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在初级保健中整合一个新的在线平台用于自闭症谱系障碍的早期检测、转诊和干预:首个意大利关键项目。

Integrating a New Online Platform in Primary Care for Early Detection, Referral, and Intervention in Autism Spectrum Disorder: The First Italian Pivotal Project.

作者信息

Colombo Paola, Buo Noemi, Busti Ceccarelli Silvia, Molteni Massimo

机构信息

Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, 23842 Lecco, Italy.

出版信息

Brain Sci. 2022 Feb 12;12(2):256. doi: 10.3390/brainsci12020256.

Abstract

Autism spectrum disorder (ASD) is a heterogeneous condition characterized by deficits in social communication and a repetitive pattern of behavior, with recent Italian prevalence estimates of 1 in 77. Although the core behavioral features of ASD appear to emerge within the first two years of life, clinical diagnosis is often not received before the third birthday. The American Academy of Pediatrics (AAP) has recommended that primary care physicians routinely screen for ASD at the 18- and 24-month visits. In Italy, the Guidelines of the Italian National Institute for Health (ISS) recommend the Checklist for Autism in Toddlers (CHAT) as a screening tool for ASD, which compares parent responses with a semistructured observation by a healthcare provider. In the Italian National Health System, pediatricians have regular visits with all children; however, there is wide variability in following screening guidelines, and some barriers have been detected. For these reasons, other studies have highlighted the advantages of using telemedicine with the potential for enhancing ASD screening practices. The current study is an examination of the implementation of the first Italian online web-based screening tool (Web Italian Network for Autism Spectrum DisorderWIN4ASD), an innovative web app for pediatricians. We present the data obtained from the screening activity through the platform by a small group of pediatricians. The results of this study show that the implemented web-based platform appears to be an effective, efficient, and sustainable way to integrate screening services into primary care.

摘要

自闭症谱系障碍(ASD)是一种异质性疾病,其特征为社交沟通缺陷和重复性行为模式,意大利最近的患病率估计为77分之一。尽管ASD的核心行为特征似乎在生命的头两年内就会出现,但临床诊断通常要到三岁生日之后才会做出。美国儿科学会(AAP)建议初级保健医生在18个月和24个月的就诊时常规筛查ASD。在意大利,意大利国家卫生研究所(ISS)的指南推荐使用幼儿自闭症检查表(CHAT)作为ASD的筛查工具,该检查表将家长的回答与医疗服务提供者的半结构化观察结果进行比较。在意大利国家卫生系统中,儿科医生会定期对所有儿童进行检查;然而,在遵循筛查指南方面存在很大差异,并且已经发现了一些障碍。出于这些原因,其他研究强调了使用远程医疗在加强ASD筛查实践方面的优势。本研究是对首个意大利在线网络筛查工具(意大利自闭症谱系障碍网络WIN4ASD)实施情况的检查,这是一款面向儿科医生的创新网络应用程序。我们展示了一小群儿科医生通过该平台的筛查活动获得的数据。这项研究的结果表明,实施的基于网络的平台似乎是将筛查服务整合到初级保健中的一种有效、高效且可持续的方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91ec/8869863/d6a9f99fcee2/brainsci-12-00256-g001.jpg

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