.
Nelson KB, Ellenberg JH. Epidemiology of cerebral palsy . Adv Neurol. 1978;;19:421-435.
Peacock WJ, Staudt LA. Cerebral palsy and rhizotomy: a review . J Pediatr Neurosci. 1988;;4:153-158.
Abbott R, Forem SL, Johann M. Selective posterior rhizotomy for the treatment of spasticity: a review . Childs Nerv Syst. 1989;;5:337-346.
Peacock WJ, Arens LJ. Selective posterior rhizotomy for the relief of spasticity in cerebral palsy . S Afr Med J. 1982;;62:119-124.
Binder H, Eng GD. Rehabilitation management of children with spastic diplegic cerebral palsy . Arch Phys Med Rehabil. 1989;;70:482-489.
Penn RD, Savoy SM, Corcos D, et al. Intrathecal baclofen for severe spinal spasticity . N Engl J Med. 1989;;320:1517-1521.
Cooper IS, Riklan M, Amin I, Waltz JM, Cullinan T. Chronic cerebellar stimulation in cerebral palsy . Neurology. 1976;;26:744.
Fraioli B, Guidetti B. Posterior partial rootlet section in the treatment of spasticity . J Neurosurg. 1977;;46:618-626.
Fasano VA, Barolat-Romana G, Zeme S, Squazzi A. Electrophysiological assessment of spinal circuits in spasticity by direct dorsal root stimulation . Neurosurgery. 1979;;4:146-151.
Cohen AR. Treatment of spasticity in children . Presented at 58th Annual Meeting of the American Association of Neurological Surgeons; May 3, 1990; Nashville, Tenn. Paper 62.
Fasano VA, Broggi G, Barolat-Romana G, Squazzi A. Surgical treatment of spasticity in cerebral palsy . Childs Brain. 1978;;4:289-305.
Peacock WJ, Arens LJ, Berman B. Cerebral palsy spasticity: selective posterior rhizotomy . Pediatr Neurosci. 1987;;13:61-66.
Arens LJ, Peacock WJ, Peter J. Selective posterior rhizotomy: a long-term follow-up study . Childs Nerv Syst. 1989;;5:148-152.
Irwin-Carruthers SH, Davids LM, Van Rensbeir CK, Magasiner V, Scott D. Early physiotherapy in selective posterior rhizotomy . Physiotherapy. 1985;;41:45-49.
Yasuoka S, Peterson HA, MacCarty CS. Incidence of spinal column deformity after multilevel laminectomy in children and adults . J Neurosurg. 1982;;57:441-445.
Fasano VA, Broggi G, Zeme S, LoRusso G, Sguazzi A: Long-term results of posterior functional rhizotomy . Acta Neurochir. 1980;;30(
Laitinen LV, Nilsson S, Fugh-Meyer AR. Selective posterior rhizotomy for treatment of spasticity . J Neurosurg. 1983;;58:895-899.
Vaughan CL, Berman B, Staudt LA, Peacock WJ. Gait analysis of cerebral palsy children before and after rhizotomy . Pediatr Neurosci. 1988;;14:297-300.
Cahan LD, Adams J, Perry J, Beeler L. Instrumental gait analysis in selective dorsal rhizotomy . Presented at 58th Annual Meeting of the American Association of Neurological Surgeons; May 3, 1990; Nashville, Tenn . Paper 832.
Perry J, Adams J, Cahan LD. Foot floor contact patterns following selective dorsal rhizotomy . Develop Med Child Neurol . In press.