Screening Tools for Autism Spectrum Disorder in Primary Care: A Systematic Evidence Review

作者：Susan E. Levy, Audrey E Wolfe, Daniel L. Coury, John C. Duby, Justin G. Farmer, Edward L. Schor, Jeanne Van Cleave, Zachary Warren · 发表于：PEDIATRICS · 年份：2020 · DOI：10.1542/peds.2019-1895h · 被引用次数：58 · 研究领域：Autism Spectrum Disorder Research、Child Nutrition and Feeding Issues、Behavioral and Psychological Studies

CONTEXT: Recommendations conflict regarding universal application of formal screening instruments in primary care (PC) and PC-like settings for autism spectrum disorder (ASD). OBJECTIVES: We systematically reviewed evidence for universal screening of children for ASD in PC. DATA SOURCES: We searched Medline, PsychInfo, Educational Resources Informational Clearinghouse, and Cumulative Index of Nursing and Allied Health Literature. STUDY SELECTION: We included studies in which researchers report psychometric properties of screening tools in unselected populations across PC and PC-like settings. DATA EXTRACTION: At least 2 authors reviewed each study, extracted data, checked accuracy, and assigned quality ratings using predefined criteria. RESULTS: We found evidence for moderate to high positive predictive values for ASD screening tools to identify children aged 16 to 40 months and 1 study for ≥48 months in PC and PC-like settings. Limited evidence evaluating sensitivity, specificity, and negative predictive value of instruments was available. No studies directly evaluated the impact of screening on treatment or harm. LIMITATIONS: Potential limitations include publication bias, selective reporting within studies, and a constrained search. CONCLUSIONS: ASD screening tools can be used to accurately identify percentages of unselected populations of young children for ASD in PC and PC-like settings. The scope of challenges associated with establishing direct linkage suggests that cl...