Evidence-based use of scalable biomarkers to increase diagnostic efficiency and decrease the lifetime costs of autism / T. W. FRAZIER in Autism Research, 14-6 (June 2021)  

Public ISBD [article]  inAutism Research > 14-6 (June 2021) . - p.1271-1283 Titre : Evidence-based use of scalable biomarkers to increase diagnostic efficiency and decrease the lifetime costs of autism Type de document : Texte imprimé et/ou numérique Auteurs : T. W. FRAZIER, Auteur ; D. L. COURY, Auteur ; K. SOHL, Auteur ; Kayla E. WAGNER, Auteur ; R. UHLIG, Auteur ; S. D. HICKS, Auteur ; F. A. MIDDLETON, Auteur Article en page(s) : p.1271-1283 Langues : Anglais (eng) Mots-clés : Autism Spectrum Disorder/diagnosis  Autistic Disorder  Biomarkers  Child  Early Diagnosis  Humans  Mass Screening  United States  autism spectrum disorder  biomarkers  cost analysis  early diagnosis  evidence-based assessment  developer of the eye tracking test that was used in the EBM analysis. Thomas W.  Frazier has received federal funding or research support from, acted as a consultant  to, received travel support from, and/or received a speaker's honorarium from  Quadrant Biosciences, Impel NeuroPharma, F. Hoffmann?La Roche AG Pharmaceuticals,  the Cole Family Research Fund, Simons Foundation, Ingalls Foundation, Forest  Laboratories, Ecoeos, IntegraGen, Kugona LLC, Shire Development, Bristol?Myers  Squibb, Roche Pharma, National Institutes of Health, and the Brain and Behavior  Research Foundation and has an investor stake in AutismEYES LLC. Steven D. Hicks and  Frank A. Middleton are co?developers of the saliva RNA based autism test that is  used in the EBM analysis, and members of the Clinical and Scientific Advisory Boards  of Quadrant Biosciences. Kristin Sohl is director of ECHO Autism and both Kristin  Sohl and Daniel L. Coury are a member of the Clinical Advisory Board of Quadrant  Biosciences. Daniel L. Coury has received federal funding or research support from  National Institutes of Health, GW Biosciences, Neurim, Stemina Biosciences, and  Stalicla SA  and acted as a consultant to BioRosa, Cognoa, GW Biosciences, and  Stalicla SA. Kayla E. Wagner and Richard Uhlig are employees of Quadrant  Biosciences. Quadrant Biosciences holds patent rights and exclusive sales rights for  the Clarifi ASD saliva test. Index. décimale : PER Périodiques Résumé : Challenges associated with the current screening and diagnostic process for autism spectrum disorder (ASD) in the US cause a significant delay in the initiation of evidence-based interventions at an early age when treatments are most effective. The present study shows how implementing a second-order diagnostic measure to high risk cases initially flagged positive from screening tools can further inform clinical judgment and substantially improve early identification. We use two example measures for the purposes of this demonstration; a saliva test and eye-tracking technology, both scalable and easy-to-implement biomarkers recently introduced in ASD research. Results of the current cost-savings analysis indicate that lifetime societal cost savings in special education, medical and residential care are estimated to be nearly $580,000 per ASD child, with annual cost savings in education exceeding $13.3 billion, and annual cost savings in medical and residential care exceeding $23.8 billion (of these, nearly $11.2 billion are attributable to Medicaid). These savings total more than $37 billion/year in societal savings in the US. Initiating appropriate interventions faster and reducing the number of unnecessary diagnostic evaluations can decrease the lifetime costs of ASD to society. We demonstrate the value of implementing a scalable highly accurate diagnostic in terms of cost savings to the US. LAY SUMMARY: This paper demonstrates how biomarkers with high accuracy for detecting autism spectrum disorder (ASD) could be used to increase the efficiency of early diagnosis. Results also show that, if more children with ASD are identified early and referred for early intervention services, the system would realize substantial costs savings across the lifespan. En ligne : http://dx.doi.org/10.1002/aur.2498 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=449 [article] Evidence-based use of scalable biomarkers to increase diagnostic efficiency and decrease the lifetime costs of autism [Texte imprimé et/ou numérique] / T. W. FRAZIER, Auteur ; D. L. COURY, Auteur ; K. SOHL, Auteur ; Kayla E. WAGNER, Auteur ; R. UHLIG, Auteur ; S. D. HICKS, Auteur ; F. A. MIDDLETON, Auteur . - p.1271-1283. Langues : Anglais (eng) in Autism Research > 14-6 (June 2021) . - p.1271-1283 Mots-clés : Autism Spectrum Disorder/diagnosis  Autistic Disorder  Biomarkers  Child  Early Diagnosis  Humans  Mass Screening  United States  autism spectrum disorder  biomarkers  cost analysis  early diagnosis  evidence-based assessment  developer of the eye tracking test that was used in the EBM analysis. Thomas W.  Frazier has received federal funding or research support from, acted as a consultant  to, received travel support from, and/or received a speaker's honorarium from  Quadrant Biosciences, Impel NeuroPharma, F. Hoffmann?La Roche AG Pharmaceuticals,  the Cole Family Research Fund, Simons Foundation, Ingalls Foundation, Forest  Laboratories, Ecoeos, IntegraGen, Kugona LLC, Shire Development, Bristol?Myers  Squibb, Roche Pharma, National Institutes of Health, and the Brain and Behavior  Research Foundation and has an investor stake in AutismEYES LLC. Steven D. Hicks and  Frank A. Middleton are co?developers of the saliva RNA based autism test that is  used in the EBM analysis, and members of the Clinical and Scientific Advisory Boards  of Quadrant Biosciences. Kristin Sohl is director of ECHO Autism and both Kristin  Sohl and Daniel L. Coury are a member of the Clinical Advisory Board of Quadrant  Biosciences. Daniel L. Coury has received federal funding or research support from  National Institutes of Health, GW Biosciences, Neurim, Stemina Biosciences, and  Stalicla SA  and acted as a consultant to BioRosa, Cognoa, GW Biosciences, and  Stalicla SA. Kayla E. Wagner and Richard Uhlig are employees of Quadrant  Biosciences. Quadrant Biosciences holds patent rights and exclusive sales rights for  the Clarifi ASD saliva test. Index. décimale : PER Périodiques Résumé : Challenges associated with the current screening and diagnostic process for autism spectrum disorder (ASD) in the US cause a significant delay in the initiation of evidence-based interventions at an early age when treatments are most effective. The present study shows how implementing a second-order diagnostic measure to high risk cases initially flagged positive from screening tools can further inform clinical judgment and substantially improve early identification. We use two example measures for the purposes of this demonstration; a saliva test and eye-tracking technology, both scalable and easy-to-implement biomarkers recently introduced in ASD research. Results of the current cost-savings analysis indicate that lifetime societal cost savings in special education, medical and residential care are estimated to be nearly $580,000 per ASD child, with annual cost savings in education exceeding $13.3 billion, and annual cost savings in medical and residential care exceeding $23.8 billion (of these, nearly $11.2 billion are attributable to Medicaid). These savings total more than $37 billion/year in societal savings in the US. Initiating appropriate interventions faster and reducing the number of unnecessary diagnostic evaluations can decrease the lifetime costs of ASD to society. We demonstrate the value of implementing a scalable highly accurate diagnostic in terms of cost savings to the US. LAY SUMMARY: This paper demonstrates how biomarkers with high accuracy for detecting autism spectrum disorder (ASD) could be used to increase the efficiency of early diagnosis. Results also show that, if more children with ASD are identified early and referred for early intervention services, the system would realize substantial costs savings across the lifespan. En ligne : http://dx.doi.org/10.1002/aur.2498 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=449

Oral microbiome activity in children with autism spectrum disorder / S. D. HICKS in Autism Research, 11-9 (September 2018)  

Public ISBD [article]  inAutism Research > 11-9 (September 2018) . - p.1286-1299 Titre : Oral microbiome activity in children with autism spectrum disorder Type de document : Texte imprimé et/ou numérique Auteurs : S. D. HICKS, Auteur ; R. UHLIG, Auteur ; P. AFSHARI, Auteur ; J. WILLIAMS, Auteur ; M. CHRONEOS, Auteur ; C. TIERNEY-AVES, Auteur ; K. WAGNER, Auteur ; F. A. MIDDLETON, Auteur Article en page(s) : p.1286-1299 Langues : Anglais (eng) Mots-clés : autism spectrum disorder  developmental delay  gastrointestinal disturbance  microbiome  oropharynx  saliva Index. décimale : PER Périodiques Résumé : Autism spectrum disorder (ASD) is associated with several oropharyngeal abnormalities, including buccal sensory sensitivity, taste and texture aversions, speech apraxia, and salivary transcriptome alterations. Furthermore, the oropharynx represents the sole entry point to the gastrointestinal (GI) tract. GI disturbances and alterations in the GI microbiome are established features of ASD, and may impact behavior through the "microbial-gut-brain axis." Most studies of the ASD microbiome have used fecal samples. Here, we identified changes in the salivary microbiome of children aged 2-6 years across three developmental profiles: ASD (n = 180), nonautistic developmental delay (DD; n = 60), and typically developing (TD; n = 106) children. After RNA extraction and shotgun sequencing, actively transcribing taxa were quantified and tested for differences between groups and within ASD endophenotypes. A total of 12 taxa were altered between the developmental groups and 28 taxa were identified that distinguished ASD patients with and without GI disturbance, providing further evidence for the role of the gut-brain axis in ASD. Group classification accuracy was visualized with receiver operating characteristic curves and validated using a 50/50 hold-out procedure. Five microbial ratios distinguished ASD from TD participants (79.5% accuracy), three distinguished ASD from DD (76.5%), and three distinguished ASD children with/without GI disturbance (85.7%). Taxonomic pathways were assessed using the Kyoto Encyclopedia of Genes and Genomes microbial database and compared with one-way analysis of variance, revealing significant differences within energy metabolism and lysine degradation. Together, these results indicate that GI microbiome disruption in ASD extends to the oropharynx, and suggests oral microbiome profiling as a potential tool to evaluate ASD status. Autism Res 2018, 11: 1286-1299. (c) 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Previous research suggests that the bacteria living in the human gut may influence autistic behavior. This study examined genetic activity of microbes living in the mouth of over 300 children. The microbes with differences in children with autism were involved in energy processing and showed potential for identifying autism status. En ligne : http://dx.doi.org/10.1002/aur.1972 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=369 [article] Oral microbiome activity in children with autism spectrum disorder [Texte imprimé et/ou numérique] / S. D. HICKS, Auteur ; R. UHLIG, Auteur ; P. AFSHARI, Auteur ; J. WILLIAMS, Auteur ; M. CHRONEOS, Auteur ; C. TIERNEY-AVES, Auteur ; K. WAGNER, Auteur ; F. A. MIDDLETON, Auteur . - p.1286-1299. Langues : Anglais (eng) in Autism Research > 11-9 (September 2018) . - p.1286-1299 Mots-clés : autism spectrum disorder  developmental delay  gastrointestinal disturbance  microbiome  oropharynx  saliva Index. décimale : PER Périodiques Résumé : Autism spectrum disorder (ASD) is associated with several oropharyngeal abnormalities, including buccal sensory sensitivity, taste and texture aversions, speech apraxia, and salivary transcriptome alterations. Furthermore, the oropharynx represents the sole entry point to the gastrointestinal (GI) tract. GI disturbances and alterations in the GI microbiome are established features of ASD, and may impact behavior through the "microbial-gut-brain axis." Most studies of the ASD microbiome have used fecal samples. Here, we identified changes in the salivary microbiome of children aged 2-6 years across three developmental profiles: ASD (n = 180), nonautistic developmental delay (DD; n = 60), and typically developing (TD; n = 106) children. After RNA extraction and shotgun sequencing, actively transcribing taxa were quantified and tested for differences between groups and within ASD endophenotypes. A total of 12 taxa were altered between the developmental groups and 28 taxa were identified that distinguished ASD patients with and without GI disturbance, providing further evidence for the role of the gut-brain axis in ASD. Group classification accuracy was visualized with receiver operating characteristic curves and validated using a 50/50 hold-out procedure. Five microbial ratios distinguished ASD from TD participants (79.5% accuracy), three distinguished ASD from DD (76.5%), and three distinguished ASD children with/without GI disturbance (85.7%). Taxonomic pathways were assessed using the Kyoto Encyclopedia of Genes and Genomes microbial database and compared with one-way analysis of variance, revealing significant differences within energy metabolism and lysine degradation. Together, these results indicate that GI microbiome disruption in ASD extends to the oropharynx, and suggests oral microbiome profiling as a potential tool to evaluate ASD status. Autism Res 2018, 11: 1286-1299. (c) 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Previous research suggests that the bacteria living in the human gut may influence autistic behavior. This study examined genetic activity of microbes living in the mouth of over 300 children. The microbes with differences in children with autism were involved in energy processing and showed potential for identifying autism status. En ligne : http://dx.doi.org/10.1002/aur.1972 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=369

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