Diagnosing the full spectrum of fetal alcohol-exposed individuals: Introducing the 4-Digit Diagnostic Code
Diagnosing the full spectrum of fetal alcohol-exposed individuals: Introducing the 4-Digit Diagnostic Code
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DOI：
10.1093/alcalc/35.4.400
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发表时间：
2000-07-01
影响因子：
2.8
通讯作者：
Clarren, SK
中科院分区：
文献类型：
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作者：
Astley, SJ;Clarren, SK
华盛顿州胎儿酒精综合症 (FAS) 诊断和预防网络 (DPN) 诊所诊断的 1014 名患者的医疗/研究记录被用来开发一种新的、全面的、可重复的方法，用于诊断产前酒精暴露患者的全方位结果。这种新的诊断方法称为 4 位诊断代码，对前 454 名接受 FAS 格式塔诊断的患者进行了与标准格式塔诊断方法的比较。在开发 4 位诊断代码之前，存在非典型 FAS (AFAS) 或可能的胎儿酒精效应 (PFAE)。由于使用定量、客观的测量量表和具体的病例定义，4 位诊断代码更准确、更全面地记录了患者的结果。代码中的四位数字按以下顺序反映了FAS的四个关键诊断特征的表达程度：（1）生长缺陷； （2）FAS面部表型：（3）中枢神经系统损伤/功能障碍； (4)妊娠期酒精暴露。每个特征的表达程度按照四点李克特量表独立排名，1 反映完全不存在 FAS 特征，4 反映 FAS 特征的强烈“经典”存在。 4 位数诊断代码正在有效地用于华盛顿州所有 FAS DPN 诊所的诊断、筛查和监测工作。
The medical/research records of 1014 patients diagnosed at the Washington State Fetal Alcohol Syndrome (FAS) Diagnostic and Prevention Network (DPN) of clinics were used to develop a new, comprehensive, reproducible method for diagnosing the full spectrum of outcomes among patients with prenatal alcohol exposure. This new diagnostic method, called the 4-Digit Diagnostic Code, was compared to the standard gestalt method of diagnosis on the first 454 patients who had received a gestalt diagnosis of FAS. atypical FAS (AFAS) or possible fetal alcohol effect (PFAE) prior to the development of the 4-Digit Diagnostic Code. The outcomes of the patients were more accurately and comprehensively documented by the 4-Digit Diagnostic Code, because of its use of quantitative, objective measurement scales and specific case definitions. The four digits in the code reflect the magnitude of expression of the four key diagnostic features of FAS in the following order: (1) growth deficiency; (2) the FAS facial phenotype: (3) central nervous system damage/dysfunction; (4) gestational alcohol exposure. The magnitude of expression of each feature is ranked independently on a four-point Likert scale with 1 reflecting complete absence of the FAS feature and 4 reflecting a strong 'classic' presence of thr FAS feature. The 4-Digit Diagnostic Code is being used effectively for diagnosis, screening, and surveillance efforts in all Washington State FAS DPN clinics.