Estimating the impact of missed cases on the accuracy of autism screening tools.

IF 3.1 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Psychological Assessment Pub Date : 2026-03-05 DOI:10.1037/pas0001445

Brian Barger,Terri Deocampo Pigott,R Christopher Sheldrick,Jonathan Campbell,Alexa Gonzalez Laca,Jon Starnes,Betsy Davis,Rachel Waford,John Olmstead

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Abstract

A common problem for assessing psychiatric screening tools is that initial diagnostic accuracy estimates are conducted on cross-sectional data and later found to be lower than expected when longitudinal analyses are conducted. This article uses prevalence estimates to identify potentially missed cases and adjust diagnostic accuracy metrics. To display this approach, we meta-analyze and assess 27 population-level autism screening studies identified via an umbrella review and contrast four population adjustments (none, national, U.S.-centric, and world prevalence). Studies with no positive screen adjustments displayed adequate sensitivity (.75), but poor sensitivity resulted when applying national (.52), world (.50), and U.S.-centric (.33) population adjustments. We also address missing positive screen cases due to the common problem of attrition (Sheldrick et al., 2023). Positive screen adjustments suggested a range of sensitivity impacts ranging from very poor (.32) to good (.89). Across analyses, positive predictive value estimates also ranged from .20 to .73 depending on population and missed case assumptions. The strengths and benefits of blending epidemiology and psychometric perspectives to identify screening tools that are weaker than expected are discussed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

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估计漏诊病例对自闭症筛查工具准确性的影响。

评估精神病筛查工具的一个常见问题是，最初的诊断准确性估计是在横断面数据上进行的，后来在进行纵向分析时发现比预期的要低。本文使用患病率估计来识别潜在的遗漏病例并调整诊断准确性指标。为了展示这种方法，我们荟萃分析和评估了27项人群水平的自闭症筛查研究，这些研究是通过总括性回顾确定的，并对比了四种人群调整（无、全国、以美国为中心和世界患病率）。没有正面筛选调整的研究显示出足够的灵敏度。75)，但在应用国家(。世界，世界；50)，以及以美国为中心的人口调整（0.33）。我们还解决了由于人员流失的常见问题而缺失的阳性筛查病例（Sheldrick et al., 2023）。积极的屏幕调整表明灵敏度影响范围从非常差（0.32）到良好（0.89）。在整个分析中，积极的预测值估计范围也从。20到。73个，取决于总体和遗漏病例假设。讨论了混合流行病学和心理测量学的观点来识别比预期弱的筛选工具的优势和好处。（PsycInfo数据库记录(c) 2026 APA，版权所有）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychological Assessment PSYCHOLOGY, CLINICAL-

CiteScore

5.70

自引率

5.60%

发文量

167

期刊介绍： Psychological Assessment is concerned mainly with empirical research on measurement and evaluation relevant to the broad field of clinical psychology. Submissions are welcome in the areas of assessment processes and methods. Included are - clinical judgment and the application of decision-making models - paradigms derived from basic psychological research in cognition, personality–social psychology, and biological psychology - development, validation, and application of assessment instruments, observational methods, and interviews