Original Paper

Journal of Autism and Developmental Disorders

, Volume 41, Issue 2, pp 227-236

Evaluation of a Records-Review Surveillance System Used to Determine the Prevalence of Autism Spectrum Disorders

  • Rachel Nonkin AvchenAffiliated withDevelopmental Disabilities Branch, Centers for Disease Control and Prevention Email author 
  • , Lisa D. WigginsAffiliated withDevelopmental Disabilities Branch, Centers for Disease Control and Prevention
  • , Owen DevineAffiliated withDevelopmental Disabilities Branch, Centers for Disease Control and Prevention
  • , Kim Van Naarden BraunAffiliated withDevelopmental Disabilities Branch, Centers for Disease Control and Prevention
  • , Catherine RiceAffiliated withDevelopmental Disabilities Branch, Centers for Disease Control and Prevention
  • , Nancy C. HobsonAffiliated withResearch Triangle Institute
  • , Diana SchendelAffiliated withDevelopmental Disabilities Branch, Centers for Disease Control and Prevention
  • , Marshalyn Yeargin-AllsoppAffiliated withDevelopmental Disabilities Branch, Centers for Disease Control and Prevention

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Abstract

We conducted the first study that estimates the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of a population-based autism spectrum disorders (ASD) surveillance system developed at the Centers for Disease Control and Prevention. The system employs a records-review methodology that yields ASD classification (case versus non-ASD case) and was compared with classification based on clinical examination. The study enrolled 177 children. Estimated specificity (0.96, [CI.95 = 0.94, 0.99]), PPV (0.79 [CI.95 = 0.66, 0.93]), and NPV (0.91 [CI.95 = 0.87, 0.96]) were high. Sensitivity was lower (0.60 [CI.95 = 0.45, 0.75]). Given diagnostic heterogeneity, and the broad array of ASD in the population, identifying children with ASD is challenging. Records-based surveillance yields a population-based estimate of ASD that is likely conservative.

Keywords

Autism Surveillance Sensitivity Specificity Prevalence