Algorithms for treatment of Neonatal Opioid Withdrawal Syndrome (NOWS) based on Modified and Abbreviated Finnegan Symptom Score

Abstract

Abstract OBJECTIVE Chervoneva et al (2020) developed an abbreviated score (sMNAS-9) for evaluating NOWS symptoms. We sought to develop NOWS treatment algorithms for clinical decision rules based on sMNAS-9 instead of the full modified Finnegan MOTHER NAS scale (MNAS) scores. STUDY DESIGN: This was a retrospective study of 373 infants with NOWS treated with morphine between 2007–2016. The infants were randomly split into training/test sets. The training set was used to derive cutoff values for sMNAS-9 scores for optimal sensitivities and specificities. The independent test set evaluated the agreement of the clinical decision rules based on sMNAS-9 with full MNAS in NOWS morphine and buprenorphine treatment algorithms. RESULT Clinical decision rules based on sMNAS-9 yielded sensitivities of 88% or higher and specificities of 85% or higher for predicting the respective rules based on full MNAS. CONCLUSION The sMNAS-9 scoring instrument is expected to yield similar clinical decisions in treatment of NOWS