{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:27:57Z","timestamp":1789586877062,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T00:00:00Z","timestamp":1673481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000027","name":"National Institute on Alcohol Abuse and Alcoholism","doi-asserted-by":"publisher","award":["R01\u00a0AA027785"],"award-info":[{"award-number":["R01\u00a0AA027785"]}],"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 AA019894"],"award-info":[{"award-number":["U01 AA019894"]}],"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\u00a0AA019879"],"award-info":[{"award-number":["U01\u00a0AA019879"]}],"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>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>It is estimated that 1%\u20135% of children in the United States are affected by prenatal alcohol exposure while only a small percentage are so identified in clinical practice. One explanation for this discrepancy may be the way in which diagnostic criteria are operationalized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>To evaluate the extent to which three commonly used systems for the diagnosis of Fetal Alcohol Spectrum Disorder (FASD) consistently identified children in a community sample, data from the Collaboration on Fetal Alcohol Spectrum Disorders Prevalence (COFASP) study were re\u2010analyzed. In the data set, there were 2325 children with variables necessary to allow diagnosis by three systems commonly used in North America. These systems were (1) that used by COFASP, which is a revised modification of the Institute of Medicine's recommendations, (2) the 4\u2010Digit Code, and (3) the most recent Canadian Guidelines. To determine the degree of association among these classifications, the Fleiss Multirater Kappa measure of agreement was applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among these three systems, 408 children were classified as FASD, 208 by the CoFASP system, 319 by the 4\u2010Digit Code, and 28 by the Canadian Guidelines. Agreement among the findings from the three systems varied from slight to fair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These results indicate a lack of consistency in these approaches to FASD diagnosis. Discrepancies result from differences in specifying the criteria used to define the diagnosis, including growth, physical features, neurobehavior, and alcohol\u2010use thresholds. The question of their relative accuracy cannot be resolved without reference to a measure of validity that does not currently exist, and this suggests the need for a more empirically based diagnostic schema.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acer.14999","type":"journal-article","created":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T20:04:11Z","timestamp":1671134651000},"page":"370-381","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Comparison of three systems for the diagnosis of fetal alcohol spectrum disorders in a community sample"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3399-6644","authenticated-orcid":false,"given":"Claire D.","family":"Coles","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences and Pediatrics Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2167-8921","authenticated-orcid":false,"given":"Gretchen","family":"Bandoli","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Family Medicine and Public Health University of California San Diego School of Medicine  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5008-0887","authenticated-orcid":false,"given":"Julie A.","family":"Kable","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences and Pediatrics Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"del Campo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Family Medicine and Public Health University of California San Diego School of Medicine  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Suttie","sequence":"additional","affiliation":[{"name":"Department of Women's and Reproductive Health University of Oxford  Oxford UK"},{"name":"Big Data Institute University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4675-7722","authenticated-orcid":false,"given":"Christina D.","family":"Chambers","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Family Medicine and Public Health University of California San Diego School of Medicine  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,12]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Manual for the ASEBA school\u2010age forms & profiles","author":"Achenbach T.M.","year":"2001"},{"key":"e_1_2_8_3_1","volume-title":"Diagnostic guide for fetal alcohol spectrum disorders: the 4\u2010digit diagnostic code","author":"Astley S.J.","year":"2004"},{"key":"e_1_2_8_4_1","first-page":"13","article-title":"Comparison of the FASD 4\u2010Digit Code and Hoyme et al. 2016 FASD Diagnostic Guidelines","volume":"4","author":"Astley S.J.","year":"2017","journal-title":"Advances in Pediatric Research"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9781139017343"},{"key":"e_1_2_8_6_1","volume-title":"The Beery\u2010Buktenica developmental test of visual\u2010motor integration","author":"Beery K.E.","year":"2004"},{"key":"e_1_2_8_7_1","volume-title":"Fetal alcohol syndrome: guidelines for referral and diagnosis","author":"Bertrand J.","year":"2004"},{"key":"e_1_2_8_8_1","unstructured":"Bower C.&Elliott E.J.(2016)Report to the Australian Government Department of Health: \u201cAustralian Guide to the diagnosis of Fetal Alcohol Spectrum Disorder (FASD)\u201d."},{"key":"e_1_2_8_9_1","volume-title":"Bracken basic concept scale \u2013 revised","author":"Bracken B.A.","year":"1998"},{"key":"e_1_2_8_10_1","unstructured":"CDC.gov. 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