Combining information from multiple sources in the diagnosis of autism spectrum disorders
Combining information from multiple sources in the diagnosis of autism spectrum disorders
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DOI：
10.1097/01.chi.0000227880.42780.0e
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发表时间：
2006-09-01
影响因子：
13.3
通讯作者：
Pickles, Andrew
中科院分区：
文献类型：
--
作者：
Risi, Susan;Lord, Catherine;Pickles, Andrew
背景资料：标准的情况下，标准建议联合使用的自闭症诊断访谈修订版和自闭症诊断观察时间表，以诊断自闭症，并定义更广泛的类别自闭症谱系障碍。方法：在四个样本中，将单一和组合的自闭症诊断访谈-修订版和自闭症诊断观察时间表算法与最佳估计诊断进行了比较：美国（n = 960）和加拿大（n = 232）参与者3岁及以上，美国参与者小于36个月（n = 270），美国参与者大于36个月，有严重精神发育迟滞（n = 67）。结果如下：当使用这两种仪器进行自闭症诊断的严格标准应用于美国样本时，获得了80%或更高的灵敏度和特异性，而在加拿大样本中则为75%或更高。单一仪器标准导致特异性显著丧失。在深度智力低下的样本中特异性较差。当应用更广泛疾病的拟议标准时，灵敏度和特异性也较低。结论：孤独症诊断访谈修订版和孤独症诊断观察表对临床医生的判断做出了独立的、附加的贡献，从而使诊断标准的应用更加一致和严格。
Background: Standard case criteria are proposed for combined use of the Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule to diagnose autism and to define the broader category of autism spectrum disorders. Method: Single and combined Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule algorithms were compared to best estimate diagnoses in four samples: U.S. (n = 960) and Canadian (n = 232) participants 3 years and older, U.S. participants younger than 36 months (n = 270), and U.S. participants older than 36 months with profound mental retardation (n = 67). Results: Sensitivities and specificities of 80% and higher were obtained when strict criteria for an autism diagnosis using both instruments were applied in the U.S. samples, and 75% or greater in the Canadian sample. Single-instrument criteria resulted in significant loss of specificity. Specificity was poor in the sample with profound mental retardation. Lower sensitivity and specificity were also obtained when proposed criteria for broader spectrum disorders were applied. Conclusions: The Autism Diagnostic Interview-Revised and Autism Diagnostic Observation Schedule make independent, additive contributions to the judgment of clinicians that result in a more consistent and rigorous application of diagnostic criteria.