Analysis of Race and Sex Bias in the Autism Diagnostic Observation Schedule (ADOS-2).
Analysis of Race and Sex Bias in the Autism Diagnostic Observation Schedule (ADOS-2).
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DOI：
10.1001/jamanetworkopen.2022.9498
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发表时间：
2022-04-01
影响因子：
13.8
通讯作者：
Landa, Rebecca
中科院分区：
文献类型：
--
作者：
Kalb, Luther G.;Singh, Vini;Hong, Ji Su;Holingue, Calliope;Ludwig, Natasha N.;Pfeiffer, Danika;Reetzke, Rachel;Gross, Alden L.;Landa, Rebecca
自闭症谱系障碍（ASD）的参考标准测量，自闭症诊断观察表，第二版（ADOS-2），在性别和种族上有系统性偏见吗？在这项在美国ASD专科诊所评价的6269名儿童的横断面研究中，11%的ADOS-2诊断项目显示黑人/非裔美国人与白色儿童以及女性与男性儿童存在偏倚。只有2个重复/限制行为兴趣项目的偏差程度为中度到重度。虽然ADOS-2总体上显示出最小的偏差，但这些研究结果表明，需要进一步的研究来解决黑人/非洲裔美国儿童和女童ASD症状检测不足的一些证据。这项横断面研究探讨了自闭症诊断观察计划，第二版，跨性别和种族的差异项目功能。自闭症谱系障碍（ASD）的患病率在种族和性别之间存在长期差异。令人惊讶的是，很少有研究探讨这些差异是否部分源于自闭症诊断观察表第二版（ADOS-2）的系统性偏差，这是ASD的参考标准。检查不同性别和种族的ADOS-2项目的差异项目功能（DIF）。这是一项横断面研究，研究对象是2014年至2020年间在美国大西洋中部地区的一家专科门诊诊所接受ASD评估的儿童。数据分析时间为2021年7月至2022年2月。儿童种族（黑人/非裔美国人vs白色）和性别（女性vs男性）。在3个模块中评价了ADOS-2协调算法项目的项目级偏倚，包括社会影响（SA; 10项）和重复/限制行为（RRB; 4项）。测量偏差被确定为检查DIF和差分测试功能（DTF），在一个分级的反应，项目反应理论框架。通过似然比χ2检验确定统计学显著性，并使用一系列度量来检查DIF和DTF的大小。本研究共纳入6269例儿童（平均[SD]年龄，6.77 [3.27]岁; 1619例黑人/非裔美国人[25.9%]，3151例白色[50.3%]，4970例男性[79.4%]）。总体而言，140个ADOS-2诊断项目中有16个（11%）具有显著DIF。在人种方面，8个项目具有显著的DIF，其中6个涉及SA。没有一个项目在所有模块中一致地显示DIF。与白色儿童相比，黑人/非裔美国儿童的大多数DIF项目的难度更大，辨别力更差。在性别方面，有5个项目显示出显著的DIF。DIF分为SA和RRB。然而，手习惯证明了所有5种算法的DIF，通常具有更大的难度。DIF的大小只有2个项目：手习惯（女童）和重复的兴趣（黑人/非洲裔美国儿童）的中等偏大。DIF对总DTF的总体估计影响不大。这些结果表明，ADOS-2在种族或性别之间没有广泛的系统性测量偏倚。然而，这些发现引发了一些关于检测不足的担忧，需要进一步研究。
Is a reference standard measure of autism spectrum disorder (ASD), the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), systematically biased across sex and race? In this cross-sectional study of 6269 children evaluated at an ASD specialty clinic in the US, 11% of ADOS-2 diagnostic items demonstrated bias for Black/African American vs White children and for female vs male children. The magnitude of bias was moderate to large for only 2 repetitive/restricted behavior interest items. Although the ADOS-2 demonstrated minimal bias overall, these findings suggest that further research is needed to address some evidence of underdetection of ASD symptoms in Black/African American children and female children. This cross-sectional study examines differential item functioning of the Autism Diagnostic Observation Schedule, Second Edition, across sex and race. There are long-standing disparities in the prevalence of autism spectrum disorder (ASD) across race and sex. Surprisingly, few studies have examined whether these disparities arise partially out of systematic biases in the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), the reference standard measure of ASD. To examine differential item functioning (DIF) of ADOS-2 items across sex and race. This is a cross-sectional study of children who were evaluated for ASD between 2014 and 2020 at a specialty outpatient clinic located in the Mid-Atlantic region of the US. Data were analyzed from July 2021 to February 2022. Child race (Black/African American vs White) and sex (female vs male). Item-level biases across ADOS-2 harmonized algorithm items, including social affect (SA; 10 items) and repetitive/restricted behaviors (RRBs; 4 items), were evaluated across 3 modules. Measurement bias was identified by examining DIF and differential test functioning (DTF), within a graded response, item response theory framework. Statistical significance was determined by a likelihood ratio χ2 test, and a series of metrics was used to examine the magnitude of DIF and DTF. A total of 6269 children (mean [SD] age, 6.77 [3.27] years; 1619 Black/African American [25.9%], 3151 White [50.3%], and 4970 male [79.4%]), were included in this study. Overall, 16 of 140 ADOS-2 diagnostic items (11%) had a significant DIF. For race, 8 items had a significant DIF, 6 of which involved SA. No single item showed DIF consistently across all modules. Most items with DIF had greater difficulty and poorer discrimination in Black/African American children compared with White children. For sex, 5 items showed significant DIF. DIF was split across SA and RRB. However, hand mannerisms evidenced DIF across all 5 algorithms, with generally greater difficulty. The magnitude of DIF was only moderate to large for 2 items: hand mannerisms (among female children) and repetitive interests (among Black/African American children). The overall estimated effect of DIF on total DTF was not large. These findings suggest that the ADOS-2 does not have widespread systematic measurement bias across race or sex. However, the findings raise some concerns around underdetection that warrant further research.
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影响因子：
3.9
作者：
Gotham, Katherine;Pickles, Andrew;Lord, Catherine
通讯作者：
Lord, Catherine
自闭症诊断观察表： 提高诊断有效性的修订算法
影响因子：
3.9
作者：
Gotham, Katherine;Risi, Susan;Lord, Catherine
通讯作者：
Lord, Catherine
DOI：
10.1002/ajmg.b.30535
发表时间：
2007-12-05
影响因子：
2.8
作者：
Cuccaro, Michael L.;Brinkley, Jason;Pericak-Vance, Margaret A.
通讯作者：
Pericak-Vance, Margaret A.
影响因子：
3.9
作者：
Esler, Amy N.;Bal, Vanessa Hus;Lord, Catherine
通讯作者：
Lord, Catherine
影响因子：
2
作者：
Crane, PK;van Belle, G;Larson, EB
通讯作者：
Larson, EB