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使用 Optum 数据集评估自闭症谱系障碍儿童眼科诊断的患病率:一项基于人群的研究。

Prevalence of Ophthalmologic Diagnoses in Children With Autism Spectrum Disorder Using the Optum Dataset: APopulation-Based Study.

机构信息

Vision Center, Children's Hospital of Los Angeles, Los Angeles, CA, USA; Roski Eye Center, University of Southern CA, Los Angeles, Los Angeles, CA, USA.

Department of Medicine Statistics Core, David Geffen School of Medicine, University of CA, Los Angeles, Los Angeles, CA, USA.

出版信息

Am J Ophthalmol. 2021 Jan;221:147-153. doi: 10.1016/j.ajo.2020.08.048. Epub 2020 Sep 5.

Abstract

PURPOSE

Autism spectrum disorder (ASD) affects an estimated 1.85% of children in the United States and is increasing in prevalence. Any relationship between ophthalmologic disorders and ASD is poorly understood. The purpose of this study was to calculate the prevalence of ophthalmologic disorders in children with ASD.

DESIGN

Population-based retrospective cohort study.

METHODS

Setting: claims data from Optum Labs Data Warehouse, a longitudinal real-world data asset with de-identified administrative claims and electronic health records data. StudyPopulation: children ≤18 years of age at the time of first claim between 2007 and 2013.

OBSERVATION

diagnosis of pervasive developmental disorder (PDD) or autistic disorder (AD) according to International Classification of Disease-9th edition (ICD-9) codes. MainOutcomeMeasurements: prevalence of an ophthalmologic diagnosis (amblyopia, strabismus, optic neuropathy, nystagmus, or retinopathy of prematurity) by ICD-9 codes in typically developing (TD) controls and children with PDD and AD. Adjusted odds ratios (OR) for each diagnosis were calculated using multivariate logistic regression models.

RESULTS

Claims from more than 10 million children were included. The prevalence of any ophthalmologic diagnosis considered in this study was 3.5% in TD controls, 12.5% in children with PDD (adjusted OR, 3.22; 95% confidence interval [CI, ], 3.16-3.29; P < .001), and 13.5% in children with AD (adjusted OR, 3.23; 95% CI, 3.15-3.31; P < .001).

CONCLUSIONS

Population-based data suggested an increased risk of ophthalmologic diagnoses in children with ASD. Future research is necessary to further clarify the relationship between ophthalmologic disorders and autistic symptoms and severity.

摘要

目的

自闭症谱系障碍(ASD)影响美国约 1.85%的儿童,且其发病率呈上升趋势。眼科疾病与 ASD 之间的任何关系都知之甚少。本研究的目的是计算 ASD 儿童中眼科疾病的患病率。

设计

基于人群的回顾性队列研究。

方法

设置:来自 Optum Labs Data Warehouse 的索赔数据,这是一个具有去识别管理索赔和电子健康记录数据的纵向真实世界数据资产。研究人群:2007 年至 2013 年间首次索赔时年龄≤18 岁的儿童。

观察

根据国际疾病分类第 9 版(ICD-9)代码诊断为广泛性发育障碍(PDD)或孤独症障碍(AD)。主要观察指标:根据 ICD-9 代码,在典型发育(TD)对照组和 PDD 及 AD 儿童中,眼科诊断(弱视、斜视、视神经病变、眼球震颤或早产儿视网膜病变)的患病率。使用多变量逻辑回归模型计算每种诊断的调整后优势比(OR)。

结果

纳入了超过 1000 万儿童的索赔数据。本研究考虑的任何眼科诊断的患病率在 TD 对照组中为 3.5%,在 PDD 儿童中为 12.5%(调整后 OR,3.22;95%置信区间[CI],3.16-3.29;P<0.001),在 AD 儿童中为 13.5%(调整后 OR,3.23;95% CI,3.15-3.31;P<0.001)。

结论

基于人群的数据表明 ASD 儿童发生眼科诊断的风险增加。未来的研究有必要进一步阐明眼科疾病与自闭症症状和严重程度之间的关系。

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