Resident Medical College of Georgia at Augusta University Augusta, Georgia, United States
Background: The Modified Checklist for Autism in Toddlers-Revised with Follow Up (M-CHAT-R/F) is a commonly used screening tool for autism spectrum disorder (ASD) that yields risk categories to assist clinicians with an algorithm-driven care for high-risk patients. Although low and high-risk categories provide clarity for next steps in care, patients who screen in the medium risk category are recommended for a follow-up interview (FUI) to clarify responses of failed items on the M-CHAT-R/F. The goal of the FUI is to decrease the number of false positive screens and improve ASD detection. Objective: This study evaluates how the FUI of the M-CHAT-R/F is utilized for patients of an academic medical center's pediatrics clinic with medium risk of ASD and examines how the use (or absence) of FUI impacts follow on management for medium-risk patients when compared with high-risk patients for ASD. Design/Methods: The study was determined to be exempt by the Institutional Review Board at Augusta University. Demographic information, M-CHAT-R/F screening results, FUI score, referrals, and family history were extracted from the medical record for 307 patients. Analysis will involve descriptive statistics to describe differences in groups by their outcomes: FUI performed and/or referrals made for further evaluation. Categorical variables will be compared between medium- and high-risk autism groups using Chi-squared or Fisher’s exact tests. Significant variables associated with outcome variables will be incorporated into multivariate models to identify associations between ASD risk, FUI, and referral. We will also account for potential confounders. All tests will be two-sided at 0.05 significance level. We anticipate the project’s completion by January 2024.
