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Hidden Aspects of the Research ADOS Are Bound to Affect Autism Science
Neural Computation ( IF 2.9 ) Pub Date : 2020-03-01 , DOI: 10.1162/neco_a_01263 Elizabeth B Torres 1 , Richa Rai 2 , Sejal Mistry 3 , Brenda Gupta 4
Neural Computation ( IF 2.9 ) Pub Date : 2020-03-01 , DOI: 10.1162/neco_a_01263 Elizabeth B Torres 1 , Richa Rai 2 , Sejal Mistry 3 , Brenda Gupta 4
Affiliation
The research-grade Autism Diagnostic Observational Schedule (ADOS) is a broadly used instrument that informs and steers much of the science of autism. Despite its broad use, little is known about the empirical variability inherently present in the scores of the ADOS scale or their appropriateness to define change and its rate, to repeatedly use this test to characterize neurodevelopmental trajectories. Here we examine the empirical distributions of research-grade ADOS scores from 1324 records in a cross-section of the population comprising participants with autism between five and 65 years of age. We find that these empirical distributions violate the theoretical requirements of normality and homogeneous variance, essential for independence between bias and sensitivity. Further, we assess a subset of 52 typical controls versus those with autism and find a lack of proper elements to characterize neurodevelopmental trajectories in a coping nervous system changing at nonuniform, nonlinear rates. Repeating the assessments over four visits in a subset of the participants with autism for whom verbal criteria retained the same appropriate ADOS modules over the time span of the four visits reveals that switching the clinician changes the cutoff scores and consequently influences the diagnosis, despite maintaining fidelity in the same test's modules, room conditions, and tasks' fluidity per visit. Given the changes in probability distribution shape and dispersion of these ADOS scores, the lack of appropriate metric spaces to define similarity measures to characterize change and the impact that these elements have on sensitivity-bias codependencies and on longitudinal tracking of autism, we invite a discussion on readjusting the use of this test for scientific purposes.
中文翻译:
ADOS 研究的隐藏方面必然会影响自闭症科学
研究级自闭症诊断观察表 (ADOS) 是一种广泛使用的工具,可为自闭症科学提供信息和指导。尽管使用广泛,但人们对 ADOS 量表分数中固有的经验变异性或其定义变化及其速率的适当性知之甚少,以反复使用该测试来表征神经发育轨迹。在这里,我们研究了 1324 条记录的研究级 ADOS 分数的经验分布,这些记录包括 5 至 65 岁的自闭症参与者。我们发现这些经验分布违反了正态性和齐次方差的理论要求,这对于偏差和敏感性之间的独立性至关重要。更多,我们评估了 52 个典型对照与自闭症患者的子集,发现缺乏适当的元素来表征以不均匀、非线性速率变化的应对神经系统中的神经发育轨迹。在四次就诊的时间跨度内,口头标准保留相同的适当 ADOS 模块的一部分自闭症参与者重复评估四次,结果表明,尽管保持保真度,但切换临床医生会改变截止分数并因此影响诊断在同一测试的模块中,房间条件和每次访问的任务流动性。鉴于这些 ADOS 分数的概率分布形状和离散度的变化,
更新日期:2020-03-01
中文翻译:
ADOS 研究的隐藏方面必然会影响自闭症科学
研究级自闭症诊断观察表 (ADOS) 是一种广泛使用的工具,可为自闭症科学提供信息和指导。尽管使用广泛,但人们对 ADOS 量表分数中固有的经验变异性或其定义变化及其速率的适当性知之甚少,以反复使用该测试来表征神经发育轨迹。在这里,我们研究了 1324 条记录的研究级 ADOS 分数的经验分布,这些记录包括 5 至 65 岁的自闭症参与者。我们发现这些经验分布违反了正态性和齐次方差的理论要求,这对于偏差和敏感性之间的独立性至关重要。更多,我们评估了 52 个典型对照与自闭症患者的子集,发现缺乏适当的元素来表征以不均匀、非线性速率变化的应对神经系统中的神经发育轨迹。在四次就诊的时间跨度内,口头标准保留相同的适当 ADOS 模块的一部分自闭症参与者重复评估四次,结果表明,尽管保持保真度,但切换临床医生会改变截止分数并因此影响诊断在同一测试的模块中,房间条件和每次访问的任务流动性。鉴于这些 ADOS 分数的概率分布形状和离散度的变化,