Department of Pediatrics, North Dakota FAS Center, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND.
J Dev Behav Pediatr. 2018 Feb/Mar;39(2):163-167. doi: 10.1097/DBP.0000000000000523.
Recently, increased attention has been focused on the diagnosis of the most prevalent category of fetal alcohol spectrum disorders, alcohol-related neurodevelopmental disorders (ARNDs). In 2013, proposed criteria for neurodevelopmental disorders associated with prenatal alcohol exposure (ND-PAE) were included in the appendix of the latest revision of the Diagnostic and Statistical Manual of Mental Disorders. The concordance of the 2 sets of criteria is unknown. This study examines the overlap in diagnostic criteria for ND-PAE and the ARND Behavioral Checklist in children.
Clinical charts from June 2013 to July 2016 were reviewed to identify patients with an evaluation for ARNDs and where the criteria for ND-PAE were also available.
The review found 86 charts with a diagnosis of ARNDs, which included the ARND Checklist and the ND-PAE criteria. We then calculated the sensitivity and specificity comparing the ND-PAE with the ARND Checklist as the comparison standard. The sensitivity was 95.0%, specificity was 75.0%, and the ND-PAE diagnosis correctly classified 89.5% of cases identified as meeting criteria for ARNDs by the checklist. The receiver operating characteristics resulted in a large shared area under the curve of 90.1%.
The 2 diagnostic constructs of ARNDs and ND-PAE seem to be very similar. Both the ARND and the ND-PAE variables are written in familiar formats and could be widely used by a variety of health care providers.
最近,人们越来越关注最常见的胎儿酒精谱系障碍类别,即酒精相关神经发育障碍(ARNDs)的诊断。2013 年,与产前酒精暴露相关的神经发育障碍(ND-PAE)的诊断标准被纳入精神障碍诊断与统计手册最新修订版的附录。这两套标准的一致性尚不清楚。本研究检查了 ND-PAE 与儿童 ARND 行为检查表之间的诊断标准重叠情况。
回顾了 2013 年 6 月至 2016 年 7 月的临床图表,以确定接受 ARNDs 评估且 ND-PAE 标准也可用的患者。
该回顾发现了 86 份 ARND 诊断的图表,其中包括 ARND 检查表和 ND-PAE 标准。然后,我们计算了 ND-PAE 与 ARND 检查表作为比较标准的敏感性和特异性。ND-PAE 的敏感性为 95.0%,特异性为 75.0%,ND-PAE 诊断正确地将检查表中符合 ARND 标准的 89.5%的病例进行了分类。受试者工作特征曲线的共享面积很大,为 90.1%。
ARND 和 ND-PAE 的这两个诊断结构似乎非常相似。ARND 和 ND-PAE 变量均以熟悉的格式书写,可由各种医疗保健提供者广泛使用。