Development of an Objective Autism Risk Index Using Remote Eye Tracking.
Development of an Objective Autism Risk Index Using Remote Eye Tracking.
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DOI：
10.1016/j.jaac.2016.01.011
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发表时间：
2016-04
影响因子：
13.3
通讯作者：
Strauss MS
中科院分区：
文献类型：
--
作者：
Frazier TW;Klingemier EW;Beukemann M;Speer L;Markowitz L;Parikh S;Wexberg S;Giuliano K;Schulte E;Delahunty C;Ahuja V;Eng C;Manos MJ;Hardan AY;Youngstrom EA;Strauss MS
异常的眼睛注视是自闭症谱系障碍（ASD）的标志性特征，许多研究已经确定了ASD的异常注意力模式。本研究的主要目的是建立一个客观的，基于眼动追踪的自闭症风险指数。在初始和重复研究中，在转诊后招募儿童进行ASD的综合多学科评价，随后根据临床共识诊断进行分组（初始/重复样本ASD n=25/15，非ASD n=20/19）。远程眼动追踪对诊断不知情，并且包括多种刺激。记录每个优先定义的感兴趣区域（ROI）的停留时间，并在ROI中取平均值，以创建自闭症风险指数。受试者工作特征曲线分析检查分类准确性。与临床测量的相关性评估了自闭症风险指数是否与独立于语言能力的自闭症症状严重程度相关。在这两个样本中，孤独症风险指数具有较高的诊断准确性（曲线下面积[AUC]= 0.91和0.85，95%CI = 0.81 - 0.98和0.71 - 0.96），与孤独症诊断观察表-第二版（ADOS-2）严重程度评分密切相关（r= 0.58和0.59，p<0.001），与语言能力无显著相关（r≤ 0.001）。|-0.28|，p>.095）。自闭症风险指数可能是一个有用的定量和客观的措施，在风险设置自闭症的风险。未来需要在更大的样本中进行研究，以交叉验证这些发现。如果是一个经过验证的临床使用量表，该测量可以为ASD诊断和跟踪症状改善的临床判断提供信息。
Abnormal eye gaze is a hallmark characteristic of autism spectrum disorder (ASD), and numerous studies have identified abnormal attention patterns in ASD. The primary aim of the present study was to create an objective, eye tracking-based autism risk index. In initial and replication studies, children were recruited after referral for comprehensive multidisciplinary evaluation of ASD and subsequently grouped by clinical consensus diagnosis (ASD n=25/15, non-ASD n=20/19 for initial/replication samples). Remote eye tracking was blinded to diagnosis and included multiple stimuli. Dwell times were recorded to each a priori-defined region-of-interest (ROI) and averaged across ROIs to create an autism risk index. Receiver operating characteristic curve analyses examined classification accuracy. Correlations with clinical measures evaluated whether the autism risk index was associated with autism symptom severity independent of language ability. In both samples, the autism risk index had high diagnostic accuracy (area under the curve [AUC]=.91 and .85, 95%CIs=.81–.98 and .71–.96), was strongly associated with Autism Diagnostic Observation Schedule–Second Edition (ADOS-2) severity scores (r=.58 and .59, p<.001), and not significantly correlated with language ability (r≤|−.28|, p>.095). The autism risk index may be a useful quantitative and objective measure of risk for autism in at-risk settings. Future research in larger samples is needed to cross-validate these findings. If a validated scale for clinical use, this measure could inform clinical judgment regarding ASD diagnosis and track symptom improvements.