Primary care doctors receiving specialized training can diagnose autism

In most cases, community-based primary care clinicians who receive specialized training can accurately diagnose autism spectrum disorder (ASD), according to a study published online July 18 in Pediatrics.

Rebecca McNally Keehn, Ph.D., from the Indiana University School of Medicine in Indianapolis, and colleagues examined the diagnostic accuracy of the Early Autism Evaluation (EAE) Hub system, which provides specialized training and collaborative support to community primary care providers for diagnosing young children at risk for ASD. Children aged 14 to 48 months were referred by EAE Hub clinicians for follow-up expert evaluation. The primary outcome was agreement of categorical ASD diagnosis between EAE Hub clinician and ASD expert (index diagnosis and reference standard).

The researchers found that 82% of the 126 children had consistent ASD outcomes between the index and reference evaluation. Sensitivity and specificity were 81.5 and 82.4%, respectively, and the positive and negative predictive values were 92.6 and 62.2%, respectively. No difference was seen in accuracy by EAE Hub clinician or site. Significant differences between true-positive and false-negative cases were seen across measures of development, with greater impairment evident for true-positive cases.

"The study of innovative diagnostic models has important implications for how future population health solutions that address the ASD diagnosis crisis are designed and implemented," the authors write.

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