University of Wisconsin-Madison, USA.
Colorado Department of Public Health and Environment, USA.
Autism. 2019 Nov;23(8):1927-1935. doi: 10.1177/1362361319827510. Epub 2019 Mar 20.
This study assessed potential under-ascertainment of autism spectrum disorder due to missing administrative information for Hispanic and non-Hispanic Black children within the Autism and Developmental Disabilities Monitoring Network. We analyzed data from two Network sites (Colorado and Wisconsin) for surveillance years 2012 and 2014 to determine whether children excluded from autism spectrum disorder prevalence estimates due to missing residency and other information differed from those included by race and ethnicity. We used multiple approaches to impute missing information to evaluate impacts on racial and ethnic disparities in autism spectrum disorder prevalence. Compared with confirmed autism spectrum disorder cases, those excluded due to missing residency were more than twice as likely to be Hispanic (19% vs 44%; < 0.002), yet the number of cases excluded due to missing residency information was too small to account for prevalence differences. Confirmation of autism spectrum disorder case status was more likely for children with relevant health records than for those with school records only. Moreover, relevant health records were more likely to be missing for Black and Hispanic children than for White children. Observed disparities in autism spectrum disorder prevalence were not accounted for by missing demographic data, but may reflect disparities in healthcare access for developmental evaluations.
本研究评估了由于孤独症和发育障碍监测网络（Autism and Developmental Disabilities Monitoring Network）中西班牙裔和非西班牙裔黑人儿童的行政信息缺失，可能导致孤独症谱系障碍（autism spectrum disorder）漏报的情况。我们分析了两个监测点（科罗拉多州和威斯康星州）的 2012 年和 2014 年的数据，以确定因居住和其他信息缺失而被排除在孤独症谱系障碍流行率估计之外的儿童与因种族和族裔而被纳入的儿童是否存在差异。我们使用多种方法对缺失信息进行了推断，以评估对孤独症谱系障碍流行率的种族和族裔差异的影响。与确诊的孤独症谱系障碍病例相比，因居住地缺失而被排除在外的病例中，西班牙裔的比例高出一倍多（19%比 44%；<0.002），但由于居住地信息缺失而被排除的病例数量太少，无法解释流行率差异。有相关健康记录的儿童比只有学校记录的儿童更有可能被确认孤独症谱系障碍病例状态。此外，黑人儿童和西班牙裔儿童的相关健康记录更有可能缺失。观察到的孤独症谱系障碍流行率差异不能用缺失的人口统计学数据来解释，但可能反映了发展评估方面的医疗保健获取方面的差异。
