Screening and Diagnostic Tools for Autism Spectrum Disorder: Systematic Review and Meta-Analysis
Clinics
Santos, C. L. D., Barreto,, II, et al. (2024).
Clinics, 79, 100323.
<div>This systematic review and meta-analysis investigates the psychometric properties of screening and diagnostic tools for individuals on the autism spectrum.</div>
Not stated
From database inception to August 2023
<div>Cross-sectional studies</div>
19
<div>Six studies evaluated the Modified Checklist for Autism in Children, Revised, with Follow-up (M-CHAT-R/F). Findings indicated:</div>
<div>
<ul>
<li>sensitivity = 78%;</li>
<li>specificity = 98%;</li>
<li>positive likelihood ratio = 35.62; and</li>
<li>negative likelihood ratio = 0.225.</li>
</ul>
<div>Limitations included heterogeneity in the methodology used across studies included in this review.</div>
</div>
<div>Six articles investigated the use of the Autism Diagnostic Observation Schedule (ADOS). Results showed:</div>
<div>
<ul>
<li>sensitivity = 87%;</li>
<li>specificity = 75%;</li>
<li>positive likelihood ratio = 3.52; and</li>
<li>negative likelihood ratio = 0.174.</li>
</ul>
<div>Limitations included heterogeneity in the methodology used across studies included in this review.</div>
</div>
<div>Three articles investigated the properties of the Autism Diagnostic Interview-Revised (ADI-R). Findings were as follows:</div>
<div>
<ul>
<li>sensitivity = 77%;</li>
<li>specificity = 68%;</li>
<li>positive likelihood ratio = 2.401; and</li>
<li>negative likelihood ratio = 0.34.</li>
</ul>
<div>Limitations included heterogeneity in the methodology used across studies included in this review.</div>
</div>
<div>Five articles examined the Childhood Autism Rating Scale (CARS) tool. They found:</div>
<div>
<ul>
<li>sensitivity = 89%;</li>
<li>specificity = 79%;</li>
<li>positive likelihood ratio = 3.637; and</li>
<li>negative likelihood ratio = 0.156.</li>
</ul>
<div>Limitations included heterogeneity in the methodology used across studies included in this review.</div>
</div>
<div>The post-test probability in a 50% prevalence context was 97% for the M-CHAT-R/F, 77% for the ADOS, 70% for the ADI-R, and 78% for the CARS. The most recommended screening test was the M-CHAT-R/F. For diagnosis, the CARS and ADOS were recommended.</div>
<div> </div>
<div>Limitations included heterogeneity in the methodology used across studies included in this review.</div>
