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首页> 美国卫生研究院文献>Springer Open Choice >The agreement between the referrer practitioner and research diagnosis of autistic spectrum conditions among children attending child and adolescent mental health services
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The agreement between the referrer practitioner and research diagnosis of autistic spectrum conditions among children attending child and adolescent mental health services

机译：推荐人从业者和参加儿童和青少年心理健康服务的儿童中自闭症状况的研究诊断之间的协议

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We aimed to explore the levels of agreement about the diagnoses of Autistic Spectrum Conditions between the referrer, CAMHS practitioner and a research diagnosis, as well as the stability of the practitioner’s diagnosis over time in a secondary analysis of data from 302 children attending two Child and Adolescent Mental Health Services over two years. Kappa coefficient was used to assess the agreement between the referrer and research diagnosis. Kendall’s tau b coefficient was used to assess the agreement between the practitioner and the research diagnosis assigned using the Development and Well-Being Assessment, as well as the agreement between the referrer’s indication of presenting problems and the practitioner diagnosis. Diagnostic stability was explored in children with and without a research diagnosis of Autistic Spectrum Condition. There was a moderate level of agreement between the referrer and research diagnosis (Kappa = 0.51) and between practitioner’s and research diagnosis (Kendall’s tau = 0.60) at baseline, which reduced over the subsequent two years. Agreement between the referrer and practitioner’s diagnosis at baseline was fair (Kendall’s tau = 0.36).The greatest diagnostic instability occurred among children who practitioners considered to have possible Autistic Spectrum Conditions but who did not meet research diagnostic criteria. Further studies could explore the approaches used by practitioners to reach diagnoses and the impact these may have on diagnostic stability in Autistic Spectrum Conditions. Standardised assessment using a clinically rated diagnostic framework has a potential role as an adjunct to standard clinical care and might be particularly useful where practitioners are uncertain.
机译：我们的目的是通过对来自302名参加两个儿童节和两个儿童节的302名儿童的数据进行二次分析，探讨引荐人，CAMHS从业者与研究诊断之间关于自闭症状况诊断的共识水平，以及从业者诊断随时间推移的稳定性。两年以上的青少年心理健康服务。 Kappa系数用于评估推荐人与研究诊断之间的一致性。肯德尔的tau b系数用于评估从业者与使用“发展和幸福感评估”分配的研究诊断之间的一致性，以及引荐人出现问题的指示与从业者诊断之间的一致性。在有或没有自闭症谱系研究诊断的儿童中探讨了诊断稳定性。推荐人与研究诊断之间（Kappa = 0.51）以及从业者与研究诊断之间（Kendall's tau = 0.60）在基线时达成了中等水平的协议，此后的两年中这有所减少。推荐人和从业者在基线时的诊断之间的协议是公平的（肯德尔的tau = 0.36）。最大的诊断不稳定发生在从业者认为可能患有自闭症但不符合研究诊断标准的儿童中。进一步的研究可以探索从业人员用于进行诊断的方法，以及这些方法可能对自闭症患者的诊断稳定性产生的影响。使用经过临床评估的诊断框架进行的标准化评估具有作为标准临床护理的辅助功能，并且在从业人员不确定的情况下可能特别有用。

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