When Are We Sure? Predictors of Clinician Certainty in the Diagnosis of Autism Spectrum Disorder
When Are We Sure? Predictors of Clinician Certainty in the Diagnosis of Autism Spectrum Disorder
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DOI：
10.1007/s10803-018-3831-3
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发表时间：
2019-04-01
影响因子：
3.9
通讯作者：
Carpenter, Laura A.
中科院分区：
文献类型：
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作者：
McDonnell, Christina G.;Bradley, Catherine C.;Carpenter, Laura A.
自闭症谱系障碍（ASD）的鉴别诊断是具有挑战性的，关于儿童诊断的不确定性可能导致识别不足或诊断途径延长。目前的研究检查了诊断的确定性，或者临床医生对他们的诊断准确性的确定性，其中478名幼儿和学龄前儿童被转介到学术医学专业诊所。总体而言，60%的诊断是完全确定的。临床医生在积极识别ASD时比排除它更确定。表现出中度（与高或低）可观察到的ASD症状的儿童不太可能有某种诊断。此外，临床医生对年龄较大的儿童、有公共保险的儿童以及智商和适应行为能力较高的儿童的诊断确定性较低。
Differential diagnosis of autism spectrum disorder (ASD) is challenging, and uncertainty regarding a child's diagnosis may result in under-identification or prolonged diagnostic pathways. The current study examined diagnostic certainty, or how sure clinicians were that their diagnosis was accurate, among 478 toddler and preschool-aged children referred for possible ASD to academic medical specialty clinics. Overall, 60 percent of diagnoses were made with complete certainty. Clinicians were more certain when positively identifying ASD than ruling it out. Children presenting with a moderate (vs high or low) level of observable ASD symptoms were less likely to have a certain diagnosis. Further, clinicians rated less diagnostic certainty for older children, those with public insurance, and those with higher IQ and adaptive behavior abilities.