{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T22:42:13Z","timestamp":1784673733673,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T00:00:00Z","timestamp":1676851200000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["T32 AA013525"],"award-info":[{"award-number":["T32 AA013525"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["U01 AA014834"],"award-info":[{"award-number":["U01 AA014834"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["U01 AA026102"],"award-info":[{"award-number":["U01 AA026102"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["U24 AA014811"],"award-info":[{"award-number":["U24 AA014811"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["U24 AA014815"],"award-info":[{"award-number":["U24 AA014815"]}],"id":[{"id":"10.13039\/100000027","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alcohol: Clinical and Experimental Research"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>As many as 80% of individuals with fetal alcohol spectrum disorders (FASD) are misdiagnosed or not diagnosed. This study tests the accuracy and validity of a web\u2010based screening tool (the FASD\u2010Tree) for identifying children and adolescents with FASD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children with histories of prenatal alcohol exposure (PAE) and controls (<jats:italic>N<\/jats:italic>\u00a0=\u2009302, including 224 with PAE and 78 controls) were examined for physical signs of fetal alcohol syndrome (FAS), and parents completed behavioral questionnaires. Data were entered into the FASD\u2010Tree, a web\u2010based decision tree application. The FASD\u2010Tree provided two outcomes: a dichotomous indicator (yes\/no) and a numeric risk score (0 to 5), which have been shown separately to identify children with PAE and neurobehavioral impairment and to correlate with neurobehavioral outcomes. Overall accuracy (ACC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for the decision tree, risk score, and their combination. Misclassified cases were examined for systematic bias.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The FASD\u2010Tree was successful in accurately identifying youth with histories of PAE and the subgroup of individuals with FASD, indicating its validity as an FASD screening tool. Overall accuracy rates for FASD\u2010Tree components ranged from 75.0% to 84.1%, and both the decision tree outcome and risk score, and their combination, resulted in fair to good discrimination (area under the curve =\u00a00.722 to 0.862) of youth with histories of PAE or FASD. While most participants were correctly classified, those who were misclassified differed in IQ and attention. Race, ethnicity, and sex did not affect the results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The FASD\u2010Tree is not a biomarker of PAE and does not provide definitive evidence of prenatal alcohol exposure. Rather it is an accurate and valid screening tool for FASD and can be used by clinicians who suspect that a patient has a history of PAE, even if the exposure is unknown.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.14987","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T07:13:13Z","timestamp":1676963593000},"page":"263-272","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Validation of the <scp>FASD\u2010Tree<\/scp> as a screening tool for fetal alcohol spectrum disorders"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8499-9605","authenticated-orcid":false,"given":"Sarah N.","family":"Mattson","sequence":"first","affiliation":[{"name":"Center for Behavioral Teratology and Department of Psychology San Diego State University  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth Lyons","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine University of California, San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganz","family":"Chockalingam","sequence":"additional","affiliation":[{"name":"Center for Behavioral Teratology and Department of Psychology San Diego State University  San Diego California USA"},{"name":"Blue Resonance, LLC  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey\u00a0R.","family":"Wozniak","sequence":"additional","affiliation":[{"name":"Department of Psychiatry &amp; Behavioral Sciences University of Minnesota  Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew T.","family":"Hyland","sequence":"additional","affiliation":[{"name":"Center for Behavioral Teratology and Department of Psychology San Diego State University  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9231-647X","authenticated-orcid":false,"given":"Natasia S.","family":"Courchesne\u2010Krak","sequence":"additional","affiliation":[{"name":"Center for Behavioral Teratology and Department of Psychology San Diego State University  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Del Campo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine University of California, San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward P.","family":"Riley","sequence":"additional","affiliation":[{"name":"Center for Behavioral Teratology and Department of Psychology San Diego State University  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the 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