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Auteur R. E. FRYE |
Documents disponibles écrits par cet auteur (3)
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Clustering of co-occurring conditions in autism spectrum disorder during early childhood: A retrospective analysis of medical claims data / T. VARGASON in Autism Research, 12-8 (August 2019)
[article]
Titre : Clustering of co-occurring conditions in autism spectrum disorder during early childhood: A retrospective analysis of medical claims data Type de document : Texte imprimé et/ou numérique Auteurs : T. VARGASON, Auteur ; R. E. FRYE, Auteur ; D. L. MCGUINNESS, Auteur ; J. HAHN, Auteur Article en page(s) : p.1272-1285 Langues : Anglais (eng) Mots-clés : k-means clustering autism spectrum disorder co-occurring condition comorbidity medical claims retrospective analysis Index. décimale : PER Périodiques Résumé : Individuals with autism spectrum disorder (ASD) are frequently affected by co-occurring medical conditions (COCs), which vary in severity, age of onset, and pathophysiological characteristics. The presence of COCs contributes to significant heterogeneity in the clinical presentation of ASD between individuals and a better understanding of COCs may offer greater insight into the etiology of ASD in specific subgroups while also providing guidance for diagnostic and treatment protocols. This study retrospectively analyzed medical claims data from a private United States health plan between years 2000 and 2015 to investigate patterns of COC diagnoses in a cohort of 3,278 children with ASD throughout their first 5 years of enrollment compared to 279,693 children from the general population without ASD diagnoses (POP cohort). Three subgroups of children with ASD were identified by k-means clustering using these COC patterns. The first cluster was characterized by generally high rates of COC diagnosis and comprised 23.7% (n = 776) of the cohort. Diagnoses of developmental delays were dominant in the second cluster containing 26.5% (n = 870) of the cohort. Children in the third cluster, making up 49.8% (n = 1,632) of the cohort, had the lowest rates of COC diagnosis, which were slightly higher than rates observed in the POP cohort. A secondary analysis using these data found that gastrointestinal and immune disorders showed similar longitudinal patterns of prevalence, as did seizure and sleep disorders. These findings may help to better inform the development of diagnostic workup and treatment protocols for COCs in children with ASD. Autism Res 2019, 12: 1272-1285. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Medical conditions that co-occur with autism spectrum disorder (ASD) vary significantly from person to person. This study analyzed patterns in diagnosis of co-occurring conditions from medical claims data and observed three subtypes of children with ASD. These results may aid with screening for co-occurring conditions in children with ASD and with understanding ASD subtypes. En ligne : http://dx.doi.org/10.1002/aur.2128 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=405
in Autism Research > 12-8 (August 2019) . - p.1272-1285[article] Clustering of co-occurring conditions in autism spectrum disorder during early childhood: A retrospective analysis of medical claims data [Texte imprimé et/ou numérique] / T. VARGASON, Auteur ; R. E. FRYE, Auteur ; D. L. MCGUINNESS, Auteur ; J. HAHN, Auteur . - p.1272-1285.
Langues : Anglais (eng)
in Autism Research > 12-8 (August 2019) . - p.1272-1285
Mots-clés : k-means clustering autism spectrum disorder co-occurring condition comorbidity medical claims retrospective analysis Index. décimale : PER Périodiques Résumé : Individuals with autism spectrum disorder (ASD) are frequently affected by co-occurring medical conditions (COCs), which vary in severity, age of onset, and pathophysiological characteristics. The presence of COCs contributes to significant heterogeneity in the clinical presentation of ASD between individuals and a better understanding of COCs may offer greater insight into the etiology of ASD in specific subgroups while also providing guidance for diagnostic and treatment protocols. This study retrospectively analyzed medical claims data from a private United States health plan between years 2000 and 2015 to investigate patterns of COC diagnoses in a cohort of 3,278 children with ASD throughout their first 5 years of enrollment compared to 279,693 children from the general population without ASD diagnoses (POP cohort). Three subgroups of children with ASD were identified by k-means clustering using these COC patterns. The first cluster was characterized by generally high rates of COC diagnosis and comprised 23.7% (n = 776) of the cohort. Diagnoses of developmental delays were dominant in the second cluster containing 26.5% (n = 870) of the cohort. Children in the third cluster, making up 49.8% (n = 1,632) of the cohort, had the lowest rates of COC diagnosis, which were slightly higher than rates observed in the POP cohort. A secondary analysis using these data found that gastrointestinal and immune disorders showed similar longitudinal patterns of prevalence, as did seizure and sleep disorders. These findings may help to better inform the development of diagnostic workup and treatment protocols for COCs in children with ASD. Autism Res 2019, 12: 1272-1285. (c) 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Medical conditions that co-occur with autism spectrum disorder (ASD) vary significantly from person to person. This study analyzed patterns in diagnosis of co-occurring conditions from medical claims data and observed three subtypes of children with ASD. These results may aid with screening for co-occurring conditions in children with ASD and with understanding ASD subtypes. En ligne : http://dx.doi.org/10.1002/aur.2128 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=405 Correction to: Randomized controlled trial of sulforaphane and metabolite discovery in children with Autism Spectrum Disorder / Andrew W. ZIMMERMAN in Molecular Autism, 12 (2021)
[article]
Titre : Correction to: Randomized controlled trial of sulforaphane and metabolite discovery in children with Autism Spectrum Disorder Type de document : Texte imprimé et/ou numérique Auteurs : Andrew W. ZIMMERMAN, Auteur ; K. SINGH, Auteur ; S. L. CONNORS, Auteur ; H. LIU, Auteur ; Anita A PANJWANI, Auteur ; L. C. LEE, Auteur ; E. DIGGINS, Auteur ; A. FOLEY, Auteur ; S. MELNYK, Auteur ; I. N. SINGH, Auteur ; S. JILL JAMES, Auteur ; R. E. FRYE, Auteur ; J. W. FAHEY, Auteur Article en page(s) : 44 p. Langues : Anglais (eng) Index. décimale : PER Périodiques En ligne : http://dx.doi.org/10.1186/s13229-021-00451-9 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=459
in Molecular Autism > 12 (2021) . - 44 p.[article] Correction to: Randomized controlled trial of sulforaphane and metabolite discovery in children with Autism Spectrum Disorder [Texte imprimé et/ou numérique] / Andrew W. ZIMMERMAN, Auteur ; K. SINGH, Auteur ; S. L. CONNORS, Auteur ; H. LIU, Auteur ; Anita A PANJWANI, Auteur ; L. C. LEE, Auteur ; E. DIGGINS, Auteur ; A. FOLEY, Auteur ; S. MELNYK, Auteur ; I. N. SINGH, Auteur ; S. JILL JAMES, Auteur ; R. E. FRYE, Auteur ; J. W. FAHEY, Auteur . - 44 p.
Langues : Anglais (eng)
in Molecular Autism > 12 (2021) . - 44 p.
Index. décimale : PER Périodiques En ligne : http://dx.doi.org/10.1186/s13229-021-00451-9 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=459 Randomized controlled trial of sulforaphane and metabolite discovery in children with Autism Spectrum Disorder / Andrew W. ZIMMERMAN in Molecular Autism, 12 (2021)
[article]
Titre : Randomized controlled trial of sulforaphane and metabolite discovery in children with Autism Spectrum Disorder Type de document : Texte imprimé et/ou numérique Auteurs : Andrew W. ZIMMERMAN, Auteur ; K. SINGH, Auteur ; S. L. CONNORS, Auteur ; H. LIU, Auteur ; Anita A PANJWANI, Auteur ; L. C. LEE, Auteur ; E. DIGGINS, Auteur ; A. FOLEY, Auteur ; S. MELNYK, Auteur ; I. N. SINGH, Auteur ; S. J. JAMES, Auteur ; R. E. FRYE, Auteur ; J. W. FAHEY, Auteur Article en page(s) : 38 p. Langues : Anglais (eng) Mots-clés : Autism spectrum disorder (ASD) Biomarkers Clinical trial Placebo effects Sulforaphane defendants in matters related to pediatric neurology and Autism Spectrum Disorder. JWF retired from the full-time faculty at Johns Hopkins in mid-2020, and now serves as a scientific advisor to Brassica Protection Products LLC (Baltimore, MD, USA), which produces a glucoraphanin-rich broccoli seed extract that it supplies to the supplement industry. AWZ is named on a patent on the use of sulforaphane for the treatment of autism that has been assigned to Johns Hopkins University. Index. décimale : PER Périodiques Résumé : BACKGROUND: Sulforaphane (SF), an isothiocyanate in broccoli, has potential benefits relevant to autism spectrum disorder (ASD) through its effects on several metabolic and immunologic pathways. Previous clinical trials of oral SF demonstrated positive clinical effects on behavior in young men and changes in urinary metabolomics in children with ASD. METHODS: We conducted a 15-week randomized parallel double-blind placebo-controlled clinical trial with 15-week open-label treatment and 6-week no-treatment extensions in 57 children, ages 3-12 years, with ASD over 36 weeks. Twenty-eight were assigned SF and 29 received placebo (PL). Clinical effects, safety and tolerability of SF were measured as were biomarkers to elucidate mechanisms of action of SF in ASD. RESULTS: Data from 22 children taking SF and 23 on PL were analyzed. Treatment effects on the primary outcome measure, the Ohio Autism Clinical Impressions Scale (OACIS), in the general level of autism were not significant between SF and PL groups at 7 and 15 weeks. The effect sizes on the OACIS were non-statistically significant but positive, suggesting a possible trend toward greater improvement in those on treatment with SF (Cohen's d 0.21; 95% CI -?0.46, 0.88 and 0.10; 95% CI -?0.52, 0.72, respectively). Both groups improved in all subscales when on SF during the open-label phase. Caregiver ratings on secondary outcome measures improved significantly on the Aberrant Behavior Checklist (ABC) at 15 weeks (Cohen's d -?0.96; 95% CI -?1.73, -?0.15), but not on the Social Responsiveness Scale-2 (SRS-2). Ratings on the ABC and SRS-2 improved with a non-randomized analysis of the length of exposure to SF, compared to the pre-treatment baseline (p?0.001). There were significant changes with SF compared to PL in biomarkers of glutathione redox status, mitochondrial respiration, inflammatory markers and heat shock proteins. Clinical laboratory studies confirmed product safety. SF was very well tolerated and side effects of treatment, none serious, included rare insomnia, irritability and intolerance of the taste and smell. LIMITATIONS: The sample size was limited to 45 children with ASD and we did not impute missing data. We were unable to document significant changes in clinical assessments during clinical visits in those taking SF compared to PL. The clinical results were confounded by placebo effects during the open-label phase. CONCLUSIONS: SF led to small yet non-statistically significant changes in the total and all subscale scores of the primary outcome measure, while for secondary outcome measures, caregivers' assessments of children taking SF showed statistically significant improvements compared to those taking PL on the ABC but not the SRS-2. Clinical effects of SF were less notable in children compared to our previous trial of a SF-rich preparation in young men with ASD. Several of the effects of SF on biomarkers correlated to clinical improvements. SF was very well tolerated and safe and effective based on our secondary clinical measures. TRIAL REGISTRATION: This study was prospectively registered at clinicaltrials.gov (NCT02561481) on September 28, 2015. Funding was provided by the U.S. Department of Defense. En ligne : http://dx.doi.org/10.1186/s13229-021-00447-5 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=459
in Molecular Autism > 12 (2021) . - 38 p.[article] Randomized controlled trial of sulforaphane and metabolite discovery in children with Autism Spectrum Disorder [Texte imprimé et/ou numérique] / Andrew W. ZIMMERMAN, Auteur ; K. SINGH, Auteur ; S. L. CONNORS, Auteur ; H. LIU, Auteur ; Anita A PANJWANI, Auteur ; L. C. LEE, Auteur ; E. DIGGINS, Auteur ; A. FOLEY, Auteur ; S. MELNYK, Auteur ; I. N. SINGH, Auteur ; S. J. JAMES, Auteur ; R. E. FRYE, Auteur ; J. W. FAHEY, Auteur . - 38 p.
Langues : Anglais (eng)
in Molecular Autism > 12 (2021) . - 38 p.
Mots-clés : Autism spectrum disorder (ASD) Biomarkers Clinical trial Placebo effects Sulforaphane defendants in matters related to pediatric neurology and Autism Spectrum Disorder. JWF retired from the full-time faculty at Johns Hopkins in mid-2020, and now serves as a scientific advisor to Brassica Protection Products LLC (Baltimore, MD, USA), which produces a glucoraphanin-rich broccoli seed extract that it supplies to the supplement industry. AWZ is named on a patent on the use of sulforaphane for the treatment of autism that has been assigned to Johns Hopkins University. Index. décimale : PER Périodiques Résumé : BACKGROUND: Sulforaphane (SF), an isothiocyanate in broccoli, has potential benefits relevant to autism spectrum disorder (ASD) through its effects on several metabolic and immunologic pathways. Previous clinical trials of oral SF demonstrated positive clinical effects on behavior in young men and changes in urinary metabolomics in children with ASD. METHODS: We conducted a 15-week randomized parallel double-blind placebo-controlled clinical trial with 15-week open-label treatment and 6-week no-treatment extensions in 57 children, ages 3-12 years, with ASD over 36 weeks. Twenty-eight were assigned SF and 29 received placebo (PL). Clinical effects, safety and tolerability of SF were measured as were biomarkers to elucidate mechanisms of action of SF in ASD. RESULTS: Data from 22 children taking SF and 23 on PL were analyzed. Treatment effects on the primary outcome measure, the Ohio Autism Clinical Impressions Scale (OACIS), in the general level of autism were not significant between SF and PL groups at 7 and 15 weeks. The effect sizes on the OACIS were non-statistically significant but positive, suggesting a possible trend toward greater improvement in those on treatment with SF (Cohen's d 0.21; 95% CI -?0.46, 0.88 and 0.10; 95% CI -?0.52, 0.72, respectively). Both groups improved in all subscales when on SF during the open-label phase. Caregiver ratings on secondary outcome measures improved significantly on the Aberrant Behavior Checklist (ABC) at 15 weeks (Cohen's d -?0.96; 95% CI -?1.73, -?0.15), but not on the Social Responsiveness Scale-2 (SRS-2). Ratings on the ABC and SRS-2 improved with a non-randomized analysis of the length of exposure to SF, compared to the pre-treatment baseline (p?0.001). There were significant changes with SF compared to PL in biomarkers of glutathione redox status, mitochondrial respiration, inflammatory markers and heat shock proteins. Clinical laboratory studies confirmed product safety. SF was very well tolerated and side effects of treatment, none serious, included rare insomnia, irritability and intolerance of the taste and smell. LIMITATIONS: The sample size was limited to 45 children with ASD and we did not impute missing data. We were unable to document significant changes in clinical assessments during clinical visits in those taking SF compared to PL. The clinical results were confounded by placebo effects during the open-label phase. CONCLUSIONS: SF led to small yet non-statistically significant changes in the total and all subscale scores of the primary outcome measure, while for secondary outcome measures, caregivers' assessments of children taking SF showed statistically significant improvements compared to those taking PL on the ABC but not the SRS-2. Clinical effects of SF were less notable in children compared to our previous trial of a SF-rich preparation in young men with ASD. Several of the effects of SF on biomarkers correlated to clinical improvements. SF was very well tolerated and safe and effective based on our secondary clinical measures. TRIAL REGISTRATION: This study was prospectively registered at clinicaltrials.gov (NCT02561481) on September 28, 2015. Funding was provided by the U.S. Department of Defense. En ligne : http://dx.doi.org/10.1186/s13229-021-00447-5 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=459