用德语评估自闭症的新型筛查工具:RAADS-R(RADS-R)德语版的验证。

IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY
Jördis Rausch, Thomas Fangmeier, Christine M Falter-Wagner, Helene Ackermann, Julia Espelöer, Lars P Hölzel, Andreas Riedel, Ariella Ritvo, Kai Vogeley, Ludger Tebartz van Elst
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引用次数: 0

摘要

Ritvo 自闭症阿斯伯格诊断量表-修订版(RAADS-R)在最初的研究中取得了优异的成绩,灵敏度为 97%,特异度为 100%(Ritvo 等人,载于《自闭症与发展》(J Autism Dev Disord)41:1076-1089,2011 年)。因此,它被纳入了美国国家健康与护理卓越研究所(NICE)的指南(建议|成人自闭症谱系障碍:诊断与管理|指南|NICE,2022 年)。问卷包括 80 个问题,涉及四个子类别(语言、社交关系、限定兴趣、感官运动)。迄今为止,尽管感觉运动子类别是 DSM-5 中规定的诊断标准的一部分(Falkai 等人,载于 Diagnostisches Und Statistisches Manual Psychischer Störungen DSM-5。Hogrefe, 2015)和 ICD-11 (ICD-11 for Mortality and Morbidity Statistics, 2022)中规定的诊断标准。在验证研究中,我们对 299 人(根据 ICD-10 F84.0、F84.5,110 人患有 ASD,64 人患有原发性精神障碍(PMD),125 人无精神障碍)进行了德语翻译版问卷测试。为了提高该工具在临床日常实践中的实用性,与最初的研究不同,问卷由参与者在没有临床医生在场的情况下完成。精神病学诊断是按照最高标准确定的,心理测量学特性也是按照既定方案计算的。德文版 RADS-R 的结果非常好,灵敏度高达 92.5%,特异性高达 93.6%。曲线下面积(AUC = 0.976)表明 RADS-R 具有很高的质量和判别能力。此外,ROC 曲线分析表明,在德文版 RAADS-R 中,区分 ASD 组和非 ASD 组的最佳阈值是 81 分。与RADS-R相比,共同使用的社交反应量表(SRS)、自闭症谱系商数(AQ)和移情商数(EQ)在该样本中的特异性稍好,但灵敏度较差。研究对象包括根据ICD-10(F84.0、F84.5)已被诊断为ASD的患者,无论是否患有原发性精神障碍,因此我们无法确定合并症对RADS-R结果的影响。此外,自我报告问卷的客观性通常有限,可能会造成症状的虚假表述。RADS-R 与其他调查问卷相比具有很好的可比性,可以提供有价值的额外信息。在德国,它可能会成为对患者有帮助的诊断工具。我们建议将德文版 RADS-R 命名为 "Ritvo 自闭症诊断量表-rRevised",以反映术语的变化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A novel screening instrument for the assessment of autism in German language: validation of the German version of the RAADS-R, the RADS-R.

The Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R) demonstrated excellent results in its original study, with a sensitivity of 97% and a specificity of 100% (Ritvo et al. in J Autism Dev Disord 41:1076-1089, 2011). As a result, it was included in the National Institute for Health and Care Excellence (NICE) guidelines (Recommendations | Autism spectrum disorder in adults: diagnosis and management | Guidance | NICE, 2022). The questionnaire includes 80 questions across four subcategories (language, social relatedness, circumscribed interests, sensory motor). So far, the subcategory sensory motor has not been addressed in most available instruments, despite being part of the diagnostic criteria specified in DSM-5 (Falkai et al., in Diagnostisches Und Statistisches Manual Psychischer Störungen DSM-5. Hogrefe, 2015) and ICD-11 (ICD-11 for Mortality and Morbidity Statistics, 2022). In our validation study, we tested a translated German version of the questionnaire in 299 individuals (110 persons with ASD according to ICD-10 F84.0, F84.5, 64 persons with an primary mental disorders (PMD), 125 persons with no disorders). To enhance the practical use of the instrument in clinical everyday practice, the questionnaire was completed by the participants without the presence of a clinician-unlike the original study. Psychiatric diagnoses were established following the highest standards, and psychometric properties were calculated using established protocols. The German version of the RADS-R yielded very good results, with a high sensitivity of 92.5% and a high specificity of 93.6%. The area under the curve (AUC = 0.976), indicates a high quality and discriminatory power of RADS-R. Furthermore, the ROC curve analysis showed that the optimal threshold to distinguish between the ASD and non-ASD groups in the German version of the RAADS-R is a score of 81. In comparison to the RADS-R, the co-administered instruments Social Responsiveness Scale (SRS), Autism Spectrum Quotient (AQ), and Empathy Quotient (EQ) each showed slightly better specificity but worse sensitivity in this sample.The study included individuals already diagnosed with ASD according to ICD-10 (F84.0, F84.5), with or without an primary mental disorders, preventing us from identifying the influence of comorbidities on the RADS-R results. In addition, a self-report questionnaire has generally only limited objectivity and may allow for false representation of the symptoms. The RADS-R compares well with other questionnaires and can provide valuable additional information. It could turn out to be a helpful diagnostic tool for patients in Germany. We propose naming the German version RADS-R (Ritvo Autism Diagnostic Scale - rRevised) to reflect the change in terminology.

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来源期刊
CiteScore
8.80
自引率
4.30%
发文量
154
审稿时长
6-12 weeks
期刊介绍: The original papers published in the European Archives of Psychiatry and Clinical Neuroscience deal with all aspects of psychiatry and related clinical neuroscience. Clinical psychiatry, psychopathology, epidemiology as well as brain imaging, neuropathological, neurophysiological, neurochemical and moleculargenetic studies of psychiatric disorders are among the topics covered. Thus both the clinician and the neuroscientist are provided with a handy source of information on important scientific developments.
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