Christiansen Jens, Pedersen Lennart
Center for Autism, Copenhagen, Denmark.
J Autism Dev Disord. 2024 Jul 30. doi: 10.1007/s10803-024-06480-6.
Psychometric properties and diagnostic performance of the ADOS-2 module 4 were evaluated with participants from an autism-specialized clinic.
The sample had 331 participants with 226 males and 70 females receiving an ASD diagnosis. The evaluation consisted of the following: (1) A replication of the Exploratory Factor Analysis (EFA) reported by Hus, V., & Lord, C. (2014). The Autism Diagnostic Observation Schedule, Module 4: Revised Algorithm and Standardized Severity Scores. Journal of Autism and Developmental Disorders, 44(8), 1996-2012. https://doi.org/10.1007/s10803014-2080-3 .). (2) Identification of ADOS-2 items best predicting clinical diagnosis using Recursive Feature Elimination (RFE) and comparison of these items to previous findings. (3) Receiver Operating Characteristic (ROC) curve analyses of the effects of age and IQ on diagnostic performance. (4) Comparisons of ADOS-2 revised algorithm scores between females and males and their association with ADI-R scores.
The EFA item-to-factor allocation of the ADOS-2 revised algorithm was largely reproduced. When comparing the present RFE to previous RFE findings, the item Quality of Social Responses stood out. ROC curve analysis showed outstanding diagnostic performance for adults with IQ above 70 but for females, ADOS-2 revised algorithm scores were lowered, and, contrary to males, did not correlate with ADI-R scores.
Reproducing the item-to-factor allocation and finding outstanding agreement with the diagnostic decision for adults with IQ > 70 showcase the strength of the ADOS-2 revised algorithm. Furthermore, by incorporating, into future revisions, the finding of inter-clinic importance of the item Quality of Social Responses, performance might be further enhanced. Lastly, though, that female scores were lowered and did not correlate with ADI-R indicate a weakness in the ADOS-2 when applied to the adult female population.
对来自一家自闭症专科诊所的参与者评估《自闭症诊断观察量表第二版》（ADOS - 2）模块4的心理测量特性和诊断性能。
样本中有331名参与者，其中226名男性和70名女性被诊断为患有自闭症谱系障碍（ASD）。评估包括以下内容：（1）重复V. 胡斯和C. 洛德（2014年）报告的探索性因素分析（EFA）。《自闭症诊断观察量表，模块4：修订算法和标准化严重程度评分》。《自闭症与发育障碍杂志》，44(8)，1996 - 2012。https://doi.org/10.1007/s10803014 - 2080 - 3 。（2）使用递归特征消除（RFE）确定最能预测临床诊断的ADOS - 2项目，并将这些项目与先前的研究结果进行比较。（3）对年龄和智商对诊断性能影响的受试者工作特征（ROC）曲线分析。（4）比较ADOS - 2修订算法分数在男性和女性之间的差异及其与《自闭症诊断访谈量表修订版》（ADI - R）分数的关联。
ADOS - 2修订算法的EFA项目到因素的分配在很大程度上得以重现。将当前的RFE与先前的RFE结果进行比较时，“社交反应质量”这一项目尤为突出。ROC曲线分析显示，智商高于7０的成年人具有出色的诊断性能，但对于女性而言，ADOS - 2修订算法分数较低，并且与男性不同，与ADI - R分数不相关。
重现项目到因素的分配，并与智商＞7０的成年人的诊断决策达成高度一致，展示了ADOS - 2修订算法的优势。此外，通过在未来修订中纳入“社交反应质量”项目在不同诊所间的重要性这一发现，性能可能会进一步提高。不过，最后女性分数较低且与ADI - R不相关表明ADOS - 2应用于成年女性群体时存在弱点。
