title: Genetic Testing for Autism Spectrum Disorder is Lacking Evidence of Cost-effectiveness. A Systematic Review.
abstract: BACKGROUND
  Autism Spectrum Disorder (ASD) is a highly heritable neural development disorder characterized by social impairment. The earlier the diagnosis is made, the higher are the chances of obtaining relief of symptoms. A very early diagnosis uses molecular genetic tests, which are also offered commercially.
  
  
  OBJECTIVE
  Systematic review of the economic impact of genetic tests in ASD.
  
  
  METHODS
  We performed a systematic search of databases Pubmed, Medline, Cochrane, Econlit and the NHS Center for Reviews and Dissemination for articles in English and German from January 1, 2000 to December 31, 2015. Original articles published in peer-reviewed journals were screened in a two-step process. First, we focused our search on economic evaluations of genetic tests for ASD. Second, we searched for any economic evaluation (EE) of genetic tests.
  
  
  RESULTS
  We identified 185 EE of genetic tests for various diseases. However, not a single EE of genetic tests has been found for ASD. The outcomes used in the EE of the genetic tests were heterogeneous, and results were generally not comparable.
  
  
  CONCLUSIONS
  There is no evidence for cost-effectiveness of any genetic diagnostic test for ASD, although such genetic tests are available commercially. Cost-effectiveness analyses for genetic diagnostic tests for ASD are urgently required. There is a clear lack in research for EE of genetic tests.
authors.affiliation: Univ.-Prof. Dr. Andreas Ziegler, Institut für Medizinische Biometrie und Statistik Universität zu Lübeck, Universitätsklinikum Schleswig-Holstein Campus Lübeck, Ratzeburger Allee 160, 23562 Lübeck, Germany, E-mail: infoimbs@imbs.uni-luebeck.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Ziegler
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rudolph-Rothfeld
authors.forename: Reinhard
authors.initials: R
authors.lastname: Vonthein
mesh_terms: D000067877:Autism Spectrum Disorder / Q000175:diagnosis / Q000191:economics* / Q000235:genetics*; D003362:Cost-Benefit Analysis / Q000191:economics* / Q000379:methods*; D019317:Evidence-Based Medicine / Q000191:economics*; D005820:Genetic Testing / Q000191:economics* / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D015995:Prevalence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: ASD; Autism; JEL Classification I11; cost-effectiveness; genetic test