{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T01:19:28Z","timestamp":1793409568718,"version":"4.5.0"},"reference-count":78,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Pediatr"],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>The Modified Checklist for Autism in Toddlers (M-CHAT) and the M-CHAT, Revised With Follow-up (M-CHAT-R\/F)\u2014henceforth referred to as M-CHAT(-R\/F)\u2014are the most commonly used toddler screeners for autism spectrum disorder (ASD). Their use often differs from that in the original validation studies, resulting in a range of estimates of sensitivity and specificity. Also, given the variability in reports of the clinical utility of the M-CHAT(-R\/F), researchers and practitioners lack guidance to inform autism screening protocols.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To synthesize variability in sensitivity and specificity of M-CHAT(-R\/F) across multiple factors, including procedures for identifying missed cases, likelihood level, screening age, and single compared with repeated screenings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>A literature search was conducted with PubMed, Web of Science, and Scopus to identify studies published between January 1, 2001, and August 31, 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Selection<\/jats:title>\n                    <jats:p>Articles were included if the studies used the M-CHAT(-R\/F) (ie, original or revised version) to identify new ASD cases, were published in English-language peer-reviewed journals, included at least 10 ASD cases, reported procedures for false-negative case identification, screened children by 48 months, and included information (or had information provided by authors when contacted) needed to conduct the meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Extraction and Synthesis<\/jats:title>\n                    <jats:p>\n                      The systematic review and meta-analysis was conducted within the Preferred Reporting Items for Systematic Reviews and Meta-analyses (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.equator-network.org\/reporting-guidelines\/prisma\/\">PRISMA<\/jats:ext-link>\n                      ) reporting guideline. The Quality Assessment of Diagnostic Accuracy Studies\u20132 tool evaluated bias in sample selection. Data extraction and quality assessment were performed by 2 authors independently. The overall diagnostic accuracy of the M-CHAT(-R\/F) was assessed with the hierarchic summary receiver operating characteristic (HSROC) model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Sensitivity, specificity, diagnostic odds ratios, and HSROC curves of M-CHAT(-R\/F).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The review included 50 studies with 51 samples. The pooled sensitivity of M-CHAT(-R\/F) was 0.83 (95% CI, 0.77-0.88), and the pooled specificity was 0.94 (95% CI, 0.89-0.97). Heterogeneity analyses revealed greater diagnostic accuracy for low- vs high-likelihood samples, a concurrent vs prospective case confirmation strategy, a large vs small sample size, use of M-CHAT(-R\/F) Follow-up, and non-English vs English only.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Overall, results of this study suggest the utility of the M-CHAT(-R\/F) as an ASD screener. The wide variability in psychometric properties of M-CHAT(-R\/F) highlights differences in screener use that should be considered in research and practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamapediatrics.2022.5975","type":"journal-article","created":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T11:03:52Z","timestamp":1676891032000},"page":"373","source":"Crossref","is-referenced-by-count":106,"title":["Sensitivity and Specificity of the Modified Checklist for Autism in Toddlers (Original and Revised)"],"prefix":"10.1001","volume":"177","author":[{"given":"Andrea Trubanova","family":"Wieckowski","sequence":"first","affiliation":[{"name":"A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lashae N.","family":"Williams","sequence":"additional","affiliation":[{"name":"A.J. 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