title: Evaluation of a records-review surveillance system used to determine the prevalence of autism spectrum disorders.
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.
authors.affiliation: Developmental Disabilities Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-92, Atlanta, GA 30333, USA. ravchen@cdc.gov
authors.forename: Rachel Nonkin
authors.initials: RN
authors.lastname: Avchen
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Wiggins
authors.forename: Owen
authors.initials: O
authors.lastname: Devine
authors.forename: Kim
authors.initials: K
authors.lastname: Van Naarden Braun
authors.forename: Catherine
authors.initials: C
authors.lastname: Rice
authors.forename: Nancy C
authors.initials: NC
authors.lastname: Hobson
authors.forename: Diana
authors.initials: D
authors.lastname: Schendel
authors.forename: Marshalyn
authors.initials: M
authors.lastname: Yeargin-Allsopp
mesh_terms: D016009:Chi-Square Distribution; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis / Q000453:epidemiology*; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D011159:Population Surveillance / Q000379:methods; D015995:Prevalence; D012680:Sensitivity and Specificity; D014481:United States / Q000453:epidemiology