Health professionals' perceptions about the adoption of existing guidelines for the diagnosis of fetal alcohol spectrum disorders in Australia.
BACKGROUND
Despite the availability of five guidelines for the diagnosis of fetal alcohol spectrum disorders (FASD), there is no national endorsement for their use in diagnosis in Australia. In this study we aimed to describe health professionals' perceptions about the adoption of existing guidelines for the diagnosis of FASD in Australia and identify implications for the development of national guidelines.


METHODS
We surveyed 130 Australian and 9 international health professionals with expertise or involvement in the screening or diagnosis of FASD. An online questionnaire was used to evaluate participants' familiarity with and use of five existing diagnostic guidelines for FASD, and to assess their perceptions about the adoption of these guidelines in Australia.


RESULTS
Of the 139 participants surveyed, 84 Australian and 8 international health professionals (66.2%) responded to the questions on existing diagnostic guidelines. Participants most frequently reported using the University of Washington 4-Digit Diagnostic Code (27.2%) and the Canadian guidelines (18.5%) for diagnosis. These two guidelines were also most frequently recommended for adoption in Australia: 32.5% of the 40 participants who were familiar with the University of Washington 4-Digit Diagnostic Code recommended adoption of this guideline in Australia, and 30.8% of the 26 participants who were familiar with the Canadian guidelines recommended adoption of this guideline in Australia. However, for the majority of guidelines examined, most participants were unsure whether they should be adopted in Australia. The adoption of existing guidelines in Australia was perceived to be limited by: their lack of evidence base, including the appropriateness of established reference standards for the Australian population; their complexity; the need for training and support to use the guidelines; and the lack of an interdisciplinary and interagency model to support service delivery in Australia.


CONCLUSIONS
Participants indicated some support for the adoption of the University of Washington or Canadian guidelines for FASD diagnosis; however, concerns were raised about the adoption of these diagnostic guidelines in their current form. Australian diagnostic guidelines will require evaluation to establish their validity in the Australian context, and a comprehensive implementation model is needed to facilitate improved diagnostic capacity in Australia.
Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, Perth, Australia. rwatkins@ichr.uwa.edu.au
Rochelle E
RE
Watkins
Elizabeth J
EJ
Elliott
Raewyn C
RC
Mutch
Jane
J
Latimer
Amanda
A
Wilkins
Janet M
JM
Payne
Heather M
HM
Jones
Sue
S
Miers
Elizabeth
E
Peadon
Anne
A
McKenzie
Heather A
HA
D'Antoine
Elizabeth
E
Russell
James
J
Fitzpatrick
Colleen M
CM
O'Leary
Jane
J
Halliday
Lorian
L
Hayes
Lucinda
L
Burns
Maureen
M
Carter
Carol
C
Bower
D001291:Attitude of Health Personnel; D001315:Australia; D003430:Cross-Sectional Studies; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000175:diagnosis*; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D017410:Practice Guidelines as Topic; D057184:Practice Patterns, Nurses' / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011247:Pregnancy; D011795:Surveys and Questionnaires