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《自闭症精神状态检查在儿童自闭症谱系障碍诊断中的有效性和截断值》。

Validity and Cutoff Score of the Autism Mental Status Exam for an Autism Spectrum Disorder Diagnosis in Chinese Children.

机构信息

Department of Psychosomatic Medicine, Shanghai East Hospital, Tongji University School of Medicine, 150 Jimo Road, Shanghai, 200120, China.

Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, 650000, Yunnan, China.

出版信息

J Autism Dev Disord. 2023 Dec;53(12):4822-4829. doi: 10.1007/s10803-022-05730-9. Epub 2022 Sep 10.

Abstract

The Autism Mental Status exam (AMSE) has demonstrated excellent sensitivity and specificity in Western high-risk population with suspected autism spectrum disorder (ASD). This study aimed to evaluate the psychometric properties of the AMSE in a sample of high-risk Chinese children, and to determine the optimal cutoff score of the Chinese version of the AMSE in supporting ASD diagnosis. 66 young children aged from 2 to 11 years with suspected ASD were enrolled in the present study. A diagnosis of ASD or non-ASD was determined by a Best Estimate Diagnosis protocol according to the DSM-5 criteria. Receiver operating characteristic (ROC) curve analysis was conducted to assess the validity of the AMSE and search for the most effective cutoff score. The ROC curve analysis yields the area under the ROC curve of 0.98 which represents excellent diagnostic accuracy. Findings indicate the optimal cutoff score of the Chinese version of the AMSE was estimated as 6, producing the highest sensitivity of 98% and a specificity of 87%. Preliminary findings of the study suggest the AMSE has promising psychometric properties as an assessment tool for identifying ASD symptoms and supporting diagnostic decision-making in high-risk Chinese children population.

摘要

自闭症精神状态检查(AMSE)在西方高风险自闭症谱系障碍(ASD)疑似人群中表现出了优异的敏感性和特异性。本研究旨在评估 AMSE 在高危中国儿童样本中的心理测量特性,并确定 AMSE 中文版支持 ASD 诊断的最佳截断分数。本研究纳入了 66 名年龄在 2 至 11 岁之间的疑似 ASD 的幼儿。根据 DSM-5 标准,通过最佳估计诊断方案确定 ASD 或非 ASD 诊断。进行了受试者工作特征(ROC)曲线分析,以评估 AMSE 的有效性并寻找最有效的截断分数。ROC 曲线分析得到的 ROC 曲线下面积为 0.98,代表了极好的诊断准确性。研究结果表明,中文版 AMSE 的最佳截断分数估计为 6,其敏感性为 98%,特异性为 87%。研究的初步结果表明,AMSE 具有良好的心理测量特性,可作为识别 ASD 症状的评估工具,并为高危中国儿童人群的诊断决策提供支持。

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