170: Community General Paediatricians' Barriers to Providing Autism Spectrum Disorder Diagnoses
Notice bibliographique
Résumé
Wait times for diagnosis of autism spectrum disorders (ASD) may negatively impact outcomes by delaying access to early interventions. Community general pediatricians (CGPs) are often consulted in cases of suspected ASD, and may play a role in increasing ASD diagnostic capacity in the community setting. The objective of this study was to explore the perspectives of CGPs regarding their role in the system of ASD diagnoses using qualitative methods. We performed a phenomenological qualitative study of CGPs' experiences with cases of suspected ASD. Two groups of CGPs were sampled to provide varying perspectives: CGPs that had referred patients with suspected ASD for a subspecialist assessment, and CGPs that regularly attended ASD educational events. Individual in-depth interviews were recorded and transcribed. Two investigators coded each interview. Thematic saturation was reached when two successive interviews did not generate new codes. Texts were analyzed using a grounded theory approach. A preliminary theoretical framework was developed, summarized and sent to participants with a request for feedback. This feedback was incorporated into the final theoretical framework. Eleven in-depth interviews were conducted (six males, five females; mean years in practice 17.1). Participants described three elements to the process of assessment: diagnostic determination, communication of the diagnosis, and management of the diagnosis. Each element contains potential barriers to assigning a diagnosis of ASD. Diagnostic determination is affected by patient factors (such as age, severity, and comorbidities), family factors (the reliability of the historian), and physician factors (such as training, access to informal expert consultation, and interest in ASD). When communicating the diagnosis, it is important that families know enough, but not too much, about ASD; families who know too much are perceived to need an “expert” opinion. Participants described a significant emotional burden and were very sensitive to the impact of the diagnosis. They feel ill equipped to deal with the fragmented service delivery system for ASD. Helping families to access services is time-consuming, poorly remunerated, and less satisfying than other areas of pediatric practice. Though CGPs are frequently consulted on cases of suspected ASD, they experience many barriers to making a diagnosis, leading to increased subspecialist referrals. Efforts to improve diagnostic capacity in this group must focus not only on diagnostic determination, but also on communicating the diagnosis and efficiently connecting families to resources.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,009 | 0,044 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,005 | 0,003 |
| Communication savante | 0,003 | 0,003 |
| Science ouverte | 0,002 | 0,005 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».