Sensibilidad y especificidad del ADOS – 2 y el ADI- R en el diagnóstico del trastorno del espectro autista en niños: revisión sistemática

Abstract

Title: Sensitivity and specificity of ADOS-2 and ADI-R in the diagnosis of Autism Spectrum Disorder in children: a systematic review. Objectives: To evaluate and compare the sensitivity and specificity of the diagnostic methods ADOS-2 and ADI-R in identifying Autism Spectrum Disorder (ASD) in the pediatric population. Methodology: Observational studies (retrospective cohorts studies and case-control studies) published between 2014 and 2024 in English and Spanish were included. Incomplete articles, clinical trials, and studies conducted in non-pediatric populations were excluded. Information sources included Scopus, SciELO, PubMed, EBSCO, Web of Science, Redalyc, Springer, and ScienceDirect. The ROBINS tool and the National Heart, Lung, and Blood Institute guidelines were used to assess risk of bias and methodological quality. Sensitivity, specificity, and positive likelihood ratios (PLR) and negative likelihood ratios (NLR) were analyzed. Results: Seven studies with 3,570 participants were included. ADOS-2 showed a sensitivity ranging from 79% to 95% and a specificity ranging from 63% to 92%. ADI-R demonstrated a sensitivity of 77% to 91% and a specificity of 73% to 85%. The combination of both instruments reached a sensitivity of 83% and a specificity of 85%. The PLR ranged from 5 to 10, indicating moderate diagnostic effectiveness, while the NLR was less than 1, reducing the probability of ASD in cases of negative results. Conclusions: The combination of ADOS-2 and ADI-R improves early the detection and diagnostic accuracy of ASD in the pediatric population, reducing clinical errors and promoting a comprehensive assessment. Keywords: ADI-R, ADOS-2, specificity, sensitivity, autism spectrum disorder