Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia.
BMJ Open. 2012 Oct 25;2(5). doi: 10.1136/bmjopen-2012-001918. Print 2012.
To evaluate health professionals' agreement with components of published diagnostic criteria for fetal alcohol spectrum disorders (FASD) in order to guide the development of standard diagnostic guidelines for Australia.
A modified Delphi process was used to assess agreement among health professionals with expertise or experience in FASD screening or diagnosis. An online survey, which included 36 Likert statements on diagnostic methods, was administered over two survey rounds. For fetal alcohol syndrome (FAS), health professionals were presented with concepts from the Institute of Medicine (IOM), University of Washington (UW), Centers for Disease Control (CDC), revised IOM and Canadian diagnostic criteria. For partial FAS (PFAS), alcohol-related neurodevelopmental disorder (ARND), and alcohol-related birth defects (ARBD), concepts based on the IOM and the Canadian diagnostic criteria were compared.
SETTING/PARTICIPANTS: 130 Australian and 9 international health professionals.
Of 139 health professionals invited to complete the survey, 103 (74.1%) responded, and 74 (53.2%) completed one or more questions on diagnostic criteria. We found consensus agreement among participants on the diagnostic criteria for FAS, with the UW criteria most commonly endorsed when compared with all other published criteria for FAS. When health professionals were presented with concepts based on the Canadian and IOM diagnostic criteria, we found consensus agreement but no clear preference for either the Canadian or IOM criteria for the diagnosis of PFAS, and no consensus agreement on diagnostic criteria for ARND. We also found no consensus on the IOM diagnostic criteria for ARBD.
Participants indicated clear support for use of the UW diagnostic criteria for FAS in Australia. These findings should be used to develop guidelines to facilitate improved awareness of, and address identified gaps in the infrastructure for, FASD diagnosis in Australia.
评估健康专业人员对已发表的胎儿酒精谱系障碍（FASD）诊断标准中各组成部分的认同度，以指导澳大利亚制定标准诊断指南。
采用改良 Delphi 法评估有 FASD 筛查或诊断专业知识或经验的健康专业人员之间的一致性。一项在线调查，其中包括 36 个关于诊断方法的李克特量表陈述，在两轮调查中进行。对于胎儿酒精综合征（FAS），健康专业人员接受了来自医学研究所（IOM）、华盛顿大学（UW）、疾病控制中心（CDC）、修订后的 IOM 和加拿大诊断标准的概念。对于部分 FAS（PFAS）、酒精相关神经发育障碍（ARND）和酒精相关出生缺陷（ARBD），则比较了基于 IOM 和加拿大诊断标准的概念。
设置/参与者：130 名澳大利亚和 9 名国际健康专业人员。
在受邀完成调查的 139 名健康专业人员中，有 103 名（74.1%）做出了回应，其中 74 名（53.2%）完成了一项或多项诊断标准问题。我们发现参与者对 FAS 的诊断标准达成了共识，与所有其他已发表的 FAS 标准相比，UW 标准最常被认可。当健康专业人员接受基于加拿大和 IOM 诊断标准的概念时，我们发现存在共识，但对于 PFAS 的诊断，既没有明确偏好加拿大标准，也没有明确偏好 IOM 标准，对于 ARND 的诊断标准也没有达成共识。我们还发现，IOM 关于 ARBD 的诊断标准也没有达成共识。
参与者明确表示支持在澳大利亚使用 UW 诊断标准用于 FAS。这些发现应被用于制定指南，以促进提高对澳大利亚 FASD 诊断的认识，并解决在基础设施方面发现的差距。
