Detection of ASD at the 1st birthday as standard of care: The Get SET Early Model

在 1 岁生日时检测 ASD 作为护理标准：Get SET Early 模型

• 批准号: 8916193
• 负责人: Karen L Pierce
• 金额: $ 110.7万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-25 至 2019-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8916193
• 关键词: 1 year old; Age; Americas; Autistic Disorder; Biological Models; CDC2 gene; Centers for Disease Control and Prevention (U.S.); Characteristics; Child; Childhood; Cities; Clinic; Clinical; Data; Databases; Detection; Development; Developmental Delay Disorders; Diagnosis; Diagnostic; Early Diagnosis; Early Intervention; Ensure; Evaluation; Guidelines; Habits; Health; Household; Income; Left; Life; Los Angeles; Measures; Medical; Modeling; Notification; Online Systems; Outcome Measure; Parents; Performance; Provider; Reporting; Research; Risk; Schedule; Sensitivity and Specificity; Services; Site; Speed; Staging; Surveys; System; Telephone; Testing; Toddler; Treatment outcome; United States Dept. of Health and Human Services; base; brain cell; catalyst; checkup examination; clinical practice; cohort; data sharing; design; digital; follow-up; improved; innovation; medical specialties; member; pediatrician; primary outcome; programs; prospective; research study; satisfaction; screening; standard of care; tool

DESCRIPTION (provided by applicant): We previously demonstrated that our early intervention model system, which was centered on using the CSBS to screen all babies at the 1-year check-up as standard of care, resulted in a mean age of 12 months for screening, 14 months for evaluation, and 18 months for treatment participation. These are far younger ages than is common in the U.S. Our 3-stage model system, Get SET (S=Screen; E=Evaluate; T=Treat) Early, screened >10,000 1 year olds in our first trial run1 detecting over 100 ASD and other developmental delayed toddlers. We will build on this highly effective model by implementing a new version in two major cities: San Diego and Phoenix; Los Angeles, Irvine, and Phoenix will provide baseline control data. In Phoenix, we test the feasibility of establishing the Get SET Early model in a city with one of the lowest median incomes and oldest age of first diagnosis in America. In AIM #1, the Screen and Refer Early stage, we will create a Pediatrician Network with 100 members. In San Diego we will utilize our existing Pediatrician Network and test new innovations such as a repeat triple screen at 12, 18, and 24 months to ensure that no toddlers are missed. Speed of referral for evaluation will be compared and contrasted using parent (self) and automatic (referral i- Pad App) options. We will track every toddler with an eventual ASD diagnosis within circumscribed medical groups to determine the true sensitivity and specificity of the screening tool and the percentage of ASD toddlers detected by our model. Anonymous survey data regarding screening habits will be administered to parents and pediatricians. AIM #2 implements the Evaluate and Refer Early stage. Its key attribute is an ASD Early Evaluation Clinic that specializes in the rapid scheduling and evaluation of every referred screened positive toddler. Toddlers will enter the program at the age they fail the screen (i.e., 12, 18 or 24 months) and will be thoroughly diagnostically evaluated and tracked once per year until they turn 3 years. This specialty Clinic is at our Autism Center in San Diego and will be developed at SARRC in Phoenix. Automated versus optional self-referral for treatment will be tested and compared. AIM #3 implements the Treat Early stage. Its key attributes are a network of providers of empirically based treatment and the innovative use of an inexpensive and readily available web-based treatment tracking system to document engagement. Treatment Networks will be created in San Diego and Phoenix. Primary outcome measures include rates and ages of screening and referral, evaluation and referral, and treatment engagement; sustainability across years; diagnostic, clinical and demographic characteristics of subjects; professional and parent satisfaction at each stage. We hypothesize that providing screening tools with clear cut-off scores and guidelines for automatic referral for evaluation and treatment, will result in dramatically lowering mean age of diagnosis and treatment in Phoenix from 4-5 years down to 1-2 years; San Diego will likewise have mean ages of 1-2 years for diagnosis and treatment making them significantly earlier than Los Angeles and Irvine control sites.

描述（由申请人提供）：我们先前证明，我们的早期干预模型系统以使用CSB为中心，以使用CSB作为1年检查作为护理标准的所有婴儿，导致筛查的平均年龄为12个月，评估14个月和18个月进行治疗。这些年龄远比美国的年龄要年轻，我们的三阶段模型系统是在我们的第一个试验中，筛选了> 10,000名1岁的筛查（s = screat; e =评估; t =治疗），在我们的第一次试验中> 10,000个1岁的孩子，检测100多个ASD和其他发育延迟的幼儿。我们将通过在两个主要城市实施新版本：圣地亚哥和凤凰城，以这种高效的模型为基础；洛杉矶，尔湾和凤凰城将提供基线控制数据。在凤凰城，我们测试了建立的可行性 在美国中位数最低和最古老的城市之一的城市中，获得了早期模型。在AIM＃1，屏幕并参考早期阶段，我们将创建一个具有100名成员的儿科网络。在圣地亚哥，我们将利用我们现有的儿科网络，并测试新的创新，例如在12、18和24个月的重复三重屏幕，以确保不会错过任何幼儿。将使用父（自动）和自动（推荐I- PAD应用程序）选项比较转介速度进行评估和对比。我们将在限定的医疗组中最终通过ASD诊断的每个幼儿跟踪每个幼儿，以确定筛选工具的真实敏感性和特异性以及我们模型检测到的ASD幼儿百分比。有关筛查习惯的匿名调查数据将向父母和儿科医生进行管理。 AIM＃2实现评估并参考早期阶段。它的关键属性是ASD早期评估诊所，专门研究每个推荐的筛选阳性幼儿的快速调度和评估。幼儿将在他们失败屏幕的年龄（即12、18或24个月）的年龄上输入该计划，并将每年对一次进行诊断和跟踪，直到他们3岁。该专业诊所位于我们位于圣地亚哥的自闭症中心，将在凤凰城的Sarrc开发。将测试和比较自动化自动和可选的自我推荐。目标＃3实现了早期阶段。它的关键属性是基于经验的治疗提供者的网络以及廉价且易于使用的基于Web的治疗跟踪系统的创新使用来记录参与度。将在圣地亚哥和凤凰城创建治疗网络。主要结果指标包括筛查和推荐，评估和转诊以及治疗参与的年龄；多年来的可持续性；受试者的诊断，临床和人口统计学特征；每个阶段的专业和父母满意度。我们假设为筛查工具提供明确的截止分数和自动转诊指南进行评估和治疗，将大大降低凤凰城的平均诊断和治疗年龄，从4 - 5年降至1-2岁。同样，圣地亚哥的诊断和治疗平均年龄将比洛杉矶和尔湾控制地点早1-2岁。