{"title":"联合使用两种主要筛查工具（K-SCQ和K-SRS-2）及设定新的临界值提高幼儿自闭症谱系障碍的诊断准确性","authors":"Yoojeong Lee, Guiyoung Bong, Da-Yea Song, Heejeong Yoo","doi":"10.30773/pi.2025.0015","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the diagnostic validity of primary screening instruments (Korean version of the Social Communication Questionnaire [K-SCQ] and Korean version of Social Responsiveness Scale second edition [K-SRS-2]) in Korean children aged 10-60 months and to examine patterns of validity across age. Additionally, we aimed to propose new cutoff values specific to age subgroups.</p><p><strong>Methods: </strong>The study included 1,326 children (autism spectrum disorder [ASD], n=822, M=41.79, SD=10.28; non-ASD, n=504, M=32.48, SD=10.88) divided by age (10-17, 18-29, 30-41, 42-53, and 54-60 months) who completed the instruments and underwent clinical best-estimate diagnostic evaluation. An optimal screening strategy was sought by calculating sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) based on instrument combinations. Receiver operating characteristic (ROC) analysis was conducted to determine the optimal novel cutoff values for the instruments in each age subgroup.</p><p><strong>Results: </strong>The validity of individual instruments varied significantly across age subgroups. However, there was some improvement in validity when applying \"either K-SCQ or K-SRS-2,\" especially in children aged 30 months and older (sensitivity, 83.3%-94.9%; specificity, 58.1%-90.9%; PPV, 21.7%-98.5%; NPV, 65.3%-96.2%). Estimated cutoff for K-SCQ were 13.5, 9.5, 10.5, 7.5, and 9.5 for ages 10-17, 18-29, 30-41, 42-53, and 54-60 months respectively (sensitivity, 82.4%-92.2%; specificity, 74.8%-90.9%). Estimated cutoffs for K-SRS-2 were 58.5, 54.5, 55.5, 55.5, and 52.5 for ages 10-17, 18-29, 30-41, 42-53, and 54-60 months, respectively (sensitivity, 50.0%-94.1%; specificity, 80.3%-97.7%).</p><p><strong>Conclusion: </strong>In children aged 30 to 60 months, the combination of either K-SCQ or K-SRS-2 allowed for accurate screening of ASD. To further improve accuracy, adjusted cutoff values can be applied based on age subgroups.</p>","PeriodicalId":21164,"journal":{"name":"Psychiatry Investigation","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Combination of Two Primary Screening Instruments (K-SCQ and K-SRS-2) and Setting of New Cutoff Values to Improve Diagnostic Accuracy of Autism Spectrum Disorder in Young Children.\",\"authors\":\"Yoojeong Lee, Guiyoung Bong, Da-Yea Song, Heejeong Yoo\",\"doi\":\"10.30773/pi.2025.0015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aimed to explore the diagnostic validity of primary screening instruments (Korean version of the Social Communication Questionnaire [K-SCQ] and Korean version of Social Responsiveness Scale second edition [K-SRS-2]) in Korean children aged 10-60 months and to examine patterns of validity across age. Additionally, we aimed to propose new cutoff values specific to age subgroups.</p><p><strong>Methods: </strong>The study included 1,326 children (autism spectrum disorder [ASD], n=822, M=41.79, SD=10.28; non-ASD, n=504, M=32.48, SD=10.88) divided by age (10-17, 18-29, 30-41, 42-53, and 54-60 months) who completed the instruments and underwent clinical best-estimate diagnostic evaluation. An optimal screening strategy was sought by calculating sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) based on instrument combinations. Receiver operating characteristic (ROC) analysis was conducted to determine the optimal novel cutoff values for the instruments in each age subgroup.</p><p><strong>Results: </strong>The validity of individual instruments varied significantly across age subgroups. However, there was some improvement in validity when applying \\\"either K-SCQ or K-SRS-2,\\\" especially in children aged 30 months and older (sensitivity, 83.3%-94.9%; specificity, 58.1%-90.9%; PPV, 21.7%-98.5%; NPV, 65.3%-96.2%). Estimated cutoff for K-SCQ were 13.5, 9.5, 10.5, 7.5, and 9.5 for ages 10-17, 18-29, 30-41, 42-53, and 54-60 months respectively (sensitivity, 82.4%-92.2%; specificity, 74.8%-90.9%). Estimated cutoffs for K-SRS-2 were 58.5, 54.5, 55.5, 55.5, and 52.5 for ages 10-17, 18-29, 30-41, 42-53, and 54-60 months, respectively (sensitivity, 50.0%-94.1%; specificity, 80.3%-97.7%).</p><p><strong>Conclusion: </strong>In children aged 30 to 60 months, the combination of either K-SCQ or K-SRS-2 allowed for accurate screening of ASD. To further improve accuracy, adjusted cutoff values can be applied based on age subgroups.</p>\",\"PeriodicalId\":21164,\"journal\":{\"name\":\"Psychiatry Investigation\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-06-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Psychiatry Investigation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.30773/pi.2025.0015\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Psychiatry Investigation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.30773/pi.2025.0015","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Combination of Two Primary Screening Instruments (K-SCQ and K-SRS-2) and Setting of New Cutoff Values to Improve Diagnostic Accuracy of Autism Spectrum Disorder in Young Children.
Objective: This study aimed to explore the diagnostic validity of primary screening instruments (Korean version of the Social Communication Questionnaire [K-SCQ] and Korean version of Social Responsiveness Scale second edition [K-SRS-2]) in Korean children aged 10-60 months and to examine patterns of validity across age. Additionally, we aimed to propose new cutoff values specific to age subgroups.
Methods: The study included 1,326 children (autism spectrum disorder [ASD], n=822, M=41.79, SD=10.28; non-ASD, n=504, M=32.48, SD=10.88) divided by age (10-17, 18-29, 30-41, 42-53, and 54-60 months) who completed the instruments and underwent clinical best-estimate diagnostic evaluation. An optimal screening strategy was sought by calculating sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) based on instrument combinations. Receiver operating characteristic (ROC) analysis was conducted to determine the optimal novel cutoff values for the instruments in each age subgroup.
Results: The validity of individual instruments varied significantly across age subgroups. However, there was some improvement in validity when applying "either K-SCQ or K-SRS-2," especially in children aged 30 months and older (sensitivity, 83.3%-94.9%; specificity, 58.1%-90.9%; PPV, 21.7%-98.5%; NPV, 65.3%-96.2%). Estimated cutoff for K-SCQ were 13.5, 9.5, 10.5, 7.5, and 9.5 for ages 10-17, 18-29, 30-41, 42-53, and 54-60 months respectively (sensitivity, 82.4%-92.2%; specificity, 74.8%-90.9%). Estimated cutoffs for K-SRS-2 were 58.5, 54.5, 55.5, 55.5, and 52.5 for ages 10-17, 18-29, 30-41, 42-53, and 54-60 months, respectively (sensitivity, 50.0%-94.1%; specificity, 80.3%-97.7%).
Conclusion: In children aged 30 to 60 months, the combination of either K-SCQ or K-SRS-2 allowed for accurate screening of ASD. To further improve accuracy, adjusted cutoff values can be applied based on age subgroups.
期刊介绍：
The Psychiatry Investigation is published on the 25th day of every month in English by the Korean Neuropsychiatric Association (KNPA). The Journal covers the whole range of psychiatry and neuroscience. Both basic and clinical contributions are encouraged from all disciplines and research areas relevant to the pathophysiology and management of neuropsychiatric disorders and symptoms, as well as researches related to cross cultural psychiatry and ethnic issues in psychiatry. The Journal publishes editorials, review articles, original articles, brief reports, viewpoints and correspondences. All research articles are peer reviewed. Contributions are accepted for publication on the condition that their substance has not been published or submitted for publication elsewhere. Authors submitting papers to the Journal (serially or otherwise) with a common theme or using data derived from the same sample (or a subset thereof) must send details of all relevant previous publications and simultaneous submissions. The Journal is not responsible for statements made by contributors. Material in the Journal does not necessarily reflect the views of the Editor or of the KNPA. Manuscripts accepted for publication are copy-edited to improve readability and to ensure conformity with house style.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
