ArticleAdvances in pediatric research2019
Comparison of the 4-Digit Code, Canadian 2015, Australian 2016 and Hoyme 2016 fetal alcohol spectrum disorder diagnostic guidelines.
Article in Advances in pediatric research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Recent breakthroughs in understanding the cerebellum's role in fetal alcohol spectrum disorder: A systematic review.Alcohol (Fayetteville, N.Y.) · 2024Pooled it
- Dysmorphological and Neuropsychological Phenotypes of Prenatally Alcohol-Exposed 6-Year-Old Children: A Prospective Longitudinal Birth Cohort Study.Alcohol, clinical & experimental research · 2026Article
- Comparing rates of agreement between different diagnostic criteria for fetal alcohol spectrum disorder: A systematic review.Alcohol, clinical & experimental research · 2025Review
- Normative Magnetic Resonance Imaging Data Increase the Sensitivity to Brain Volume Abnormalities in the Classification of Fetal Alcohol Spectrum Disorder.The Journal of pediatrics · 2024Article
- Diagnostic Accuracy and economic value of a Tiered Assessment for Fetal Alcohol Spectrum Disorder (DATAforFASD): Protocol.BMJ open · 2023Article
- Rapid urine screening for ethyl glucuronide from pregnant women as a tool for detecting prenatal alcohol exposure.BMC pregnancy and childbirth · 2023Article
- Children with FASD-Evolving Patterns of Developmental Problems and Intervention Costs in Ages 0 through 16 in Finland.Children (Basel, Switzerland) · 2023Article
- Article
- Visual and ocular findings in children with fetal alcohol spectrum disorders (FASD): validating the FASD Eye Code in a clinical setting.BMJ open ophthalmology · 2023Article
- Fetal alcohol spectrum disorders.Nature reviews. Disease primers · 2023Review
- Comparison of three systems for the diagnosis of fetal alcohol spectrum disorders in a community sample.Alcohol, clinical & experimental research · 2023Article
- International Survey of Specialist Fetal Alcohol Spectrum Disorder Diagnostic Clinics: Comparison of Diagnostic Approach and Considerations Regarding the Potential for Unification.International journal of environmental research and public health · 2022Article
- Key Stakeholder Priorities for the Review and Update of the Australian Guide to Diagnosis of Fetal Alcohol Spectrum Disorder: A Qualitative Descriptive Study.International journal of environmental research and public health · 2022Article
- Article
- Fetal Alcohol Spectrum Disorders: Awareness to Insight in Just 50 Years.Alcohol research : current reviews · 2022Article
- Prevalence of Fetal Alcohol Spectrum Disorders (FASD) among Children Adopted from Eastern European Countries: Russia and Ukraine.International journal of environmental research and public health · 2021Article
- The FASD Eye Code: a complementary diagnostic tool in fetal alcohol spectrum disorders.BMJ open ophthalmology · 2021Article
- High facial specificity and positive predictive value are required to diagnose fetal alcohol syndrome when prenatal alcohol exposure is unknown.Advances in pediatric research · 2020Article
- Comparing narrative storytelling ability in individuals with autism and fetal alcohol spectrum disorders.International journal of language & communication disordersArticle
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundAs clinicians strive to achieve consensus worldwide on how best to diagnose fetal alcohol spectrum disorders (FASD), the most recent FASD diagnostic systems show convergence and divergence. Applying these systems to a single clinical population illustrates the contrasts between them, but validation studies are ultimately required to identify the best system.
methodsThe 4-Digit-Code, Hoyme 2016, Canadian 2015 and Australian 2016 FASD diagnostic systems were applied to 1,392 patient records evaluated for FASD at the University of Washington. The diagnostic criteria and tools, the prevalence and concordance of diagnostic outcomes, and validity measures were compared between the systems.
resultsThe proportion diagnosed with fetal alcohol syndrome (FAS) and FASD varied significantly (4-Digit-Code 2.1%, ≤79%; Hoyme 6.4%, 44%, Australian 1.8%, 29%; Canadian 1.8%, 16%). Eighty-two percent were diagnosed FASD by at least one system; only 11% by all four systems. Key factors contributing to discordance include: requiring high alcohol exposure; excluding growth deficiency; relaxing the facial criteria; requiring brain criteria that prevent diagnosis of infants/toddlers; and excluding moderate dysfunction from the spectrum. Primate research confirms moderate dysfunction (1-2 domains ≤-2 standard deviations) is the most prevalent outcome caused by PAE (FAS 5%, severe dysfunction 31%, moderate dysfunction 59%). Only the 4-Digit-Code replicated this diagnostic pattern.
conclusionThe needs of individuals with FASD are best met when diagnostic systems provide accurate, validated diagnoses across the lifespan, the full spectrum of outcome, the full continuum of alcohol exposure; and utilize diagnostic nomenclature that accurately reflects the association between outcome and alcohol exposure.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.