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Validation of the diagnosis of autism in general practitioner records

BACKGROUND: We report on the validity of the computerized diagnoses of autism in a large case-control study investigating the possible association between autism and the measles, mumps and rubella vaccine in the UK using the General Practitioner Research Database (GPRD). We examined anonymized copie...

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Autores principales: Fombonne, Eric, Heavey, Lisa, Smeeth, Liam, Rodrigues, Laura C, Cook, Claire, Smith, Peter G, Meng, Linyan, Hall, Andrew J
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2004
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC394332/
https://www.ncbi.nlm.nih.gov/pubmed/15113435
http://dx.doi.org/10.1186/1471-2458-4-5
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author Fombonne, Eric
Heavey, Lisa
Smeeth, Liam
Rodrigues, Laura C
Cook, Claire
Smith, Peter G
Meng, Linyan
Hall, Andrew J
author_facet Fombonne, Eric
Heavey, Lisa
Smeeth, Liam
Rodrigues, Laura C
Cook, Claire
Smith, Peter G
Meng, Linyan
Hall, Andrew J
author_sort Fombonne, Eric
collection PubMed
description BACKGROUND: We report on the validity of the computerized diagnoses of autism in a large case-control study investigating the possible association between autism and the measles, mumps and rubella vaccine in the UK using the General Practitioner Research Database (GPRD). We examined anonymized copies of all relevant available clinical reports, including general practitioners' (GP) notes, consultant, speech therapy and educational psychologists reports, on 318 subjects born between 1973 and 1997 with a diagnosis of autism or a related disorder recorded in their electronic general practice record. METHODS: Data were abstracted to a case validation form allowing for the identification of developmental symptoms relevant to the diagnosis of pervasive developmental disorders (PDDs). Information on other background clinical and familial features was also abstracted. A subset of 50 notes was coded independently by 2 raters to derive reliability estimates for key clinical characteristics. RESULTS: For 294 subjects (92.5%) the diagnosis of PDD was confirmed after review of the records. Of these, 180 subjects (61.2%) fulfilled criteria for autistic disorder. The mean age at first recording of a PDD diagnosis in the GPRD database was 6.3 years (SD = 4.6). Consistent with previous estimates, the proportion of subjects experiencing regression in the course of their development was 19%. Inter-rater reliability for the presence of a PDD diagnosis was good (kappa = .73), and agreement on clinical features such as regression, age of parental recognition of first symptoms, language delay and presence of epilepsy was also good (kappas ranging from .56 to 1.0). CONCLUSIONS: This study provides evidence that the positive predictive value of a diagnosis of autism recorded in the GPRD is high.
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spelling pubmed-3943322004-04-22 Validation of the diagnosis of autism in general practitioner records Fombonne, Eric Heavey, Lisa Smeeth, Liam Rodrigues, Laura C Cook, Claire Smith, Peter G Meng, Linyan Hall, Andrew J BMC Public Health Research Article BACKGROUND: We report on the validity of the computerized diagnoses of autism in a large case-control study investigating the possible association between autism and the measles, mumps and rubella vaccine in the UK using the General Practitioner Research Database (GPRD). We examined anonymized copies of all relevant available clinical reports, including general practitioners' (GP) notes, consultant, speech therapy and educational psychologists reports, on 318 subjects born between 1973 and 1997 with a diagnosis of autism or a related disorder recorded in their electronic general practice record. METHODS: Data were abstracted to a case validation form allowing for the identification of developmental symptoms relevant to the diagnosis of pervasive developmental disorders (PDDs). Information on other background clinical and familial features was also abstracted. A subset of 50 notes was coded independently by 2 raters to derive reliability estimates for key clinical characteristics. RESULTS: For 294 subjects (92.5%) the diagnosis of PDD was confirmed after review of the records. Of these, 180 subjects (61.2%) fulfilled criteria for autistic disorder. The mean age at first recording of a PDD diagnosis in the GPRD database was 6.3 years (SD = 4.6). Consistent with previous estimates, the proportion of subjects experiencing regression in the course of their development was 19%. Inter-rater reliability for the presence of a PDD diagnosis was good (kappa = .73), and agreement on clinical features such as regression, age of parental recognition of first symptoms, language delay and presence of epilepsy was also good (kappas ranging from .56 to 1.0). CONCLUSIONS: This study provides evidence that the positive predictive value of a diagnosis of autism recorded in the GPRD is high. BioMed Central 2004-03-03 /pmc/articles/PMC394332/ /pubmed/15113435 http://dx.doi.org/10.1186/1471-2458-4-5 Text en Copyright © 2004 Fombonne et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
spellingShingle Research Article
Fombonne, Eric
Heavey, Lisa
Smeeth, Liam
Rodrigues, Laura C
Cook, Claire
Smith, Peter G
Meng, Linyan
Hall, Andrew J
Validation of the diagnosis of autism in general practitioner records
title Validation of the diagnosis of autism in general practitioner records
title_full Validation of the diagnosis of autism in general practitioner records
title_fullStr Validation of the diagnosis of autism in general practitioner records
title_full_unstemmed Validation of the diagnosis of autism in general practitioner records
title_short Validation of the diagnosis of autism in general practitioner records
title_sort validation of the diagnosis of autism in general practitioner records
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC394332/
https://www.ncbi.nlm.nih.gov/pubmed/15113435
http://dx.doi.org/10.1186/1471-2458-4-5
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