Utredning av autismespekterforstyrrelser i BUP – hvor godt samsvar er det mellom instrumenter og endelig klinisk diagnose?

Tidsskrift for Norsk psykologforening Pub Date : 2021-10-01 DOI:10.52734/n27qu88p

Hans Jørgen Berntsen, Bup Øvre Romerike Akershus universitetssykehus, Beate Ørbeck, Kristin Romvig Øvergaard, Institutt for klinisk medisin Universitetet i Oslo

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Abstract

Background: The Developmental, Dimensional and Diagnostic Interview (3Di) and the Autism Diagnostic Observation Schedule (ADOS-2) may be useful when assessing autism spectrum disorder (ASD), but the accuracy of the Norwegian 3Di is not known. Method: We investigated the classification accuracy of the 3Di and the ADOS-2 in identifying clinically diagnosed ASD in 130 participants (mean age 11 years). Results: We found acceptable accuracy in identifying ASD with both the 3Di and ADOS-2 (sensitivities/specificities > 70 %), and highest accuracy (positive likelihood ratio = 17.12) when combining the two instruments, but this gave lower sensitivity (54 %). Conclusions: The 3Di is useful when assessing ASD, and most accurate when combined with information from the ADOS-2. Clinicians should be aware that some children with ASD may be missed by requiring endorsement from both instruments. Keywords: Autism Diagnostic Observation Schedule, inter-rater reliability, sensitivity, specificity, Developmental, Dimensional and Diagnostic Interview

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背景:发育、维度和诊断性访谈(3Di)和自闭症诊断观察表(ADOS-2)在评估自闭症谱系障碍(ASD)时可能有用，但挪威3Di的准确性尚不清楚。方法:对130例(平均年龄11岁)临床诊断为ASD的受试者进行3Di和ADOS-2的分类准确性研究。结果:我们发现3Di和ADOS-2在识别ASD方面的准确性可以接受(敏感性/特异性> 70%)，当两种仪器联合使用时，准确率最高(阳性似然比= 17.12)，但灵敏度较低(54%)。结论:3Di在评估ASD时是有用的，与ADOS-2的信息结合时最准确。临床医生应该意识到，一些患有ASD的儿童可能会因为要求两种工具的背书而被遗漏。关键词:自闭症诊断观察量表，量表间信度，敏感性，特异性，发展性，维度和诊断访谈

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