Quantitative Checklist for Autism in Toddlers (Q-CHAT). A population screening study with follow-up: the case for multiple time-point screening for autism.
Quantitative Checklist for Autism in Toddlers (Q-CHAT). A population screening study with follow-up: the case for multiple time-point screening for autism.
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DOI：
10.1136/bmjpo-2020-000700
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发表时间：
2021
影响因子：
2.6
通讯作者：
Baron-Cohen S
中科院分区：
文献类型：
--
作者：
Allison C;Matthews FE;Ruta L;Pasco G;Soufer R;Brayne C;Charman T;Baron-Cohen S
这是一项前瞻性人群筛查研究，使用幼儿自闭症定量检查表（Q-CHAT）对18-30个月大的幼儿进行自闭症筛查，并在4岁时进行随访。观察性研究。英国的卢顿、贝德福德郡和剑桥郡。2008年3月至2009年4月期间，在儿童健康监测数据库中登记了13070名幼儿，并在4岁时进行了随访; 3770名（29%）在18-30个月时使用Q-CHAT和儿童自闭症谱系测试（CAST）进行了自闭症筛查。邀请Q-CHAT评分分布的分层样本进行诊断评估（第1阶段）。4年随访包括CAST和转诊清单（CFR）。邀请所有CAST ≥15、I期诊断评估或CFR上有发育问题的患者进行诊断评估（II期）。在两个时间点进行标准化诊断评估，以确定Q-CHAT的检测准确度。1期和2期的共识诊断结果。在第一阶段，返回了3770个Q-CHAT（29%的响应），121个进行了诊断评估，其中11个符合自闭症的标准。所有11名患者的Q-CHAT筛查结果均为阳性。临界点39时的阳性预测值（PPV）为17%（95% CI 8%至31%）。在第2阶段，2005年返回了3472个CAST和CFR（58%的响应）。159人接受了诊断评估，其中82人在第1阶段接受了评估。在第1阶段通过Q-CHAT确定的所有符合自闭症标准的儿童也符合第2阶段的标准。I期和II期研究后的PPV为28%（95% CI 15%-46%）。Q-CHAT可以在18-30个月时用于识别自闭症，并加速转诊进行诊断评估。PPV低表明，对于每个真阳性，然而，将有~4-5个假阳性。在随访时，发现了新病例，说明需要使用发育敏感工具在多个时间点进行持续监测和重新筛选。并不是所有后来被诊断为自闭症的孩子在蹒跚学步期间都能被发现。
This is a prospective population screening study for autism in toddlers aged 18–30 months old using the Quantitative Checklist for Autism in Toddlers (Q-CHAT), with follow-up at age 4. Observational study. Luton, Bedfordshire and Cambridgeshire in the UK. 13 070 toddlers registered on the Child Health Surveillance Database between March 2008 and April 2009, with follow-up at age 4; 3770 (29%) were screened for autism at 18–30 months using the Q-CHAT and the Childhood Autism Spectrum Test (CAST) at follow-up at age 4. A stratified sample across the Q-CHAT score distribution was invited for diagnostic assessment (phase 1). The 4-year follow-up included the CAST and the Checklist for Referral (CFR). All with CAST ≥15, phase 1 diagnostic assessment or with developmental concerns on the CFR were invited for diagnostic assessment (phase 2). Standardised diagnostic assessment at both time-points was conducted to establish the test accuracy of the Q-CHAT. Consensus diagnostic outcome at phase 1 and phase 2. At phase 1, 3770 Q-CHATs were returned (29% response) and 121 undertook diagnostic assessment, of whom 11 met the criteria for autism. All 11 screened positive on the Q-CHAT. The positive predictive value (PPV) at a cut-point of 39 was 17% (95% CI 8% to 31%). At phase 2, 2005 of 3472 CASTs and CFRs were returned (58% response). 159 underwent diagnostic assessment, including 82 assessed in phase 1. All children meeting the criteria for autism identified via the Q-CHAT at phase 1 also met the criteria at phase 2. The PPV was 28% (95% CI 15% to 46%) after phase 1 and phase 2. The Q-CHAT can be used at 18–30 months to identify autism and enable accelerated referral for diagnostic assessment. The low PPV suggests that for every true positive there would, however, be ~4–5 false positives. At follow-up, new cases were identified, illustrating the need for continued surveillance and rescreening at multiple time-points using developmentally sensitive instruments. Not all children who later receive a diagnosis of autism are detectable during the toddler period.
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影响因子：
1.8
作者：
Charman, T;Baron-Cohen, S;Drew, A
通讯作者：
Drew, A
DOI：
10.1111/j.2044-835x.1989.tb00793.x
发表时间：
1989-06-01
影响因子：
2.3
作者：
BARONCOHEN, S
通讯作者：
BARONCOHEN, S
影响因子：
10.5
作者：
Baron-Cohen, Simon;Scott, Fiona J.;Brayne, Carol
通讯作者：
Brayne, Carol
影响因子：
3.9
作者：
Constantino, JN;Davis, SA;Reich, W
通讯作者：
Reich, W
影响因子：
3.9
作者：
Kleinman, Jamie M.;Robins, Diana L.;Fein, Deborah
通讯作者：
Fein, Deborah