title: Perspective Biological Markers for Autism Spectrum Disorders: Advantages of the Use of Receiver Operating Characteristic Curves in Evaluating Marker Sensitivity and Specificity.
abstract: Autism Spectrum Disorders (ASD) are a heterogeneous group of neurodevelopmental disorders. Recognized causes of ASD include genetic factors, metabolic diseases, toxic and environmental factors, and a combination of these. Available tests fail to recognize genetic abnormalities in about 70% of ASD children, where diagnosis is solely based on behavioral signs and symptoms, which are difficult to evaluate in very young children. Although it is advisable that specific psychotherapeutic and pedagogic interventions are initiated as early as possible, early diagnosis is hampered by the lack of nongenetic specific biological markers. In the past ten years, the scientific literature has reported dozens of neurophysiological and biochemical alterations in ASD children; however no real biomarker has emerged. Such literature is here reviewed in the light of Receiver Operating Characteristic (ROC) analysis, a very valuable statistical tool, which evaluates the sensitivity and the specificity of biomarkers to be used in diagnostic decision making. We also apply ROC analysis to some of our previously published data and discuss the increased diagnostic value of combining more variables in one ROC curve analysis. We also discuss the use of biomarkers as a tool for advancing our understanding of nonsyndromic ASD.
authors.affiliation: Department of Experimental, Diagnostic and Specialty Medicine, School of Medicine, University of Bologna, Via Belmeloro 8, 40126 Bologna, Italy ; Don Carlo Gnocchi Foundation ONLUS, IRCCS "S. Maria Nascente", Via Alfonso Capecelatro 66, 20148 Milan, Italy.
authors.forename: Provvidenza M
authors.identifier: 0000-0001-5242-9448
authors.initials: PM
authors.lastname: Abruzzo
authors.affiliation: Department of Experimental, Diagnostic and Specialty Medicine, School of Medicine, University of Bologna, Via Belmeloro 8, 40126 Bologna, Italy.
authors.forename: Alessandro
authors.identifier: 0000-0002-7928-1882
authors.initials: A
authors.lastname: Ghezzo
authors.affiliation: Department of Experimental, Diagnostic and Specialty Medicine, School of Medicine, University of Bologna, Via Belmeloro 8, 40126 Bologna, Italy ; Don Carlo Gnocchi Foundation ONLUS, IRCCS "S. Maria Nascente", Via Alfonso Capecelatro 66, 20148 Milan, Italy.
authors.forename: Alessandra
authors.identifier: 0000-0002-7484-3452
authors.initials: A
authors.lastname: Bolotta
authors.affiliation: ISOF, CNR, 40129 Bologna, Italy.
authors.forename: Carla
authors.identifier: 0000-0002-1359-0869
authors.initials: C
authors.lastname: Ferreri
authors.affiliation: Comune di Bologna, 40129 Bologna, Italy.
authors.forename: Renato
authors.identifier: 0000-0003-1689-6596
authors.initials: R
authors.lastname: Minguzzi
authors.affiliation: Section of Biochemistry, Biology and Physics, Department of Clinical Sciences, Faculty of Medicine, Polytechnic University of Marche, 60128 Ancona, Italy.
authors.forename: Arianna
authors.identifier: 0000-0002-2496-7932
authors.initials: A
authors.lastname: Vignini
authors.affiliation: Child Neurology and Psychiatry Unit, IRCCS Institute of Neurological Sciences, 40139 Bologna, Italy.
authors.forename: Paola
authors.identifier: 0000-0002-4257-290X
authors.initials: P
authors.lastname: Visconti
authors.affiliation: Department of Experimental, Diagnostic and Specialty Medicine, School of Medicine, University of Bologna, Via Belmeloro 8, 40126 Bologna, Italy ; Don Carlo Gnocchi Foundation ONLUS, IRCCS "S. Maria Nascente", Via Alfonso Capecelatro 66, 20148 Milan, Italy.
authors.forename: Marina
authors.identifier: 0000-0003-1932-7380
authors.initials: M
authors.lastname: Marini
mesh_terms: D019540:Area Under Curve; D000067877:Autism Spectrum Disorder / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D006801:Humans; D007378:Interleukins / Q000097:blood; D018377:Neurotransmitter Agents / Q000097:blood; D010743:Phospholipids / Q000097:blood; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D007378:Interleukins; D018377:Neurotransmitter Agents; D010743:Phospholipids