{"title":"加拿大成人孤独症患病率：模拟模型研究的结果。","authors":"Erin Collins, Rojiemiahd Edjoc, Amy Farrow, Christoffer Dharma, Stelios Georgiades, Kieran Holmes, Christa Orchard, Siobhan O'Donnell, Sarah Palmeter, Mackenzie Salt, Ahmed Al-Jaishi","doi":"10.1136/bmjopen-2024-089414","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To estimate the prevalence of autism among adults living in Canada.</p><p><strong>Design: </strong>A Monte Carlo simulation modelling approach was employed. Input parameters included adult population estimates and mortality rates; autism population all-cause mortality risk ratios; and autism prevalence estimates derived from child and youth data due to the lack of adult data. This approach was executed through 10 000 simulations, with each iteration generating a distinct data scenario. Prevalence estimates were reported as the mean with the 2.5th and 97.5th percentiles, corresponding to a 95% simulation interval (SI).</p><p><strong>Setting: </strong>Where possible, Canadian data sources were used, including the 2019 Canadian Health Survey on Children and Youth and Statistics Canada mortality rates and population estimates.</p><p><strong>Primary outcome measure: </strong>National prevalence estimates of autistic adults living in private dwellings in Canada, with variations in prevalence by sex at birth and province/territory considered.</p><p><strong>Results: </strong>The findings suggest the prevalence of autism among adults in Canada to be 1.8% (95% SI 1.6%, 2.0%). National prevalence estimates by sex at birth were 0.7% (95% SI 0.6%, 0.9%) for females and 2.9% (95% SI 2.6%, 3.2%) for males. Provincial/territorial estimates ranged from 0.7% in Saskatchewan (95% SI 0.3%, 1.3%) to 3.6% in New Brunswick (95% SI 2.4%, 5.1%).</p><p><strong>Conclusions: </strong>The limited availability of data on autistic adults constrains our ability to fully understand and address their unique needs. In this study, autism prevalence was estimated based on diagnosed cases, which excludes individuals without a formal diagnosis. Additionally, other factors such as data availability and methodological assumptions may influence the modelling of prevalence estimates. As a result, our findings should be interpreted within the context of these limitations. Nevertheless, this study provides a valuable reference point for understanding autism prevalence among adults in Canada.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 6","pages":"e089414"},"PeriodicalIF":2.4000,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198838/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prevalence of autism among adults in Canada: results from a simulation modelling study.\",\"authors\":\"Erin Collins, Rojiemiahd Edjoc, Amy Farrow, Christoffer Dharma, Stelios Georgiades, Kieran Holmes, Christa Orchard, Siobhan O'Donnell, Sarah Palmeter, Mackenzie Salt, Ahmed Al-Jaishi\",\"doi\":\"10.1136/bmjopen-2024-089414\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To estimate the prevalence of autism among adults living in Canada.</p><p><strong>Design: </strong>A Monte Carlo simulation modelling approach was employed. Input parameters included adult population estimates and mortality rates; autism population all-cause mortality risk ratios; and autism prevalence estimates derived from child and youth data due to the lack of adult data. This approach was executed through 10 000 simulations, with each iteration generating a distinct data scenario. Prevalence estimates were reported as the mean with the 2.5th and 97.5th percentiles, corresponding to a 95% simulation interval (SI).</p><p><strong>Setting: </strong>Where possible, Canadian data sources were used, including the 2019 Canadian Health Survey on Children and Youth and Statistics Canada mortality rates and population estimates.</p><p><strong>Primary outcome measure: </strong>National prevalence estimates of autistic adults living in private dwellings in Canada, with variations in prevalence by sex at birth and province/territory considered.</p><p><strong>Results: </strong>The findings suggest the prevalence of autism among adults in Canada to be 1.8% (95% SI 1.6%, 2.0%). National prevalence estimates by sex at birth were 0.7% (95% SI 0.6%, 0.9%) for females and 2.9% (95% SI 2.6%, 3.2%) for males. Provincial/territorial estimates ranged from 0.7% in Saskatchewan (95% SI 0.3%, 1.3%) to 3.6% in New Brunswick (95% SI 2.4%, 5.1%).</p><p><strong>Conclusions: </strong>The limited availability of data on autistic adults constrains our ability to fully understand and address their unique needs. In this study, autism prevalence was estimated based on diagnosed cases, which excludes individuals without a formal diagnosis. Additionally, other factors such as data availability and methodological assumptions may influence the modelling of prevalence estimates. As a result, our findings should be interpreted within the context of these limitations. Nevertheless, this study provides a valuable reference point for understanding autism prevalence among adults in Canada.</p>\",\"PeriodicalId\":9158,\"journal\":{\"name\":\"BMJ Open\",\"volume\":\"15 6\",\"pages\":\"e089414\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-06-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198838/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMJ Open\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/bmjopen-2024-089414\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/bmjopen-2024-089414","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
目的：估计加拿大成年人中自闭症的患病率。设计：采用蒙特卡罗模拟建模方法。输入参数包括成人人口估计数和死亡率；自闭症人群全因死亡率风险比；由于缺乏成人数据，自闭症患病率估计来自儿童和青少年数据。这种方法通过10000次模拟执行，每次迭代生成一个不同的数据场景。患病率估计报告为2.5和97.5%的平均值，对应于95%的模拟区间（SI）。环境：尽可能使用加拿大的数据来源，包括2019年加拿大儿童和青年健康调查以及加拿大统计局的死亡率和人口估计数。主要结果测量：加拿大私人住宅中自闭症成年人的全国患病率估计，考虑到出生时性别和省/地区的患病率差异。结果：研究结果表明，加拿大成人自闭症患病率为1.8% （95% SI为1.6%,2.0%）。按出生时性别分列的全国患病率估计为女性0.7% (95% SI为0.6%,0.9%)，男性2.9% （95% SI为2.6%,3.2%）。各省/地区的估计范围从萨斯喀彻温省的0.7% （95% SI 0.3%, 1.3%）到新不伦瑞克省的3.6% （95% SI 2.4%, 5.1%）。结论：自闭症成人数据的有限可用性限制了我们充分理解和解决他们独特需求的能力。在这项研究中，自闭症患病率是根据诊断病例估计的，排除了没有正式诊断的个体。此外，数据可得性和方法学假设等其他因素也可能影响流行率估计的建模。因此，我们的研究结果应该在这些局限性的背景下进行解释。然而，这项研究为了解加拿大成人自闭症患病率提供了一个有价值的参考点。
Prevalence of autism among adults in Canada: results from a simulation modelling study.
Objective: To estimate the prevalence of autism among adults living in Canada.
Design: A Monte Carlo simulation modelling approach was employed. Input parameters included adult population estimates and mortality rates; autism population all-cause mortality risk ratios; and autism prevalence estimates derived from child and youth data due to the lack of adult data. This approach was executed through 10 000 simulations, with each iteration generating a distinct data scenario. Prevalence estimates were reported as the mean with the 2.5th and 97.5th percentiles, corresponding to a 95% simulation interval (SI).
Setting: Where possible, Canadian data sources were used, including the 2019 Canadian Health Survey on Children and Youth and Statistics Canada mortality rates and population estimates.
Primary outcome measure: National prevalence estimates of autistic adults living in private dwellings in Canada, with variations in prevalence by sex at birth and province/territory considered.
Results: The findings suggest the prevalence of autism among adults in Canada to be 1.8% (95% SI 1.6%, 2.0%). National prevalence estimates by sex at birth were 0.7% (95% SI 0.6%, 0.9%) for females and 2.9% (95% SI 2.6%, 3.2%) for males. Provincial/territorial estimates ranged from 0.7% in Saskatchewan (95% SI 0.3%, 1.3%) to 3.6% in New Brunswick (95% SI 2.4%, 5.1%).
Conclusions: The limited availability of data on autistic adults constrains our ability to fully understand and address their unique needs. In this study, autism prevalence was estimated based on diagnosed cases, which excludes individuals without a formal diagnosis. Additionally, other factors such as data availability and methodological assumptions may influence the modelling of prevalence estimates. As a result, our findings should be interpreted within the context of these limitations. Nevertheless, this study provides a valuable reference point for understanding autism prevalence among adults in Canada.
期刊介绍：
BMJ Open is an online, open access journal, dedicated to publishing medical research from all disciplines and therapeutic areas. The journal publishes all research study types, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Publishing procedures are built around fully open peer review and continuous publication, publishing research online as soon as the article is ready.
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