Clara Lucato dos Santos , Indyanara Inacio Barreto , Idevaldo Floriano , Luca Schiliró Tristão , Antonio Silvinato , Wanderley Marques Bernardo
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The diagnostic tools demonstrated sensitivity and specificity respectively of: ADOS, sensitivity of 87 % (95 % CI 0.79‒0.92) and specificity 75 % (95 % CI 0.73‒0.78); ADI-R demonstrated test sensitivity of 77 % (95 % CI 0.56‒0.90) and specificity 68 % (95 % CI 0.52‒0.81), CARS test sensitivity was 89 % (95 % CI 0.78‒0.95) and specificity 79 % (95 % CI 0.65‒0.88).</p></div><div><h3>Conclusion</h3><p>It is mandatory to apply a screening test, the most recommended being the M-CHAT-R/F. 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引用次数: 0
摘要
导言自闭症谱系障碍(ASD)是一种异质性神经发育障碍,主要表现与沟通、社会交往和行为模式有关。随着时间的推移,患儿会发生细微的动态变化,这就要求我们更加重视患儿开始出现的临床表现,以稳定病情。面对各种各样的 ASD 诊断方法,问题是应该使用哪种方法。本系统综述旨在推荐进行筛查和诊断的最佳工具。访问了 MEDLINE、Embase、CENTRAL(Cochrane)和 Lilacs 等数据库,并进行了灰色检索和人工检索。使用自闭症术语和诊断/宽泛过滤器创建了检索策略。对研究进行了定性和定量评估。结果M-CHAT-R/F工具的灵敏度为78%(95% CI 0.57-0.91),特异度为0.98(95% CI 0.88-1.00)。诊断工具的灵敏度和特异性分别为ADOS 的灵敏度为 87 % (95 % CI 0.79-0.92),特异度为 75 % (95 % CI 0.73-0.78);ADI-R 的测试灵敏度为 77 % (95 % CI 0.56-0.90),特异度为 68 % (95 % CI 0.52-0.81);CARS 的测试灵敏度为 89 % (95 % CI 0.78-0.95),特异度为 79 % (95 % CI 0.65-0.88)。在诊断方面,CARS 和 ADOS 是最值得推荐的工具。
Screening and diagnostic tools for autism spectrum disorder: Systematic review and meta-analysis
Introduction
Autism Spectrum Disorder (ASD) is a heterogeneous neurodevelopmental disorder, with main manifestations related to communication, social interaction, and behavioral patterns. The slight dynamics of change in the child over time require that the onset of clinical manifestations presented by the child be more valued, with the aim of stabilizing the condition. Faced with a variety of methods for diagnosing ASD, the question arises as to which method should be used. This systematic review aims to recommend the best tools to perform screening and diagnosis.
Methodology
This systematic review followed the PRISMA guidelines. The databases MEDLINE, Embase, CENTRAL (Cochrane), and Lilacs were accessed, and gray and manual searches were performed. The search strategy was created with terms referring to autism and the diagnosis/broad filter. The studies were qualitatively evaluated and quantitatively. Statistical analysis was performed using Meta-diSc-2.0 software, the confidence interval was 95 %.
Results
The M-CHAT-R/F tool demonstrated a sensitivity of 78 % (95 % CI 0.57‒0.91) and specificity of 0.98 (95 % CI 0.88–1.00). The diagnostic tools demonstrated sensitivity and specificity respectively of: ADOS, sensitivity of 87 % (95 % CI 0.79‒0.92) and specificity 75 % (95 % CI 0.73‒0.78); ADI-R demonstrated test sensitivity of 77 % (95 % CI 0.56‒0.90) and specificity 68 % (95 % CI 0.52‒0.81), CARS test sensitivity was 89 % (95 % CI 0.78‒0.95) and specificity 79 % (95 % CI 0.65‒0.88).
Conclusion
It is mandatory to apply a screening test, the most recommended being the M-CHAT-R/F. For diagnosis CARS and ADOS are the most recommended tools.
期刊介绍:
CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.