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Meta-Analysis
. 2024 Mar 13:79:100323.
doi: 10.1016/j.clinsp.2023.100323. eCollection 2024.

Screening and diagnostic tools for autism spectrum disorder: Systematic review and meta-analysis

Clara Lucato Dos Santos  1 , Indyanara Inacio Barreto  2 , Idevaldo Floriano  3 , Luca Schiliró Tristão  4 , Antonio Silvinato  5 , Wanderley Marques Bernardo  6
Affiliations
Meta-Analysis

Screening and diagnostic tools for autism spectrum disorder: Systematic review and meta-analysis

Clara Lucato Dos Santos et al. Clinics (Sao Paulo). .

Abstract

Introduction: Autism Spectrum Disorder (ASD) is a heterogeneous neurodevelopmental disorder, with main manifestations related to communication, social interaction, and behavioral patterns. The slight dynamics of change in the child over time require that the onset of clinical manifestations presented by the child be more valued, with the aim of stabilizing the condition. Faced with a variety of methods for diagnosing ASD, the question arises as to which method should be used. This systematic review aims to recommend the best tools to perform screening and diagnosis.

Methodology: This systematic review followed the PRISMA guidelines. The databases MEDLINE, Embase, CENTRAL (Cochrane), and Lilacs were accessed, and gray and manual searches were performed. The search strategy was created with terms referring to autism and the diagnosis/broad filter. The studies were qualitatively evaluated and quantitatively. Statistical analysis was performed using Meta-diSc-2.0 software, the confidence interval was 95 %.

Results: The M-CHAT-R/F tool demonstrated a sensitivity of 78 % (95 % CI 0.57‒0.91) and specificity of 0.98 (95 % CI 0.88-1.00). The diagnostic tools demonstrated sensitivity and specificity respectively of: ADOS, sensitivity of 87 % (95 % CI 0.79‒0.92) and specificity 75 % (95 % CI 0.73‒0.78); ADI-R demonstrated test sensitivity of 77 % (95 % CI 0.56‒0.90) and specificity 68 % (95 % CI 0.52‒0.81), CARS test sensitivity was 89 % (95 % CI 0.78‒0.95) and specificity 79 % (95 % CI 0.65‒0.88).

Conclusion: It is mandatory to apply a screening test, the most recommended being the M-CHAT-R/F. For diagnosis CARS and ADOS are the most recommended tools.

Keywords: Autism; Children; Diagnosis; Screening.

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Conflict of interest statement

Declaration of Competing Interest The authors declare no conflicts of interest.

Figures

Fig 1
Fig. 1
Forest plot sensitivity – screening test.
Fig 2
Fig. 2
Forest plot specificity – screening test.
Fig 3
Fig. 3
Forest plot sensitivity – diagnostic tests.
Fig 4
Fig. 4
Forest plot specificity – diagnostic tests.
Fig 5
Fig. 5
Forest plot sensitivity ‒ ADOS test.
Fig 6
Fig. 6
Forest plot specificity ‒ ADOS test.
Fig 7
Fig. 7
Forest plot sensitivity ‒ ADI-R test.
Fig 8
Fig. 8
Forest plot specificity ‒ ADI-R test.
Fig 9
Fig. 9
Forest plot sensitivity ‒ CARS test.
Fig 10
Fig. 10
Forest plot specificity ‒ CARS test.
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