关键词: 孤独症谱系障碍, 早期筛查, 三甲医院, 社区

Abstract: Objective To compare the screening results for autism spectrum disorder (ASD) between Grade Ⅲ level A hospitals and community health services,and to provide clues for future screening work. Methods A total of 7 381 toddlers aged 16~30 months were involved in the ASD screening,including 4 930 toddlers from Grade Ⅲ level A hospitals and 2 451 from communities.By using propensity score matching (PSM) method,2 451 pairs of toddlers with comparable basic information were used to compare the screening results between Grade Ⅲ level A hospitals and communities. Results The positive rate of Grade Ⅲ level A hospitals (17.7%) was higher than that of the communities (8.2%).The positive rate of follow-up interview(42.5%) was also higher than that of the communities (2.8%)(P<0.001).But the lost rate of diagnosis (11.7%) was lower than that in the communities (47.0%) (P＜0.001).The lost rates of follow-up interview in two kinds of samples were close(49.2% vs 47.0%,P=0.611). Conclusions The false positive rate in both Grade Ⅲ level A hospitals and communities is so high that the accuracy should be improved and follow-up interview should be taken seriously.Those failed to be followed up in communities are more likely to increase the risk of delayed diagnosis and treatment.An active monitoring,referral and follow-up system may help to improve early screening and diagnosis in primary health care services.

Key words: autism spectrum disorder, early screening, Grade Ⅲ level A hospital, community