Sun Xiang, Allison Carrie, Auyeung Bonnie, Zhang Zhixiang, Matthews Fiona E, Baron-Cohen Simon, Brayne Carol
Department of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK Department of Psychiatry, Autism Research Centre, University of Cambridge, Cambridge, UK (including Cambridgeshire and Peterborough NHS Foundation Trust) The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
Department of Psychiatry, Autism Research Centre, University of Cambridge, Cambridge, UK (including Cambridgeshire and Peterborough NHS Foundation Trust).
Autism. 2015 Nov;19(8):1010-7. doi: 10.1177/1362361314556785. Epub 2015 Mar 10.
Research to date in mainland China has mainly focused on children with autistic disorder rather than Autism Spectrum Conditions and the diagnosis largely depended on clinical judgment without the use of diagnostic instruments. Whether children who have been diagnosed in China before meet the diagnostic criteria of Autism Spectrum Conditions is not known nor how many such children would meet these criteria. The aim of this study was to evaluate children with a known diagnosis of autism in mainland China using the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview-Revised to verify that children who were given a diagnosis of autism made by Chinese clinicians in China were mostly children with severe autism. Of 50 children with an existing diagnosis of autism made by Chinese clinicians, 47 children met the diagnosis of autism on the Autism Diagnostic Observation Schedule algorithm and 44 children met the diagnosis of autism on the Autism Diagnostic Interview-Revised algorithm. Using the Gwet's alternative chance-corrected statistic, the agreement between the Chinese diagnosis and the Autism Diagnostic Observation Schedule diagnosis was very good (AC1 = 0.94, p < 0.005, 95% confidence interval (0.86, 1.00)), so was the agreement between the Chinese diagnosis and the Autism Diagnostic Interview-Revised (AC1 = 0.91, p < 0.005, 95% confidence interval (0.81, 1.00)). The agreement between the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview-Revised was lower but still very good (AC1 = 0.83, p < 0.005).
中国大陆迄今为止的研究主要集中在患有自闭症谱系障碍的儿童而非自闭症谱系疾病上，并且诊断很大程度上依赖临床判断，未使用诊断工具。在中国之前被诊断的儿童是否符合自闭症谱系疾病的诊断标准尚不清楚，也不知道有多少这样的儿童符合这些标准。本研究的目的是使用《自闭症诊断观察量表》和《自闭症诊断访谈修订版》对中国大陆已知患有自闭症的儿童进行评估，以验证在中国由中国临床医生诊断为自闭症的儿童大多是患有重度自闭症的儿童。在50名由中国临床医生诊断为患有自闭症的儿童中，47名儿童在《自闭症诊断观察量表》算法下符合自闭症诊断，44名儿童在《自闭症诊断访谈修订版》算法下符合自闭症诊断。使用格韦特替代机会校正统计量，中国诊断与《自闭症诊断观察量表》诊断之间的一致性非常好（AC1 = 0.94，p < 0.005，95%置信区间(0.86, 1.00)），中国诊断与《自闭症诊断访谈修订版》之间的一致性也是如此（AC1 = 0.91，p < 0.005，95%置信区间(0.81, 1.00)）。《自闭症诊断观察量表》与《自闭症诊断访谈修订版》之间的一致性较低，但仍然非常好（AC1 = 0.83，p < 0.005）。
