Replication study for ADOS-2 cut-offs to assist evaluation of autism spectrum disorder / Ji Su HONG in Autism Research, 15-11 (November 2022)  

Public ISBD [article]  inAutism Research > 15-11 (November 2022) . - p.2181-2191 Titre : Replication study for ADOS-2 cut-offs to assist evaluation of autism spectrum disorder Type de document : texte imprimé Auteurs : Ji Su HONG, Auteur ; Vini SINGH, Auteur ; Luke G. KALB, Auteur ; Rachel REETZKE, Auteur ; Natasha N. LUDWIG, Auteur ; Danika PFEIFFER, Auteur ; Calliope HOLINGUE, Auteur ; Deepa MENON, Auteur ; Qing LU, Auteur ; Ahlam ASHKAR, Auteur ; Rebecca LANDA, Auteur Article en page(s) : p.2181-2191 Langues : Anglais (eng) Mots-clés : Child  Humans  Male  Female  Autism Spectrum Disorder/diagnosis  Sensitivity and Specificity  Predictive Value of Tests  Algorithms  Autistic Disorder  autism spectrum disorder  classification  cut-off score  diagnosis Index. décimale : PER Périodiques Résumé : The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) has been widely used for ASD assessment. While prior studies investigated sensitivity and specificity of ADOS-2 Modules 1-3, there has been limited research addressing algorithm cut-off scores to optimize ADOS-2 classification. The goal of this study was to assess algorithm cut-off scores for diagnosing ASD with Modules 1-3, and to evaluate alignment of the ADOS-2 classification with the best estimate clinical diagnosis. Participants included 3144 children aged 31 months or older who received ADOS-2 Modules 1-3, as well as the best estimate clinical diagnosis. Five classification statistics were reported for each module: sensitivity, specificity, positive predictive value, negative predictive value, and accuracy (i.e., Receiver Operator Classification Statistic), and these statistics were calculated for the optimal cut-off score. Frequency tables were used to compare ADOS-2 classification and the best estimate clinical diagnosis. Half of the sample received Module 3, 21% received Module 2, and 29% received Module 1. The overall prevalence of ASD was 60%; the male-to-female ratio was 4:1, and half of the sample was non-White. Across all modules, the autism spectrum cut-off score from the ADOS-2 manual resulted in high sensitivity (95%+) and low specificity (63%-73%). The autism cut-off score resulted in better specificity (76%-86%) with favorable sensitivity (81%-94%). The optimal cut-off scores for all modules based on the current sample were within the autism spectrum classification range except Module 2 Algorithm 2. In the No ASD group, 29% had false positives (ADOS-2 autism spectrum classification or autism classification). The ADOS-2 autism spectrum classification did not indicate directionality for diagnostic outcome (ASD 56% vs. No ASD 44%). While cut-off scores of ADOS-2 Modules 1-3 in the manual yielded good clinical utility in ASD assessment, false positives and low predictability of the autism spectrum classification remain challenging for clinicians. En ligne : http://dx.doi.org/10.1002/aur.2801 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=488 [article] Replication study for ADOS-2 cut-offs to assist evaluation of autism spectrum disorder [texte imprimé] / Ji Su HONG, Auteur ; Vini SINGH, Auteur ; Luke G. KALB, Auteur ; Rachel REETZKE, Auteur ; Natasha N. LUDWIG, Auteur ; Danika PFEIFFER, Auteur ; Calliope HOLINGUE, Auteur ; Deepa MENON, Auteur ; Qing LU, Auteur ; Ahlam ASHKAR, Auteur ; Rebecca LANDA, Auteur . - p.2181-2191. Langues : Anglais (eng) in Autism Research > 15-11 (November 2022) . - p.2181-2191 Mots-clés : Child  Humans  Male  Female  Autism Spectrum Disorder/diagnosis  Sensitivity and Specificity  Predictive Value of Tests  Algorithms  Autistic Disorder  autism spectrum disorder  classification  cut-off score  diagnosis Index. décimale : PER Périodiques Résumé : The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) has been widely used for ASD assessment. While prior studies investigated sensitivity and specificity of ADOS-2 Modules 1-3, there has been limited research addressing algorithm cut-off scores to optimize ADOS-2 classification. The goal of this study was to assess algorithm cut-off scores for diagnosing ASD with Modules 1-3, and to evaluate alignment of the ADOS-2 classification with the best estimate clinical diagnosis. Participants included 3144 children aged 31 months or older who received ADOS-2 Modules 1-3, as well as the best estimate clinical diagnosis. Five classification statistics were reported for each module: sensitivity, specificity, positive predictive value, negative predictive value, and accuracy (i.e., Receiver Operator Classification Statistic), and these statistics were calculated for the optimal cut-off score. Frequency tables were used to compare ADOS-2 classification and the best estimate clinical diagnosis. Half of the sample received Module 3, 21% received Module 2, and 29% received Module 1. The overall prevalence of ASD was 60%; the male-to-female ratio was 4:1, and half of the sample was non-White. Across all modules, the autism spectrum cut-off score from the ADOS-2 manual resulted in high sensitivity (95%+) and low specificity (63%-73%). The autism cut-off score resulted in better specificity (76%-86%) with favorable sensitivity (81%-94%). The optimal cut-off scores for all modules based on the current sample were within the autism spectrum classification range except Module 2 Algorithm 2. In the No ASD group, 29% had false positives (ADOS-2 autism spectrum classification or autism classification). The ADOS-2 autism spectrum classification did not indicate directionality for diagnostic outcome (ASD 56% vs. No ASD 44%). While cut-off scores of ADOS-2 Modules 1-3 in the manual yielded good clinical utility in ASD assessment, false positives and low predictability of the autism spectrum classification remain challenging for clinicians. En ligne : http://dx.doi.org/10.1002/aur.2801 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=488

Replication study of ADOS-2 Toddler Module cut-off scores for autism spectrum disorder classification / Ji Su HONG in Autism Research, 14-6 (June 2021)  

Public ISBD [article]  inAutism Research > 14-6 (June 2021) . - p.1284-1295 Titre : Replication study of ADOS-2 Toddler Module cut-off scores for autism spectrum disorder classification Type de document : texte imprimé Auteurs : Ji Su HONG, Auteur ; Vini SINGH, Auteur ; Luther G. KALB, Auteur ; Ahlam ASHKAR, Auteur ; Rebecca LANDA, Auteur Article en page(s) : p.1284-1295 Langues : Anglais (eng) Mots-clés : Algorithms  Autism Spectrum Disorder/diagnosis  Autistic Disorder  Child, Preschool  Humans  Infant  ROC Curve  Sensitivity and Specificity  autism spectrum disorder  classification  diagnosis  validity Index. décimale : PER Périodiques Résumé : The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) has been regarded as the gold standard assessment of autism spectrum disorder (ASD). While clinical validity of ADOS-2 Modules 1-4 have been extensively studied, there has been very limited research examining the clinical validity of ADOS-2 Toddler Module. The goal of this study was to examine alignment of the ADOS-2 Toddler Module classification with clinicians' determination of ASD, with assessing cut-off scores for diagnosing ASD in toddlers. A total of 412 toddlers ages 12-30 months who received ADOS-2 Toddler Module as well as a best estimate clinical (BEC) diagnosis, were included in this study. ADOS-2 Toddler Module cut-off scores were determined using the appropriate algorithms (Algorithm 1 for toddlers aged 12-20 months and those aged 21-30 months with <5 words, Algorithm 2 for toddlers aged 21-30 months with 5 words or more). Receiver operating characteristic (ROC) curves were used to assess cut-off scores that optimized sensitivity and specificity when compared against BEC diagnosis. The selected cut-off scores were examined using frequency tables to compare ADOS-2 classification against BEC diagnosis. For Algorithm 1, classification statistics were optimized at the cut-off score of 12 with an area under the curve (AUC) of 0.92. For Algorithm 2, classification statistics were optimized at the cut-off score of 10 with an AUC of 0.96. The ADOS-2 Toddler Module classification is strongly aligned with BEC diagnosis. The optimal cut-off scores identified in the current study reflect the same results configured by the prior study. LAY SUMMARY: ADOS-2 Toddler Module has been widely used for the ASD assessment, but there have been limited research on its clinical validity. This study is the first replication of the ADOS-2 Toddler Module with a large independent sample. We examined alignment of the ADOS-2 Toddler Module classification with clinicians' determination of ASD, with assessing cut-off scores, and confirmed the clinical validity of ADOS-2 Toddler Module. Cut-off scores of ADOS-2 Toddler Module cited in the manual yielded best clinical utility for diagnosing ASD in toddlers. En ligne : http://dx.doi.org/10.1002/aur.2496 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=449 [article] Replication study of ADOS-2 Toddler Module cut-off scores for autism spectrum disorder classification [texte imprimé] / Ji Su HONG, Auteur ; Vini SINGH, Auteur ; Luther G. KALB, Auteur ; Ahlam ASHKAR, Auteur ; Rebecca LANDA, Auteur . - p.1284-1295. Langues : Anglais (eng) in Autism Research > 14-6 (June 2021) . - p.1284-1295 Mots-clés : Algorithms  Autism Spectrum Disorder/diagnosis  Autistic Disorder  Child, Preschool  Humans  Infant  ROC Curve  Sensitivity and Specificity  autism spectrum disorder  classification  diagnosis  validity Index. décimale : PER Périodiques Résumé : The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) has been regarded as the gold standard assessment of autism spectrum disorder (ASD). While clinical validity of ADOS-2 Modules 1-4 have been extensively studied, there has been very limited research examining the clinical validity of ADOS-2 Toddler Module. The goal of this study was to examine alignment of the ADOS-2 Toddler Module classification with clinicians' determination of ASD, with assessing cut-off scores for diagnosing ASD in toddlers. A total of 412 toddlers ages 12-30 months who received ADOS-2 Toddler Module as well as a best estimate clinical (BEC) diagnosis, were included in this study. ADOS-2 Toddler Module cut-off scores were determined using the appropriate algorithms (Algorithm 1 for toddlers aged 12-20 months and those aged 21-30 months with <5 words, Algorithm 2 for toddlers aged 21-30 months with 5 words or more). Receiver operating characteristic (ROC) curves were used to assess cut-off scores that optimized sensitivity and specificity when compared against BEC diagnosis. The selected cut-off scores were examined using frequency tables to compare ADOS-2 classification against BEC diagnosis. For Algorithm 1, classification statistics were optimized at the cut-off score of 12 with an area under the curve (AUC) of 0.92. For Algorithm 2, classification statistics were optimized at the cut-off score of 10 with an AUC of 0.96. The ADOS-2 Toddler Module classification is strongly aligned with BEC diagnosis. The optimal cut-off scores identified in the current study reflect the same results configured by the prior study. LAY SUMMARY: ADOS-2 Toddler Module has been widely used for the ASD assessment, but there have been limited research on its clinical validity. This study is the first replication of the ADOS-2 Toddler Module with a large independent sample. We examined alignment of the ADOS-2 Toddler Module classification with clinicians' determination of ASD, with assessing cut-off scores, and confirmed the clinical validity of ADOS-2 Toddler Module. Cut-off scores of ADOS-2 Toddler Module cited in the manual yielded best clinical utility for diagnosing ASD in toddlers. En ligne : http://dx.doi.org/10.1002/aur.2496 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=449

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