Validity and Cutoff Score of the Autism Mental Status Exam for an Autism Spectrum Disorder Diagnosis in Chinese Children

作者：Shuran Yang, Dong Han, Huizhi Zhou, Chen Yang, Kun Zhang, Shi Chen, Runxu Yang, Xia Cao, David Grodberg, Xudong Zhao & Chuanyuan Kang

摘要：

The Autism Mental Status exam (AMSE) has demonstrated excellent sensitivity and specificity in Western high-risk population with suspected autism spectrum disorder (ASD). This study aimed to evaluate the psychometric properties of the AMSE in a sample of high-risk Chinese children, and to determine the optimal cutoff score of the Chinese version of the AMSE in supporting ASD diagnosis. 66 young children aged from 2 to 11 years with suspected ASD were enrolled in the present study. A diagnosis of ASD or non-ASD was determined by a Best Estimate Diagnosis protocol according to the DSM-5 criteria. Receiver operating characteristic (ROC) curve analysis was conducted to assess the validity of the AMSE and search for the most effective cutoff score. The ROC curve analysis yields the area under the ROC curve of 0.98 which represents excellent diagnostic accuracy. Findings indicate the optimal cutoff score of the Chinese version of the AMSE was estimated as 6, producing the highest sensitivity of 98% and a specificity of 87%. Preliminary findings of the study suggest the AMSE has promising psychometric properties as an assessment tool for identifying ASD symptoms and supporting diagnostic decision-making in high-risk Chinese children population.

自闭症精神状态检查 （AMSE） 在疑似自闭症谱系障碍 （ASD） 的西方高危人群中显示出出色的敏感性和特异性。本研究旨在评估AMSE在中国高危儿童样本中的心理测量特性，并确定中文版AMSE在支持ASD诊断方面的最佳临界值。本研究招募了 66 名年龄在 2 至 11 岁之间疑似 ASD 的幼儿。根据 DSM-5 标准，通过最佳估计诊断方案确定 ASD 或非 ASD 的诊断。进行受试者工作特征 （ROC） 曲线分析以评估 AMSE 的有效性并寻找最有效的临界值。ROC 曲线分析得出的 ROC 曲线下面积为 0.98，具有出色的诊断准确性。结果表明，中文版AMSE的最佳临界值估计为6分，灵敏度最高，为98%，特异性为87%。该研究的初步结果表明，AMSE具有很有前途的心理测量特性，可作为识别ASD症状和支持中国高危儿童群体诊断决策的评估工具。