Assessing the validity of administrative health data for the identification of children and youth with autism spectrum disorder in Ontario / Jennifer D. BROOKS in Autism Research, 14-5 (May 2021)  

Public ISBD [article]  inAutism Research > 14-5 (May 2021) . - p.1037-1045 Titre : Assessing the validity of administrative health data for the identification of children and youth with autism spectrum disorder in Ontario Type de document : texte imprimé Auteurs : Jennifer D. BROOKS, Auteur ; Jasleen ARNEJA, Auteur ; Longdi FU, Auteur ; Farah E. SAXENA, Auteur ; Karen TU, Auteur ; Virgiliu Bogdan PINZARU, Auteur ; Evdokia ANAGNOSTOU, Auteur ; Kirk NYLEN, Auteur ; Natasha R. SAUNDERS, Auteur ; Hong LU, Auteur ; John MCLAUGHLIN, Auteur ; Susan E. BRONSKILL, Auteur Article en page(s) : p.1037-1045 Langues : Anglais (eng) Mots-clés : Ontario  administrative health data  algorithm  autism Index. décimale : PER Périodiques Résumé : Population-level identification of children and youth with ASD is essential for surveillance and planning for required services. The objective of this study was to develop and validate an algorithm for the identification of children and youth with ASD using administrative health data. In this retrospective validation study, we linked an electronic medical record (EMR)-based reference standard, consisting 10,000 individuals aged 1-24 years, including 112 confirmed ASD cases to Ontario administrative health data, for the testing of multiple case-finding algorithms. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and corresponding 95% confidence intervals (CI) were calculated for each algorithm. The optimal algorithm was validated in three external cohorts representing family practice, education, and specialized clinical settings. The optimal algorithm included an ASD diagnostic code for a single hospital discharge or emergency department visit or outpatient surgery, or three ASD physician billing codes in 3 years. This algorithm's sensitivity was 50.0% (95%CI 40.7-88.7%), specificity 99.6% (99.4-99.7), PPV 56.6% (46.8-66.3), and NPV 99.4% (99.3-99.6). The results of this study illustrate limitations and need for cautious interpretation when using administrative health data alone for the identification of children and youth with ASD. LAY SUMMARY: We tested algorithms (set of rules) to identify young people with ASD using routinely collected administrative health data. Even the best algorithm misses more than half of those in Ontario with ASD. To understand this better, we tested how well the algorithm worked in different settings (family practice, education, and specialized clinics). The identification of individuals with ASD at a population level is essential for planning for support services and the allocation of resources. Autism Res 2021, 14: 1037-1045. © 2021 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals LLC. En ligne : http://dx.doi.org/10.1002/aur.2491 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=444 [article] Assessing the validity of administrative health data for the identification of children and youth with autism spectrum disorder in Ontario [texte imprimé] / Jennifer D. BROOKS, Auteur ; Jasleen ARNEJA, Auteur ; Longdi FU, Auteur ; Farah E. SAXENA, Auteur ; Karen TU, Auteur ; Virgiliu Bogdan PINZARU, Auteur ; Evdokia ANAGNOSTOU, Auteur ; Kirk NYLEN, Auteur ; Natasha R. SAUNDERS, Auteur ; Hong LU, Auteur ; John MCLAUGHLIN, Auteur ; Susan E. BRONSKILL, Auteur . - p.1037-1045. Langues : Anglais (eng) in Autism Research > 14-5 (May 2021) . - p.1037-1045 Mots-clés : Ontario  administrative health data  algorithm  autism Index. décimale : PER Périodiques Résumé : Population-level identification of children and youth with ASD is essential for surveillance and planning for required services. The objective of this study was to develop and validate an algorithm for the identification of children and youth with ASD using administrative health data. In this retrospective validation study, we linked an electronic medical record (EMR)-based reference standard, consisting 10,000 individuals aged 1-24 years, including 112 confirmed ASD cases to Ontario administrative health data, for the testing of multiple case-finding algorithms. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and corresponding 95% confidence intervals (CI) were calculated for each algorithm. The optimal algorithm was validated in three external cohorts representing family practice, education, and specialized clinical settings. The optimal algorithm included an ASD diagnostic code for a single hospital discharge or emergency department visit or outpatient surgery, or three ASD physician billing codes in 3 years. This algorithm's sensitivity was 50.0% (95%CI 40.7-88.7%), specificity 99.6% (99.4-99.7), PPV 56.6% (46.8-66.3), and NPV 99.4% (99.3-99.6). The results of this study illustrate limitations and need for cautious interpretation when using administrative health data alone for the identification of children and youth with ASD. LAY SUMMARY: We tested algorithms (set of rules) to identify young people with ASD using routinely collected administrative health data. Even the best algorithm misses more than half of those in Ontario with ASD. To understand this better, we tested how well the algorithm worked in different settings (family practice, education, and specialized clinics). The identification of individuals with ASD at a population level is essential for planning for support services and the allocation of resources. Autism Res 2021, 14: 1037-1045. © 2021 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals LLC. En ligne : http://dx.doi.org/10.1002/aur.2491 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=444

Identifying Children and Youth With Autism Spectrum Disorder in Electronic Medical Records: Examining Health System Utilization and Comorbidities / Jennifer D. BROOKS in Autism Research, 14-2 (February 2021)  

Public ISBD [article]  inAutism Research > 14-2 (February 2021) . - p.400-410 Titre : Identifying Children and Youth With Autism Spectrum Disorder in Electronic Medical Records: Examining Health System Utilization and Comorbidities Type de document : texte imprimé Auteurs : Jennifer D. BROOKS, Auteur ; Susan E. BRONSKILL, Auteur ; Longdi FU, Auteur ; Farah E. SAXENA, Auteur ; Jasleen ARNEJA, Auteur ; Virgiliu Bogdan PINZARU, Auteur ; Evdokia ANAGNOSTOU, Auteur ; Kirk NYLEN, Auteur ; John MCLAUGHLIN, Auteur ; Karen TU, Auteur Article en page(s) : p.400-410 Langues : Anglais (eng) Mots-clés : Asd  algorithm  autism  comorbidity  electronic medical record  health system use Index. décimale : PER Périodiques Résumé : Autism spectrum disorder (ASD) is a neurodevelopmental disorder requiring significant health and educational resources for affected individuals. A reference standard for ASD was generated from an existing population-based cohort of 10,000 children and youth aged 1-24 years who were randomly selected for chart abstraction from 29,256 patients from 119 family physicians. We developed and validated an algorithm to identify children and youth with ASD within an electronic medical record system (N = 80,237, aged 1-24 years) in order to examine the prevalence of comorbidities and quantify health system utilization within the cohort. We identified 1,062 children and youth with ASD representing a prevalence of 1.32%. Compared to individuals without ASD, those with ASD had a higher prevalence of asthma, were more likely to visit a specialist, undergo surgery, and be hospitalized for psychiatric reasons. Children and youth with ASD in Ontario have complex health system needs, illustrated through a significant burden of comorbidities and increased health system utilization. LAY SUMMARY: Our paper generates population-based estimates of health system use by children and youth with ASD, who have a higher burden of comorbidities than the general population. We developed a case-finding algorithm and applied it in electronic medical records to create a cohort of children and youth with ASD, thereby generating an important resource to further study the health care needs of individuals with ASD. En ligne : http://dx.doi.org/10.1002/aur.2419 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=441 [article] Identifying Children and Youth With Autism Spectrum Disorder in Electronic Medical Records: Examining Health System Utilization and Comorbidities [texte imprimé] / Jennifer D. BROOKS, Auteur ; Susan E. BRONSKILL, Auteur ; Longdi FU, Auteur ; Farah E. SAXENA, Auteur ; Jasleen ARNEJA, Auteur ; Virgiliu Bogdan PINZARU, Auteur ; Evdokia ANAGNOSTOU, Auteur ; Kirk NYLEN, Auteur ; John MCLAUGHLIN, Auteur ; Karen TU, Auteur . - p.400-410. Langues : Anglais (eng) in Autism Research > 14-2 (February 2021) . - p.400-410 Mots-clés : Asd  algorithm  autism  comorbidity  electronic medical record  health system use Index. décimale : PER Périodiques Résumé : Autism spectrum disorder (ASD) is a neurodevelopmental disorder requiring significant health and educational resources for affected individuals. A reference standard for ASD was generated from an existing population-based cohort of 10,000 children and youth aged 1-24 years who were randomly selected for chart abstraction from 29,256 patients from 119 family physicians. We developed and validated an algorithm to identify children and youth with ASD within an electronic medical record system (N = 80,237, aged 1-24 years) in order to examine the prevalence of comorbidities and quantify health system utilization within the cohort. We identified 1,062 children and youth with ASD representing a prevalence of 1.32%. Compared to individuals without ASD, those with ASD had a higher prevalence of asthma, were more likely to visit a specialist, undergo surgery, and be hospitalized for psychiatric reasons. Children and youth with ASD in Ontario have complex health system needs, illustrated through a significant burden of comorbidities and increased health system utilization. LAY SUMMARY: Our paper generates population-based estimates of health system use by children and youth with ASD, who have a higher burden of comorbidities than the general population. We developed a case-finding algorithm and applied it in electronic medical records to create a cohort of children and youth with ASD, thereby generating an important resource to further study the health care needs of individuals with ASD. En ligne : http://dx.doi.org/10.1002/aur.2419 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=441

Primary Care Provider and Child Characteristics Associated with Age of Diagnosis of Autism Spectrum Disorder: A Population-Based Cohort Study / Ayesha SIDDIQUA in Journal of Autism and Developmental Disorders, 52-7 (July 2022)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 52-7 (July 2022) . - p.2896-2910 Titre : Primary Care Provider and Child Characteristics Associated with Age of Diagnosis of Autism Spectrum Disorder: A Population-Based Cohort Study Type de document : texte imprimé Auteurs : Ayesha SIDDIQUA, Auteur ; Magdalena JANUS, Auteur ; Ronit MESTERMAN, Auteur ; Eric DUKU, Auteur ; Kathy GEORGIADES, Auteur ; Farah E. SAXENA, Auteur ; Haoyu ZHAO, Auteur ; Natasha R. SAUNDERS, Auteur Article en page(s) : p.2896-2910 Langues : Anglais (eng) Mots-clés : Autism Spectrum Disorder/diagnosis/epidemiology  Child  Cohort Studies  Family  Humans  Ontario/epidemiology  Primary Health Care  Autism spectrum disorder  Developmental disabilities  Diagnosis  Early development instrument  Kindergarten  Paediatricians  Primary care Index. décimale : PER Périodiques Résumé : In a cohort of kindergarten children in Ontario, Canada with Autism Spectrum Disorder (ASD) (n=1522), we tested the association of age at ASD diagnosis and characteristics of (1) the child's primary care provider and, (2) the child using health administrative databases. We tested the association of primary care practice model and time from developmental delay identification to age at ASD diagnosis. Older age of diagnosis was associated with provider foreign training (vs. domestic) (adjusted Hazard Ratio [aHR] 1.17, 95% CI 1.03, 1.33) but not sex, care model, and years of practice. After developmental delay identification, children with paediatricians had longer time to diagnosis than children with providers in care models (aHR 0.68, 95% CI 0.54, 0.86). Findings can be used to inform primary care provider ASD training. En ligne : http://dx.doi.org/10.1007/s10803-021-05165-8 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=477 [article] Primary Care Provider and Child Characteristics Associated with Age of Diagnosis of Autism Spectrum Disorder: A Population-Based Cohort Study [texte imprimé] / Ayesha SIDDIQUA, Auteur ; Magdalena JANUS, Auteur ; Ronit MESTERMAN, Auteur ; Eric DUKU, Auteur ; Kathy GEORGIADES, Auteur ; Farah E. SAXENA, Auteur ; Haoyu ZHAO, Auteur ; Natasha R. SAUNDERS, Auteur . - p.2896-2910. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 52-7 (July 2022) . - p.2896-2910 Mots-clés : Autism Spectrum Disorder/diagnosis/epidemiology  Child  Cohort Studies  Family  Humans  Ontario/epidemiology  Primary Health Care  Autism spectrum disorder  Developmental disabilities  Diagnosis  Early development instrument  Kindergarten  Paediatricians  Primary care Index. décimale : PER Périodiques Résumé : In a cohort of kindergarten children in Ontario, Canada with Autism Spectrum Disorder (ASD) (n=1522), we tested the association of age at ASD diagnosis and characteristics of (1) the child's primary care provider and, (2) the child using health administrative databases. We tested the association of primary care practice model and time from developmental delay identification to age at ASD diagnosis. Older age of diagnosis was associated with provider foreign training (vs. domestic) (adjusted Hazard Ratio [aHR] 1.17, 95% CI 1.03, 1.33) but not sex, care model, and years of practice. After developmental delay identification, children with paediatricians had longer time to diagnosis than children with providers in care models (aHR 0.68, 95% CI 0.54, 0.86). Findings can be used to inform primary care provider ASD training. En ligne : http://dx.doi.org/10.1007/s10803-021-05165-8 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=477

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