Use of a Digital Modified Checklist for Autism in Toddlers - Revised with Follow-up to Improve Quality of Screening for Autism
Use of a Digital Modified Checklist for Autism in Toddlers - Revised with Follow-up to Improve Quality of Screening for Autism
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DOI：
10.1016/j.jpeds.2017.01.021
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发表时间：
2017-04-01
影响因子：
5.1
通讯作者：
Dawson, Geraldine
中科院分区：
文献类型：
--
作者：
Campbell, Kathleen;Carpenter, Kimberly L. H.;Dawson, Geraldine
Objectives To assess changes in quality of care for children at risk for autism spectrum disorders（ASD）due to process improvement and implementation of a digital screening form.Study design ASD筛查的过程在一个学术初级保健儿科诊所进行了研究之前和之后的一个数字版本的修改后的清单自闭症幼儿-修订与随访与自动化风险评估。质量指标包括筛查结果记录的准确性和阳性筛查的适当措施（二次筛查或转诊）。参与的医生完成了干预前后的调查，以衡量对ASD筛查的可行性和价值的态度变化。结果筛查结果电子健康记录的准确性从54%提高到92%（提高38%，95% CI 14%~ 64%），筛查阳性儿童的适当行动从25%提高到85%（提高60%，95% CI 35%~ 85%）。共有90%的参与医生同意，过渡到一个数字化的筛查形式，提高了他们的临床评估自闭症risk.Conclusions实施基于平板电脑的数字版本的修订后的自闭症儿童检查表随访导致提高护理质量的儿童ASD的风险和增加的可接受性筛查ASD。继续努力改善ASD筛查过程可以促进ASD的快速，早期诊断，并提高筛查影响研究的准确性。
Objectives To assess changes in quality of care for children at risk for autism spectrum disorders (ASD) due to process improvement and implementation of a digital screening form.Study design The process of screening for ASD was studied in an academic primary care pediatrics clinic before and after implementation of a digital version of the Modified Checklist for Autism in Toddlers - Revised with Followup with automated risk assessment. Quality metrics included accuracy of documentation of screening results and appropriate action for positive screens (secondary screening or referral). Participating physicians completed preand postintervention surveys to measure changes in attitudes toward feasibility and value of screening for ASD. Evidence of change was evaluated with statistical process control charts and chi(2) tests.Results Accurate documentation in the electronic health record of screening results increased from 54% to 92% (38% increase, 95% CI 14%-64%) and appropriate action for children screening positive increased from 25% to 85% (60% increase, 95% CI 35%-85%). A total of 90% of participating physicians agreed that the transition to a digital screening form improved their clinical assessment of autism risk.Conclusions Implementation of a tablet-based digital version of the Modified Checklist for Autism in Toddlers Revised with Follow-up led to improved quality of care for children at risk for ASD and increased acceptability of screening for ASD. Continued efforts towards improving the process of screening for ASD could facilitate rapid, early diagnosis of ASD and advance the accuracy of studies of the impact of screening.