{"title":"Autism Screening Using the Parent's Observation of Social Interactions in a Large Integrated Healthcare System.","authors":"Kek Khee Loo, Su-Jau Yang, Jerry C Cheng","doi":"10.1016/j.jpeds.2024.114434","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To determine the accuracy of the Parent's Observation of Social Interactions (POSI) when deployed for universal autism screening within a large healthcare network.</p><p><strong>Study design: </strong>Retrospective analysis of electronic health record (EHR) data from children screened for autism spectrum disorder (ASD) using POSI at 18- and 24- month pediatric well child care (WCC) visits across Southern California Permanente Medical Group facilities throughout the 2022 calendar year. Data on ASD diagnoses placed in the EHR problem list were analyzed one year later (until end of 2023) to calculate sensitivity, specificity, and positive/negative likelihood ratio (LR+ and LR-) values.</p><p><strong>Results: </strong>At 18-month WCC, 8014 (26.4%) out of 30,375 children had elevated POSI scores of >3 (positive screen), and the sensitivity and specificity were 77.9% and 76.1% respectively. At 24-month WCC, 5988 children (21.4%) out of 27,975 had positive POSI screens, and the sensitivity and specificity were 76.5% and 81.4% respectively. Likelihood ratio for positive screen (LR+) was 3.3 at 18 months and 4.2 at 24 months. Likelihood ratio for negative screen (LR-) was 0.29 at both 18 and 24-month time points.</p><p><strong>Conclusion: </strong>The POSI screen for ASD had adequate sensitivity and specificity (both >76%) when systematically deployed in a primary care setting at 18- and 24-month WCC visits. Children diagnosed with ASD were 3.3 and 4.2 times more likely to have screened positive at 18 and 24 months, compared with children who were not diagnosed with ASD. Conversely, children not diagnosed with ASD were 3.4 times more likely to have screened negative than children with ASD at 18 and 24 months.</p>","PeriodicalId":54774,"journal":{"name":"Journal of Pediatrics","volume":" ","pages":"114434"},"PeriodicalIF":3.9000,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jpeds.2024.114434","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To determine the accuracy of the Parent's Observation of Social Interactions (POSI) when deployed for universal autism screening within a large healthcare network.
Study design: Retrospective analysis of electronic health record (EHR) data from children screened for autism spectrum disorder (ASD) using POSI at 18- and 24- month pediatric well child care (WCC) visits across Southern California Permanente Medical Group facilities throughout the 2022 calendar year. Data on ASD diagnoses placed in the EHR problem list were analyzed one year later (until end of 2023) to calculate sensitivity, specificity, and positive/negative likelihood ratio (LR+ and LR-) values.
Results: At 18-month WCC, 8014 (26.4%) out of 30,375 children had elevated POSI scores of >3 (positive screen), and the sensitivity and specificity were 77.9% and 76.1% respectively. At 24-month WCC, 5988 children (21.4%) out of 27,975 had positive POSI screens, and the sensitivity and specificity were 76.5% and 81.4% respectively. Likelihood ratio for positive screen (LR+) was 3.3 at 18 months and 4.2 at 24 months. Likelihood ratio for negative screen (LR-) was 0.29 at both 18 and 24-month time points.
Conclusion: The POSI screen for ASD had adequate sensitivity and specificity (both >76%) when systematically deployed in a primary care setting at 18- and 24-month WCC visits. Children diagnosed with ASD were 3.3 and 4.2 times more likely to have screened positive at 18 and 24 months, compared with children who were not diagnosed with ASD. Conversely, children not diagnosed with ASD were 3.4 times more likely to have screened negative than children with ASD at 18 and 24 months.
期刊介绍:
The Journal of Pediatrics is an international peer-reviewed journal that advances pediatric research and serves as a practical guide for pediatricians who manage health and diagnose and treat disorders in infants, children, and adolescents. The Journal publishes original work based on standards of excellence and expert review. The Journal seeks to publish high quality original articles that are immediately applicable to practice (basic science, translational research, evidence-based medicine), brief clinical and laboratory case reports, medical progress, expert commentary, grand rounds, insightful editorials, “classic” physical examinations, and novel insights into clinical and academic pediatric medicine related to every aspect of child health. Published monthly since 1932, The Journal of Pediatrics continues to promote the latest developments in pediatric medicine, child health, policy, and advocacy.
Topics covered in The Journal of Pediatrics include, but are not limited to:
General Pediatrics
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Adolescent Medicine
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Endocrinology
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Nephrology
Neurology
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Pulmonology
Rheumatology
Genetics
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Pediatric Hospitalist Medicine.