将自闭症查研究应用于现实世界的场景:对Sheldrick等人发表评论. (2023) 年的2023) 年
Kate E Wallis1, Rosalind Usher1
1The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Journal of child psychology and psychiatry, and allied disciplines
|November 27, 2023
概括
早期识别自闭症谱系障碍 (ASD) 是一个挑战. 统计建模表明,查后不完整的后续对工具准确性产生重大影响,突出了家庭参与诊断决策的必要性.
科学领域:
- 发育儿科 发育儿科
- 心理测量 心理测量 心理测量
- 公共卫生 公共卫生
背景情况:
- 早期识别自闭症谱系障碍 (ASD) 仍然是儿科医疗保健的一个重大挑战.
- 全球查工作受到查工具的敏感性和特异性低于预期的阻碍.
- 被查儿童的诊断后续不完整是影响心理测量表现的关键因素.
研究的目的:
- 分析改变了关于儿童诊断结果的假设的影响,对查工具的敏感性和特异性进行不完整的跟进.
- 要强调,初级保健中自闭症查是最初的步骤,而不是诊断评估.
- 通过加强家庭参与,探索改善查工具性能的策略.
主要方法:
- 使用统计建模来模拟不同后续率对选工具心理特征的影响.
- 分析重点是关于非完成者的诊断状态的假设如何影响灵敏度和特异性计算.
- 考虑了文献审查和现有查数据的重新评估.
主要成果:
- 改变对未完成诊断评估的儿童诊断结果的假设,会显著影响报告的敏感性和特异性.
- 该研究表明,不完整的随访是临床查的固有特征,而不仅仅是缺陷.
- 缺乏后续工作可以人工膨胀或降低选工具的感知精度.
结论:
- 在初级保健中对自闭症的查需要仔细的解释,承认不完整的诊断随访所带来的局限性.
- 与家庭共同决策至关重要,以鼓励后续遵守,从而提高查工具性能的可靠性.
- 自闭症查工具的心理测量性能与临床途径和查后的家庭参与密切相关.
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