ReviewAcademic pediatrics2017
Is a Positive Developmental-Behavioral Screening Score Sufficient to Justify Referral? A Review of Evidence and Theory.
Review in Academic pediatrics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed.
- Effect of a Computer-Based Decision Support Intervention on Autism Spectrum Disorder Screening in Pediatric Primary Care Clinics: A Cluster Randomized Clinical Trial.JAMA network open · 2019Trial
- Longitudinal Stability and Validity of Parent-Reported Mental Health Measures in a Preschool Community Population.Child psychiatry and human development · 2026Article
- Measuring child development at the 2-2½-year health and development review in England: a rapid scoping review of available tools.BMJ open · 2026Article
- Multi-informant reports of preschool mental health: Validation of parent and educator reports and normative data for the preschool Pediatric Symptom Checklist and PSC-17.Child and adolescent psychiatry and mental health · 2025Article
- Development and validation of the Parent-Reported Indicator of Developmental Evaluation for Chinese Children (PRIDE) tool.World journal of pediatrics : WJP · 2025Article
- Early and repeated screening detects children with persistent attention-deficit/hyperactivity disorder.European child & adolescent psychiatry · 2024Article
- Psychosocial Competencies Among Clinic-Referred and Community-Based Children: Known-Groups Validity of the Psychosocial Strengths Inventory for Children and Adolescents (PSICA).Research on child and adolescent psychopathology · 2024Article
- The influence of loss to follow-up in autism screening research: Taking stock and moving forward.Journal of child psychology and psychiatry, and allied disciplines · 2024Article
- Assessing the Validity of the Baby Pediatric Symptom Checklist Using a Nationally Representative Household Survey.Academic pediatrics · 2023Article
- The implementation of the screening tool for autism in toddlers in Part C early intervention programs: An 18-month follow-up.Autism : the international journal of research and practice · 2023Article
- Rapid-cycle systems modeling to support evidence-informed decision-making during system-wide implementation.Implementation science communications · 2021Article
- The decision sampling framework: a methodological approach to investigate evidence use in policy and programmatic innovation.Implementation science : IS · 2021Article
- Multi-stage Screening in Early Intervention: A Critical Strategy for Improving ASD Identification and Addressing Disparities.Journal of autism and developmental disorders · 2021Article
- Describing the emotional exhaustion, depersonalization, and low personal accomplishment symptoms associated with Maslach Burnout Inventory subscale scores in US physicians: an item response theory analysis.Journal of patient-reported outcomes · 2020Article
- Comparative Accuracy of Developmental Screening Questionnaires.JAMA pediatrics · 2020Article
- Multi-method process maps: An interdisciplinary approach to investigateJournal of clinical and translational science · 2020Article
- Autism spectrum disorder: psychological and functional assessment, and behavioral treatment approaches.Translational pediatrics · 2020Review
- Adherence to screening and referral guidelines for autism spectrum disorder in toddlers in pediatric primary care.PloS one · 2020Article
- Establishing New Norms for Developmental Milestones.Pediatrics · 2019Article
- What Drives Detection and Diagnosis of Autism Spectrum Disorder? Looking Under the Hood of a Multi-stage Screening Process in Early Intervention.Journal of autism and developmental disorders · 2019Article
Corrections and comments
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Authors and funding
2 authors.
Funding
Abstract
In their recommendations on screening for autism and developmental disabilities, the American Academy of Pediatrics recommends referral subsequent to a positive screening result. In this article, we argue that positive screening results are not always sufficient to justify a referral. We show that although positive predictive values are often low, they actually overstate the probability of having a disorder for many children who screen positive. Moreover, recommended screening thresholds are seldom set to ensure that the benefits of referral will equal or exceed the costs and risk of harm, which is a necessary condition for an optimal threshold in decision analysis. Drawing on recent recommendations for the Institute of Medicine/National Academy of Medicine, we discuss the implications of this argument for pediatric policy, education, and practice. In particular, we recommend that screening policies be revised to ensure that the costs and benefits of actions recommended in the event of a positive screen are appropriate to the screening threshold. We recommend greater focus on clinical decision-making in the education of physicians, including shared decision-making with patients and their families. Finally, we recommend broadening the scope of screening research to encompass not only the accuracy of specific screening instruments, but also their ability to improve decision-making in the context of systems of care.
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Registered trials
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