Validation of the diagnosis of autism in general practitioner records.
Validation of the diagnosis of autism in general practitioner records.
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DOI：
10.1186/1471-2458-4-5
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发表时间：
2004-03-03
影响因子：
4.5
通讯作者：
Hall AJ
中科院分区：
文献类型：
--
作者：
Fombonne E;Heavey L;Smeeth L;Rodrigues LC;Cook C;Smith PG;Meng L;Hall AJ
我们在一项大型病例对照研究中报告了自闭症计算机诊断的有效性，该研究使用全科医生研究数据库（GPRD）调查了自闭症与英国麻疹，腮腺炎和风疹疫苗之间的可能关联。我们检查了所有相关临床报告的匿名副本，包括全科医生（GP）的笔记，顾问，语言治疗和教育心理学家的报告，对1973年至1997年出生的318名被试者进行了检查，他们的电子全科医生记录中记录了自闭症或相关疾病的诊断。将数据提取为病例验证表，以确定与广泛性发育障碍（PDD）诊断相关的发育症状。还提取了其他背景临床和家族特征的信息。由2名评分员独立编码50个注释的子集，以获得关键临床特征的可靠性估计值。294例受试者（92.5%）在审查记录后确诊为PDD。其中，180名受试者（61.2%）符合自闭症障碍的标准。GPRD数据库中首次记录PDD诊断的平均年龄为6.3岁（SD = 4.6）。与之前的估计一致，在发育过程中经历退化的受试者比例为19%。评估者间对PDD诊断的可靠性良好（kappa = .73），对临床特征的一致性也良好（kappa范围从.56到1.0），如退化、父母识别首次症状的年龄、语言延迟和癫痫的存在。这项研究提供的证据表明，在GPRD中记录的自闭症诊断的阳性预测值很高。
We report on the validity of the computerized diagnoses of autism in a large case-control study investigating the possible association between autism and the measles, mumps and rubella vaccine in the UK using the General Practitioner Research Database (GPRD). We examined anonymized copies of all relevant available clinical reports, including general practitioners' (GP) notes, consultant, speech therapy and educational psychologists reports, on 318 subjects born between 1973 and 1997 with a diagnosis of autism or a related disorder recorded in their electronic general practice record. Data were abstracted to a case validation form allowing for the identification of developmental symptoms relevant to the diagnosis of pervasive developmental disorders (PDDs). Information on other background clinical and familial features was also abstracted. A subset of 50 notes was coded independently by 2 raters to derive reliability estimates for key clinical characteristics. For 294 subjects (92.5%) the diagnosis of PDD was confirmed after review of the records. Of these, 180 subjects (61.2%) fulfilled criteria for autistic disorder. The mean age at first recording of a PDD diagnosis in the GPRD database was 6.3 years (SD = 4.6). Consistent with previous estimates, the proportion of subjects experiencing regression in the course of their development was 19%. Inter-rater reliability for the presence of a PDD diagnosis was good (kappa = .73), and agreement on clinical features such as regression, age of parental recognition of first symptoms, language delay and presence of epilepsy was also good (kappas ranging from .56 to 1.0). This study provides evidence that the positive predictive value of a diagnosis of autism recorded in the GPRD is high.
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影响因子：
6.9
作者：
Chen, W;Landau, S;Fombonne, E
通讯作者：
Fombonne, E
影响因子：
--
作者：
Taylor, B;Miller, E;Stowe, J
通讯作者：
Stowe, J
影响因子：
168.9
作者：
Taylor, B;Miller, E;Waight, PA
通讯作者：
Waight, PA
影响因子：
6.7
作者：
Kobayashi, R;Murata, T
通讯作者：
Murata, T
影响因子：
3.9
作者：
Croen, LA;Grether, JK;Selvin, S
通讯作者：
Selvin, S