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Is the Combination of ADOS and ADI-R Necessary to Classify ASD? Rethinking the “Gold Standard” in Diagnosing ASD

Diagnosing autism spectrum disorder (ASD) requires extensive clinical expertise and training as well as a focus on differential diagnoses. The diagnostic process is particularly complex given symptom overlap with other mental disorders and high rates of co-occurring physical and mental health concer...

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Autores principales: Kamp-Becker, Inge, Tauscher, Johannes, Wolff, Nicole, Küpper, Charlotte, Poustka, Luise, Roepke, Stefan, Roessner, Veit, Heider, Dominik, Stroth, Sanna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8421762/
https://www.ncbi.nlm.nih.gov/pubmed/34504449
http://dx.doi.org/10.3389/fpsyt.2021.727308
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author Kamp-Becker, Inge
Tauscher, Johannes
Wolff, Nicole
Küpper, Charlotte
Poustka, Luise
Roepke, Stefan
Roessner, Veit
Heider, Dominik
Stroth, Sanna
author_facet Kamp-Becker, Inge
Tauscher, Johannes
Wolff, Nicole
Küpper, Charlotte
Poustka, Luise
Roepke, Stefan
Roessner, Veit
Heider, Dominik
Stroth, Sanna
author_sort Kamp-Becker, Inge
collection PubMed
description Diagnosing autism spectrum disorder (ASD) requires extensive clinical expertise and training as well as a focus on differential diagnoses. The diagnostic process is particularly complex given symptom overlap with other mental disorders and high rates of co-occurring physical and mental health concerns. The aim of this study was to conduct a data-driven selection of the most relevant diagnostic information collected from a behavior observation and an anamnestic interview in two clinical samples of children/younger adolescents and adolescents/adults with suspected ASD. Via random forests, the present study discovered patterns of symptoms in the diagnostic data of 2310 participants (46% ASD, 54% non-ASD, age range 4–72 years) using data from the combined Autism Diagnostic Observation Schedule (ADOS) and Autism Diagnostic Interview—Revised (ADI-R) and ADOS data alone. Classifiers built on reduced subsets of diagnostic features yield satisfactory sensitivity and specificity values. For adolescents/adults specificity values were lower compared to those for children/younger adolescents. The models including ADOS and ADI-R data were mainly built on ADOS items and in the adolescent/adult sample the classifier including only ADOS items performed even better than the classifier including information from both instruments. Results suggest that reduced subsets of ADOS and ADI-R items may suffice to effectively differentiate ASD from other mental disorders. The imbalance of ADOS and ADI-R items included in the models leads to the assumption that, particularly in adolescents and adults, the ADI-R may play a lesser role than current behavior observations.
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spelling pubmed-84217622021-09-08 Is the Combination of ADOS and ADI-R Necessary to Classify ASD? Rethinking the “Gold Standard” in Diagnosing ASD Kamp-Becker, Inge Tauscher, Johannes Wolff, Nicole Küpper, Charlotte Poustka, Luise Roepke, Stefan Roessner, Veit Heider, Dominik Stroth, Sanna Front Psychiatry Psychiatry Diagnosing autism spectrum disorder (ASD) requires extensive clinical expertise and training as well as a focus on differential diagnoses. The diagnostic process is particularly complex given symptom overlap with other mental disorders and high rates of co-occurring physical and mental health concerns. The aim of this study was to conduct a data-driven selection of the most relevant diagnostic information collected from a behavior observation and an anamnestic interview in two clinical samples of children/younger adolescents and adolescents/adults with suspected ASD. Via random forests, the present study discovered patterns of symptoms in the diagnostic data of 2310 participants (46% ASD, 54% non-ASD, age range 4–72 years) using data from the combined Autism Diagnostic Observation Schedule (ADOS) and Autism Diagnostic Interview—Revised (ADI-R) and ADOS data alone. Classifiers built on reduced subsets of diagnostic features yield satisfactory sensitivity and specificity values. For adolescents/adults specificity values were lower compared to those for children/younger adolescents. The models including ADOS and ADI-R data were mainly built on ADOS items and in the adolescent/adult sample the classifier including only ADOS items performed even better than the classifier including information from both instruments. Results suggest that reduced subsets of ADOS and ADI-R items may suffice to effectively differentiate ASD from other mental disorders. The imbalance of ADOS and ADI-R items included in the models leads to the assumption that, particularly in adolescents and adults, the ADI-R may play a lesser role than current behavior observations. Frontiers Media S.A. 2021-08-24 /pmc/articles/PMC8421762/ /pubmed/34504449 http://dx.doi.org/10.3389/fpsyt.2021.727308 Text en Copyright © 2021 Kamp-Becker, Tauscher, Wolff, Küpper, Poustka, Roepke, Roessner, Heider and Stroth. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Kamp-Becker, Inge
Tauscher, Johannes
Wolff, Nicole
Küpper, Charlotte
Poustka, Luise
Roepke, Stefan
Roessner, Veit
Heider, Dominik
Stroth, Sanna
Is the Combination of ADOS and ADI-R Necessary to Classify ASD? Rethinking the “Gold Standard” in Diagnosing ASD
title Is the Combination of ADOS and ADI-R Necessary to Classify ASD? Rethinking the “Gold Standard” in Diagnosing ASD
title_full Is the Combination of ADOS and ADI-R Necessary to Classify ASD? Rethinking the “Gold Standard” in Diagnosing ASD
title_fullStr Is the Combination of ADOS and ADI-R Necessary to Classify ASD? Rethinking the “Gold Standard” in Diagnosing ASD
title_full_unstemmed Is the Combination of ADOS and ADI-R Necessary to Classify ASD? Rethinking the “Gold Standard” in Diagnosing ASD
title_short Is the Combination of ADOS and ADI-R Necessary to Classify ASD? Rethinking the “Gold Standard” in Diagnosing ASD
title_sort is the combination of ados and adi-r necessary to classify asd? rethinking the “gold standard” in diagnosing asd
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8421762/
https://www.ncbi.nlm.nih.gov/pubmed/34504449
http://dx.doi.org/10.3389/fpsyt.2021.727308
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