Abstract
Great efforts focus on early detection of autism spectrum disorder, although some scientists and policy-makers have questioned early universal screening. The aim of this meta-analysis was to evaluate the diagnostic accuracy of the different screening tools. Several electronic databases were used to identify published studies. A Bayesian model was used to estimate the screening accuracy. The pooled sensitivity was 0.72 (95% CI 0.61–0.81), and the specificity was 0.98 (95% CI 0.97–0.99). Subgroup analyses to remove heterogeneity indicated sensitivity was 0.77 (95% CI 0.69–0.84), and specificity was 0.99 (95% CI 0.97–0.99; SD ≤ 0.01). Level 1 screening tools for ASD showed consistent statistically significant results and therefore are adequate to detect autism at 14–36 months.
Highlights
Population level screening for autism spectrum disorder (ASD) has been the subject of numerous papers, since the American Academy of Pediatrics
We excluded studies focused on tools that were not designed to screen for ASD, screening studies not applied to the general population, and all those that did not provide sufficient data to construct a 2 × 2 contingency table of screening × diagnosis, or had a low quality rating in the quality assessment
A systemic review and meta-analysis of screening tools to detect ASD in toddlers determined that these measures detect ASD with high Se and Sp
Summary
Population level (level 1) screening for autism spectrum disorder (ASD) has been the subject of numerous papers, since the American Academy of Pediatrics. The variety of screening tools for prospective identification of early signs of autism has encouraged the publication of different systematic reviews (Daniels et al 2014; McPheeters et al 2016). The U.S Preventive Services Task Force (USPSTF; Siu and Preventive Services Task Force 2016) concluded that there was insufficient evidence to provide a recommendation regarding universal toddler screening for ASD. At the same time they emphasized the potential of the M-CHAT as a universal screening tool, as evidenced by empirical results The meta-analysis is an important resource to summarize—in quantitative terms—the accuracy of diagnostic test, providing a higher level of evidence; for this reason, the current study conducted a meta-analysis to review empirical data from the studies and tools used since the first ASD. M-CHAT JOBS M-CHAT + JOBS CHAT M-CHAT PEDS+ PATH M-CHAT_JV M-CHAT M-CHAT/Yale Screener + STATM-CHAT SACS
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