Increasing incidence of autism spectrum disorder: are we over-diagnosing?

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2022-03-21 DOI:10.1108/aia-10-2021-0041

L. Watkins, H. Angus-Leppan

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Abstract

Purpose In 2016, 1 in 54 children were estimated to have autism in the USA compared to 1 in 2,500 in 1955. This study aims to consider whether there has been a worldwide rise in incidence over time that is contributing to the rise in prevalence. Design/methodology/approach A systematic review of the literature with strict inclusion criteria was performed to identify large population-based studies that include raw incidence rate data with clearly defined diagnostic criteria. The data from the included studies were pooled and analysed descriptively to compare incidence rates by decade. Findings Seven studies were included in the final quantitative analysis including incidence rate data from 1988 to 2015 with 29,026 cases, over a total of 69,562,748 person years. Considering the most robust data, the incidence rate ratio between the decade 1990–1999 and 2000–2009 provides an estimated relative risk of 4.21 (95% CI; 4.11–4.32). If we compare the limited data available in 1988–1989 and 2010–2015, there is an estimated 75 times (95% CI 49.56–115.04) increased rate of diagnosis. Originality/value The broadening of diagnostic criteria and its increasing application in clinical practice needs further consideration to ensure individuals receive the most appropriate personalised support. A true rise in the incidence of autism will influence the level of service provision required in future with the potential for significant under resourcing. More detailed assessment of the clinical characteristics of those diagnosed will help predict risk factors for specialist service involvement in future.

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自闭症谱系障碍的发病率增加:我们是否过度诊断了?

目的2016年，据估计，美国每54名儿童中就有1名患有自闭症，而1955年这一比例为2500分之一。这项研究旨在考虑全球发病率是否随着时间的推移而上升，这是导致患病率上升的原因。设计/方法/方法对具有严格纳入标准的文献进行系统回顾，以确定大型基于人群的研究，这些研究包括具有明确诊断标准的原始发病率数据。将纳入研究的数据汇总并进行描述性分析，以比较十年的发病率。发现7项研究被纳入最终定量分析，包括1988年至2015年的发病率数据，共29026例，总人数为69562748人年。考虑到最可靠的数据，1990-1999年和2000-2009年这十年的发病率比提供了4.21的估计相对风险（95%CI；4.11-4.32）。如果我们比较1988-1989年和2010-2015年的有限数据，估计诊断率增加了75倍（95%CI 49.56-115.04）。独创性/价值诊断标准的扩大及其在临床实践中的日益应用需要进一步考虑，以确保个人获得最合适的个性化支持。自闭症发病率的真正上升将影响未来所需的服务水平，并可能导致资源严重不足。对确诊患者的临床特征进行更详细的评估将有助于预测未来参与专科服务的风险因素。

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

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.