自闭症谱系障碍INCLEN诊断工具（INDT-ASD）：开发与验证

INCLEN Diagnostic Tool for Autism Spectrum Disorder (INDT-ASD): development and validation.

作者信息

Juneja Monica, Mishra Devendra, Russell Paul S S, Gulati Sheffali, Deshmukh Vaishali, Tudu Poma, Sagar Rajesh, Silberberg Donald, Bhutani Vinod K, Pinto Jennifer M, Durkin Maureen, Pandey Ravindra M, Nair M K C, Arora Narendra K

机构信息

INCLEN Trust International, New Delhi, India. Correspondence to: Dr Narendra K Arora, Executive Director, The INCLEN TRUST International, F1/5, Okhla Industrial Area, Phase-1, New Delhi, India.

出版信息

Indian Pediatr. 2014 May;51(5):359-65. doi: 10.1007/s13312-014-0417-9.

DOI:10.1007/s13312-014-0417-9

PMID:24953575

Abstract

OBJECTIVE

To develop and validate INCLEN Diagnostic Tool for Autism Spectrum Disorder (INDT-ASD).

DESIGN

Diagnostic test evaluation by cross sectional design.

SETTING

Four tertiary pediatric neurology centers in Delhi and Thiruvanthapuram, India.

METHODS

Children aged 2-9 years were enrolled in the study. INDT-ASD and Childhood Autism Rating Scale (CARS) were administered in a randomly decided sequence by trained psychologist, followed by an expert evaluation by DSM-IV TR diagnostic criteria (gold standard).

MAIN OUTCOME MEASURES

Psychometric parameters of diagnostic accuracy, validity (construct, criterion and convergent) and internal consistency.

RESULTS

154 children (110 boys, mean age 64.2 mo) were enrolled. The overall diagnostic accuracy (AUC=0.97, 95% CI 0.93, 0.99; P<0.001) and validity (sensitivity 98%, specificity 95%, positive predictive value 91%, negative predictive value 99%) of INDT-ASD for Autism spectrum disorder were high, taking expert diagnosis using DSM-IV-TR as gold standard. The concordance rate between the INDT-ASD and expert diagnosis for 'ASD group' was 82.52% [Cohen's k=0.89; 95% CI (0.82, 0.97); P=0.001]. The internal consistency of INDT-ASD was 0.96. The convergent validity with CARS (r = 0.73, P= 0.001) and divergent validity with Binet-Kamat Test of intelligence (r = -0.37; P=0.004) were significantly high. INDT-ASD has a 4-factor structure explaining 85.3% of the variance.

CONCLUSIONS

INDT-ASD has high diagnostic accuracy, adequate content validity, good internal consistency high criterion validity and high to moderate convergent validity and 4-factor construct validity for diagnosis of Autistm spectrum disorder.

摘要

目的

开发并验证自闭症谱系障碍INCLEN诊断工具（INDT - ASD）。

设计

采用横断面设计进行诊断测试评估。

地点

印度德里和蒂鲁文南特布勒姆的四家三级儿科神经科中心。

方法

招募2至9岁的儿童参与研究。由训练有素的心理学家按照随机确定的顺序使用INDT - ASD和儿童自闭症评定量表（CARS）进行评估，随后依据DSM - IV TR诊断标准（金标准）进行专家评估。

主要观察指标

诊断准确性、有效性（结构效度、效标效度和聚合效度）以及内部一致性的心理测量参数。

结果

共纳入154名儿童（110名男孩，平均年龄64.2个月）。以DSM - IV - TR专家诊断为金标准，INDT - ASD对自闭症谱系障碍的总体诊断准确性（AUC = 0.97，95% CI 0.93, 0.99；P < 0.001）和有效性（敏感性98%，特异性95%，阳性预测值91%，阴性预测值99%）较高。INDT - ASD与“自闭症谱系障碍组”专家诊断的一致性率为82.52% [科恩kappa系数 = 0.89；95% CI (0.82, 0.97)；P = 0.001]。INDT - ASD的内部一致性为0.96。与CARS的聚合效度（r = 0.73，P = 0.001）以及与比内 - 卡马特智力测验的区分效度（r = -0.37；P = 0.004）均显著较高。INDT - ASD具有四因素结构，可解释85.3%的方差。