title: Validation of existing diagnosis of autism in mainland China using standardised diagnostic instruments.
abstract: Research to date in mainland China has mainly focused on children with autistic disorder rather than Autism Spectrum Conditions and the diagnosis largely depended on clinical judgment without the use of diagnostic instruments. Whether children who have been diagnosed in China before meet the diagnostic criteria of Autism Spectrum Conditions is not known nor how many such children would meet these criteria. The aim of this study was to evaluate children with a known diagnosis of autism in mainland China using the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview-Revised to verify that children who were given a diagnosis of autism made by Chinese clinicians in China were mostly children with severe autism. Of 50 children with an existing diagnosis of autism made by Chinese clinicians, 47 children met the diagnosis of autism on the Autism Diagnostic Observation Schedule algorithm and 44 children met the diagnosis of autism on the Autism Diagnostic Interview-Revised algorithm. Using the Gwet's alternative chance-corrected statistic, the agreement between the Chinese diagnosis and the Autism Diagnostic Observation Schedule diagnosis was very good (AC1 = 0.94, p < 0.005, 95% confidence interval (0.86, 1.00)), so was the agreement between the Chinese diagnosis and the Autism Diagnostic Interview-Revised (AC1 = 0.91, p < 0.005, 95% confidence interval (0.81, 1.00)). The agreement between the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview-Revised was lower but still very good (AC1 = 0.83, p < 0.005).
authors.affiliation: Department of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK Department of Psychiatry, Autism Research Centre, University of Cambridge, Cambridge, UK (including Cambridgeshire and Peterborough NHS Foundation Trust) The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong xs227@medschl.cam.ac.uk.
authors.forename: Xiang
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Psychiatry, Autism Research Centre, University of Cambridge, Cambridge, UK (including Cambridgeshire and Peterborough NHS Foundation Trust).
authors.forename: Carrie
authors.initials: C
authors.lastname: Allison
authors.affiliation: Department of Psychiatry, Autism Research Centre, University of Cambridge, Cambridge, UK (including Cambridgeshire and Peterborough NHS Foundation Trust) Department of Psychology, University of Edinburgh, Edinburgh, UK.
authors.forename: Bonnie
authors.initials: B
authors.lastname: Auyeung
authors.affiliation: Paediatrics Department, Peking University First Hospital, Beijing, China.
authors.forename: Zhixiang
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: MRC Biostatistics Unit, Cambridge Institute of Public Health, Cambridge, UK.
authors.forename: Fiona E
authors.initials: FE
authors.lastname: Matthews
authors.affiliation: Department of Psychiatry, Autism Research Centre, University of Cambridge, Cambridge, UK (including Cambridgeshire and Peterborough NHS Foundation Trust).
authors.forename: Simon
authors.initials: S
authors.lastname: Baron-Cohen
authors.affiliation: Department of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK.
authors.forename: Carol
authors.initials: C
authors.lastname: Brayne
mesh_terms: D001321:Autistic Disorder / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D002681:China; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: China; autism spectrum disorders; diagnosis; validation