The Optimal Cut-Off Point for Thai Diagnostic Autism Scale and Probability Prediction of Autism Spectrum Disorder Diagnosis in Suspected Children

Abstract

The Thai Diagnostic Autism Scale (TDAS) was developed to diagnose autism spectrum disorder (ASD) under the context and characteristics of the Thai population. Although the tool has an excellent agreement, the interpretation of diagnostic results needs to rely on the optimal cut-off point to maximize efficiency and clarity. This study aims to find an optimal cut-off point for TDAS in the diagnosis of ASD and to compare its agreement with the DSM-5 ASD criteria. This study was conducted on 156 children aged 12–48 months old who were suspected of having ASD and had enrolled from hospitals in the four regions of Thailand in 2017–2018. The optimal cut-off point for TDAS was considered by using receiver operating characteristic (ROC) curves according to the DSM-5 ASD criteria. The areas under the curve (AUCs) for TDAS and ADOS-2 were also compared. Multivariable logistic regression was performed to create a predictive model for the probability of ASD. The AUC of TDAS was significantly higher than that of ADOS-2 (0.8748 vs. 0.7993; p = 0.033). The optimal cut-off point for TDAS was ≥20 points (accuracy = 82.05%, sensitivity = 82.86%, and specificity = 80.93%). Our findings show that TDAS with a cut-off point can yield higher diagnostic accuracy than ADOS-2 and TDAS domain. Diagnosis by using this cut-off point could be useful in practical assessments.

Economic Evaluation of the Thai Diagnostic Autism Scale for Autism Spectrum Disorder Diagnosis in Children Aged 1–5 Years Old

“…TDAS required administration by trained healthcare providers. According to previous studies [17,18], the sensitivity and specificity of TDAS were 82.86% and 80.93%, respectively, and the accuracy was 82.05%. The comparator was ClinDx of ASD in children, which was based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) [25,26].…”

“…Furthermore, TDAS showed excellent sensitivity at 100% and a good specificity at 82.4%. Another study [17] indicated that the performance of TDAS is comparable to that of the ADOS-2, a well-established instrument in ASD diagnosis. These highlight the potential of TDAS as a reliable and effective option for early ASD diagnosis.…”

“…A pragmatic review literature was conducted to determine the performance of TDAS. The performance of TDAS was derived from a previous study [17]. The probability of a true positive of TDAS was 82.86%, whereas the probability of a false negative was 19.61%.…”

“…The probability of a true positive of TDAS was 82.86%, whereas the probability of a false negative was 19.61%. The likelihood of being diagnosed by TDAS was 89.90% [27], compared to 67.31% for ClinDx [17] (Table 1). The number of ASD diagnoses (per week) 2.0 (-) Fixed…”

“…A novel ASD diagnostic tool, the Thai Diagnostic Autism Scale (TDAS), has been developed and validated for assessing children suspected of having ASD [17,18]. TDAS comprises 13 observation items and 17 interview items.…”