# Abstinence scoring algorithms for treatment of neonatal opioid withdrawal syndrome (NOWS)

## TL;DR

Researchers developed a shorter scoring system to help doctors treat newborns with opioid withdrawal more effectively.

## Contribution

A new, shorter scoring system (sMNAS-9) was developed and validated for clinical decision-making in NOWS treatment.

## Key findings

- The sMNAS-9 showed high sensitivity (88% or higher) and specificity (85% or higher) in predicting treatment decisions.
- The shorter sMNAS-9 score can be used to make similar clinical decisions as the full MNAS score in NOWS treatment.
- The study used a large dataset of 373 infants to train and test the new scoring system.

## Abstract

Chervoneva et al. (2020) developed an abbreviated score (sMNAS-9) derived from full modified Finnegan MOTHER NAS scale (MNAS) for evaluating severity of NOWS. We sought to develop NOWS treatment algorithms for clinical decision rules based on scores utilizing the shorter sMNAS.

This was a retrospective study of 373 infants with NOWS scored with MNAS and treated with morphine between 2007 and 2016. The infants were randomly split into training/test sets. The training set was used to derive optimized cutoff values for sMNAS-9 scores. The independent set evaluated the sMNAS-9 clinical decision rules based on full MNAS in NOWS morphine and buprenorphine treatment algorithms.

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.

The sMNAS-9 scoring instrument is expected to yield similar clinical decisions in treatment of NOWS.