在面对面和远程医疗自闭症评估期间的诊断确定性
Natasha N Ludwig1,2, Calliope Holingue3,4, Ji Su Hong2,3
1Department of Neuropsychology Kennedy Krieger Institute Baltimore Maryland USA.
JCPP advances
|March 15, 2024
概括
在COVID-19期间的远程医疗自闭症评估影响了诊断模式,自闭症谱系障碍 (ASD) 和ADHD的确定性较低. 一些诊断,如抑郁症,更频繁,而其他,如智力发育障碍,更少频繁.
科学领域:
- 儿童和青少年精神病学 儿童和青少年精神病学
- 发展心理学 发展心理学
- 临床心理学 临床心理学
背景情况:
- 由于COVID-19大流行,许多临床评估需要快速转向远程医疗.
- 这种转变对被评估为自闭症谱系障碍 (ASD) 的儿童诊断模式的影响在很大程度上是未知的.
研究的目的:
- 为了比较疫情期间通过远程医疗评估ASD的儿童的诊断模式和临床医生的诊断确定性,与疫情之前的面对面.
- 检查评估和诊断的频率,包括ASD和其他疾病,如ADHD,IDD,焦虑,抑郁和行为障碍.
主要方法:
- 一项对2192名儿童 (1-17岁) 的比较研究,在ASD专业中心进行评估.
- 数据包括大流行前的人身评估 (n=649) 和大流行期间远程医疗评估 (n=1543).
- 临床医生确定了ASD,ADHD,IDD,焦虑,抑郁和行为障碍的诊断 (是,不,可能,未评估).
主要成果:
- 远程医疗评估显示,ASD和ADHD的诊断确定性较低,IDD的评估/诊断频率较低.
- 抑郁症和行为障碍通过远程医疗更频繁地被诊断出来,抑郁症的诊断确定性较低.
- 焦虑诊断显示,远程医疗和面对面评估的频率没有显著差异.
结论:
- 在大流行期间的远程医疗评估导致诊断频率和临床医生的确定性与大流行前的人身评估相比有可观察到的差异.
- 这些差异可能影响了患者,并突出了远程诊断实践的挑战.
- 需要进一步的研究来概括这些发现,并了解潜在的机制.
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