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A Meta-analysis of the Diagnostic Accuracy of Autism Diagnostic Observation Schedule Module-1 for Autism Spectrum Disorders

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An Erratum to this article was published on 18 December 2014

Abstract

Objective

Autism Diagnostic Observation Schedule (ADOS) is considered gold standard for the diagnosis of Autism Spectrum Disorders (ASD). The authors evaluated the cumulative diagnostic accuracy of ADOS-Module 1 (ADOSM1) using the original diagnostic algorithm with meta-analysis and meta-regression.

Methods

The authors, electronically and manually searched for studies from 1999 to 2013 that evaluated the accuracy of ADOSM1 using the original diagnostic algorithm in detecting ASD. Primary results of Sensitivity (Sn), Specificity (Sp) and Diagnostic Odds Ratio (DOR) for ADOSM1 were summarized using random-effects model. Summary Receiver Operating characteristic Curves and its Area Under the Curve (SROC-AUC) were used to summarize overall diagnostic accuracy of ADOSM1. The modifying effects of quality of study and sample size, on the diagnostic odds ratio, were investigated using meta-regression.

Results

A total of 7 cross-sectional studies provided data on 4,057 children. The pooled Sn, Sp, DOR and SROC-AUC for the overall diagnostic accuracy of ADOSM1 were: 0.91 (95 % CI = 0.88 to 0.93), 0.27 (95 % CI = 0.24 to 0.30), 5.40 (95 % CI = 1.51 to 19.23) and 0.52 respectively. Meta-regression analysis showed a non-significant relationship between ADOSM1 and study quality as well as sample size. There were subgroup differences in the DOR.

Conclusions

The authors conclude that ADOSM1 with the original diagnostic algorithm lacks overall diagnostic accuracy and pooled specificity to confirm the diagnosis of Autism Spectrum Disorders. ADOSM1 with the revised diagnostic algorithm should be used instead for the diagnosis of this group of disorders.

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Acknowledgment

The authors thank Ms. Mary Pauline Paul and Mr. George for the support they provided for the study.

Conflict of Interest

None.

Source of Funding

This study is supported by intramural funding by the Fluid Research fund.

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Authors and Affiliations

  1. Child and Adolescent Psychiatry Unit, Department of Psychiatry, Christian Medical College, Vellore, 632 002, Tamil Nadu, India

    Sherab Tsheringla, K. A. Minju, Sushila Russell, Priya Mammen & Paul Swamidhas Sudhakar Russell

  2. Child Development Centre, Thiruvananthapuram Medical College, Thiruvananthapuram, Kerala, India

    M. K. C. Nair

Authors
  1. Sherab Tsheringla
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  2. K. A. Minju
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  3. Sushila Russell
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  4. Priya Mammen
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  5. Paul Swamidhas Sudhakar Russell
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  6. M. K. C. Nair
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Corresponding author

Correspondence to Paul Swamidhas Sudhakar Russell.

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Tsheringla, S., Minju, K.A., Russell, S. et al. A Meta-analysis of the Diagnostic Accuracy of Autism Diagnostic Observation Schedule Module-1 for Autism Spectrum Disorders. Indian J Pediatr 81 (Suppl 2), 187–192 (2014). https://doi.org/10.1007/s12098-014-1627-9

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  • DOI: https://doi.org/10.1007/s12098-014-1627-9

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