Abstract
BackgroundAutism spectrum disorder (ASD) is a complex developmental disorder characterised by impaired social interaction and communication, and restrictive and repetitive behaviour. Previous systematic reviews have traditionally assessed the prevalence of ASD on global or regional context, with very few meta-analyses at the country level. The objective of this study will be to systematically evaluate published and unpublished observational studies that present prevalence and comorbidity of ASD among children, adolescent and adult population in Spain.Methods/designWe designed and registered a study protocol for a systematic review and meta-analysis of descriptive epidemiology data. Observational studies (cohort, cross-sectional) reporting the prevalence of ASD and conducted in a wide range of people (e.g. general population, outpatient and/or school settings) will be included. The primary outcome will be the prevalence of ASD. Secondary outcomes will be the prevalence of any physical or mental comorbidity in association with ASD. No limitations will be imposed on publication status, study conduct period, and language of dissemination. Comprehensive literature searches will be conducted in seven electronic databases (from January 1980 onwards), including PubMed/MEDLINE, EMBASE, Scopus, Web of Science, PsycINFO, IME—Spanish Medical Index and IBECS—Spanish Bibliographic Index of Health Sciences. Grey literature will be identified through searching dissertation databases, Google Scholar and conference abstracts. Two team members will independently screen all citations, full-text articles, and abstract data. Potential conflicts will be resolved through discussion. The study methodological quality (or bias) will be appraised using an appropriate tool. If feasible, we will conduct random effects meta-analysis of observational data. Prevalence estimates will be stratified according to gender, age and geographical location. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g. methodological quality, sample size, diagnostic criteria).DiscussionThis systematic review and meta-analysis of observational data will identify, evaluate and integrate the epidemiological knowledge underlying the prevalence of ASD in Spain. The results of this study will be of interest to multiple audiences including patients, their families, caregivers, healthcare professional, scientists and policy makers. Results will be published in a peer-reviewed journal. Implications for future epidemiological research will be discussed.Systematic review registrationPROSPERO CRD42018090372
Highlights
Autism spectrum disorder (ASD) is a complex developmental disorder characterised by impaired social interaction and communication, and restrictive and repetitive behaviour
This systematic review and meta-analysis of observational data will identify, evaluate and integrate the epidemiological knowledge underlying the prevalence of ASD in Spain
Autism spectrum disorder (ASD) is a complex developmental disorder characterised by early-onset deficits in social communication and reciprocal interactions as well as the presence of restricted, stereotypical behaviour [1,2,3,4]
Summary
The systematic review and meta-analysis of observational data presented in this protocol will identify, collect, evaluate and integrate the epidemiological knowledge underlying the prevalence of ASD in Spain. Routine population estimates of ASD prevalence (based on the most updated systematic literature reviews) are not reported [55, 56] Outputs of this analysis could be relevant to current policy questions. We anticipate that we will identify knowledge gaps to be filled by new epidemiological research considering that the prevalence of neurodevelopmental disorders has been poorly covered in the literature [7, 57]. A key challenge is that based on knowledge from previous reviews on child mental health [7, 8, 25, 31, 57,58,59], we anticipate identifying studies using different study designs, populations, contexts and with a variable quality of reporting methods and results.
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