{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T20:46:36Z","timestamp":1767991596431,"version":"3.49.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T00:00:00Z","timestamp":1689724800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T00:00:00Z","timestamp":1689724800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["npj Digit. Med."],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Fetal alcohol-spectrum disorder (FASD) is underdiagnosed and often misdiagnosed as attention-deficit\/hyperactivity disorder (ADHD). Here, we develop a screening tool for FASD in youth with ADHD symptoms. To develop the prediction model, medical record data from a German University outpatient unit are assessed including 275 patients aged 0\u201319 years old with FASD with or without ADHD and 170 patients with ADHD without FASD aged 0\u201319 years old. We train 6 machine learning models based on 13 selected variables and evaluate their performance. Random forest models yield the best prediction models with a cross-validated AUC of 0.92 (95% confidence interval [0.84, 0.99]). Follow-up analyses indicate that a random forest model with 6 variables \u2013 body length and head circumference at birth, IQ, socially intrusive behaviour, poor memory and sleep disturbance \u2013 yields equivalent predictive accuracy. We implement the prediction model in a web-based app called FASDetect \u2013 a user-friendly, clinically scalable FASD risk calculator that is freely available at<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/fasdetect.dhc-lab.hpi.de\">https:\/\/fasdetect.dhc-lab.hpi.de<\/jats:ext-link>.<\/jats:p>","DOI":"10.1038\/s41746-023-00864-1","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T12:01:59Z","timestamp":1689768119000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["FASDetect as a machine learning-based screening app for FASD in youth with ADHD"],"prefix":"10.1038","volume":"6","author":[{"given":"Lukas","family":"Ehrig","sequence":"first","affiliation":[]},{"given":"Ann-Christin","family":"Wagner","sequence":"additional","affiliation":[]},{"given":"Heike","family":"Wolter","sequence":"additional","affiliation":[]},{"given":"Christoph U.","family":"Correll","sequence":"additional","affiliation":[]},{"given":"Olga","family":"Geisel","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9966-6819","authenticated-orcid":false,"given":"Stefan","family":"Konigorski","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2023,7,19]]},"reference":[{"key":"864_CR1","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1002\/ddrr.68","volume":"15","author":"PA May","year":"2009","unstructured":"May, P. A. et al. Prevalence and epidemiologic characteristics of FASD from various research methods with an emphasis on recent in-school studies. Dev. Disabil. Res Rev. 15, 176\u2013192 (2009).","journal-title":"Dev. Disabil. Res Rev."},{"key":"864_CR2","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1055\/s-0031-1299682","volume":"224","author":"K Alex","year":"2012","unstructured":"Alex, K. & Feldmann, R. Children and adolescents with fetal alcohol syndrome (FAS): better social and emotional integration after early diagnosis. Klin. Padiatr. 224, 66\u201371 (2012).","journal-title":"Klin. Padiatr."},{"key":"864_CR3","first-page":"64","volume":"34","author":"B Paley","year":"2011","unstructured":"Paley, B. & O'Connor, M. J. Behavioral interventions for children and adolescents with fetal alcohol spectrum disorders. Alcohol Res. Health 34, 64\u201375 (2011).","journal-title":"Alcohol Res. 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Diagnosis of fetal alcohol syndrome (FAS): German guideline version 2013. Eur. J. Paediatr. Neurol. 17, 437\u2013446 (2013).","journal-title":"Eur. J. Paediatr. Neurol."},{"key":"864_CR7","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1093\/alcalc\/35.4.400","volume":"35","author":"SJ Astley","year":"2000","unstructured":"Astley, S. J. & Clarren, S. K. Diagnosing the full spectrum of fetal alcohol-exposed individuals: introducing the 4-digit diagnostic code. Alcohol 35, 400\u2013410 (2000).","journal-title":"Alcohol"},{"key":"864_CR8","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1111\/acer.14040","volume":"43","author":"SN Mattson","year":"2019","unstructured":"Mattson, S. N., Bernes, G. A. & Doyle, L. R. Fetal Alcohol Spectrum Disorders: A Review of the Neurobehavioral Deficits Associated With Prenatal Alcohol Exposure. Alcohol Clin. Exp. Res. 43, 1046\u20131062. (2019).","journal-title":"Alcohol Clin. Exp. 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In Handbook of Research on Machine Learning Applications and Trends: Algorithms, Methods, and Techniques. 2010. 128\u201346.","DOI":"10.4018\/978-1-60566-766-9.ch006"}],"container-title":["npj Digital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41746-023-00864-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41746-023-00864-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41746-023-00864-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,17]],"date-time":"2023-12-17T09:17:34Z","timestamp":1702804654000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41746-023-00864-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,19]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["864"],"URL":"https:\/\/doi.org\/10.1038\/s41746-023-00864-1","relation":{},"ISSN":["2398-6352"],"issn-type":[{"value":"2398-6352","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,19]]},"assertion":[{"value":"13 September 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 June 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 July 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"C.U.C. has been a consultant and\/or advisor to or has received honoraria from: AbbVie, Acadia, Alkermes, Allergan, Angelini, Aristo, Boehringer-Ingelheim, Cardio Diagnostics, Cerevel, CNX Therapeutics, Compass Pathways, Damitsa, Denovo, Gedeon Richter, Hikma, Holmusk, IntraCellular Therapies, Janssen\/J&J, Karuna, LB Pharma, Lundbeck, MedAvante-ProPhase, MedInCell, Merck, Mindpax, Mitsubishi Tanabe Pharma, Mylan, Neurocrine, Newron, Noven, Otsuka, Pharmabrain, PPD Biotech, Recordati, Relmada, Reviva, Rovi, Seqirus, SK Life Science, Sunovion, Sun Pharma, Supernus, Takeda, Teva, and Viatris. He provided expert testimony for Janssen and Otsuka. He served on a Data Safety Monitoring Board for Compass Pathways, Lundbeck, Relmada, Reviva, Rovi, Supernus, and Teva. He has received grant support from Janssen and Takeda. He received royalties from UpToDate and is also a stock option holder of Cardio Diagnostics, Mindpax, LB Pharma and Quantic. O.G. received honoraria from Takeda and Novartis. C.U.C. and O.G. declare no competing non-financial interests. The remaining authors declare no competing financial or non-financial interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"This study was conducted in accordance with the principles of the Declaration of Helsinki and Good Clinical Practice and approved by the local ethics committee at Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin (EA2\/053\/20). Consent\/assent requirements were waived for this retrospective chart review study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical statement"}}],"article-number":"130"}}