Troy Vargason1,2,3, Richard E Frye4,5, Deborah L McGuinness6,7, Juergen Hahn1,2,8. 1. Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, New York. 2. Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, New York. 3. OptumLabs Visiting Fellow, Cambridge, Massachusetts. 4. Department of Child Health, University of Arizona College of Medicine, Phoenix, Arizona. 5. Phoenix Children's Hospital, Phoenix, Arizona. 6. Department of Computer Science, Rensselaer Polytechnic Institute, Troy, New York. 7. Department of Cognitive Science, Rensselaer Polytechnic Institute, Troy, New York. 8. Department of Chemical and Biological Engineering, Rensselaer Polytechnic Institute, Troy, New York.
Abstract
Individuals with autism spectrum disorder (ASD) are frequently affected by co-occurring medical conditions (COCs), which vary in severity, age of onset, and pathophysiological characteristics. The presence of COCs contributes to significant heterogeneity in the clinical presentation of ASD between individuals and a better understanding of COCs may offer greater insight into the etiology of ASD in specific subgroups while also providing guidance for diagnostic and treatment protocols. This study retrospectively analyzed medical claims data from a private United States health plan between years 2000 and 2015 to investigate patterns of COC diagnoses in a cohort of 3,278 children with ASD throughout their first 5 years of enrollment compared to 279,693 children from the general population without ASD diagnoses (POP cohort). Three subgroups of children with ASD were identified by k-means clustering using these COC patterns. The first cluster was characterized by generally high rates of COC diagnosis and comprised 23.7% (n = 776) of the cohort. Diagnoses of developmental delays were dominant in the second cluster containing 26.5% (n = 870) of the cohort. Children in the third cluster, making up 49.8% (n = 1,632) of the cohort, had the lowest rates of COC diagnosis, which were slightly higher than rates observed in the POP cohort. A secondary analysis using these data found that gastrointestinal and immune disorders showed similar longitudinal patterns of prevalence, as did seizure and sleep disorders. These findings may help to better inform the development of diagnostic workup and treatment protocols for COCs in children with ASD. Autism Res 2019, 12: 1272-1285.
Individuals with autism spectrum disorder (ASD) are frequently affected by co-occurring medical conditions (COCs), which vary in severity, age of onset, and pathophysiological characteristics. The presence of COCs contributes to significant heterogeneity in the clinical presentation of ASD between individuals and a better understanding of COCs may offer greater insight into the etiology of ASD in specific subgroups while also providing guidance for diagnostic and treatment protocols. This study retrospectively analyzed medical claims data from a private United States health plan between years 2000 and 2015 to investigate patterns of COC diagnoses in a cohort of 3,278 children with ASD throughout their first 5 years of enrollment compared to 279,693 children from the general population without ASD diagnoses (POP cohort). Three subgroups of children with ASD were identified by k-means clustering using these COC patterns. The first cluster was characterized by generally high rates of COC diagnosis and comprised 23.7% (n = 776) of the cohort. Diagnoses of developmental delays were dominant in the second cluster containing 26.5% (n = 870) of the cohort. Children in the third cluster, making up 49.8% (n = 1,632) of the cohort, had the lowest rates of COC diagnosis, which were slightly higher than rates observed in the POP cohort. A secondary analysis using these data found that gastrointestinal and immune disorders showed similar longitudinal patterns of prevalence, as did seizure and sleep disorders. These findings may help to better inform the development of diagnostic workup and treatment protocols for COCs in children with ASD. Autism Res 2019, 12: 1272-1285.
Authors: Susan E Levy; Ellen Giarelli; Li-Ching Lee; Laura A Schieve; Russell S Kirby; Christopher Cunniff; Joyce Nicholas; Judy Reaven; Catherine E Rice Journal: J Dev Behav Pediatr Date: 2010-05 Impact factor: 2.225
Authors: Roberto Sacco; Carlo Lenti; Monica Saccani; Paolo Curatolo; Barbara Manzi; Carmela Bravaccio; Antonio M Persico Journal: Autism Res Date: 2012-03-17 Impact factor: 5.216
Authors: Sue Woolfenden; Vanessa Sarkozy; Greta Ridley; Michael Coory; Katrina Williams Journal: Dev Med Child Neurol Date: 2012-02-21 Impact factor: 5.449
Authors: Timothy Buie; Daniel B Campbell; George J Fuchs; Glenn T Furuta; Joseph Levy; Judy Vandewater; Agnes H Whitaker; Dan Atkins; Margaret L Bauman; Arthur L Beaudet; Edward G Carr; Michael D Gershon; Susan L Hyman; Pipop Jirapinyo; Harumi Jyonouchi; Koorosh Kooros; Rafail Kushak; Pat Levitt; Susan E Levy; Jeffery D Lewis; Katherine F Murray; Marvin R Natowicz; Aderbal Sabra; Barry K Wershil; Sharon C Weston; Lonnie Zeltzer; Harland Winter Journal: Pediatrics Date: 2010-01 Impact factor: 7.124
Authors: Isaac S Kohane; Andrew McMurry; Griffin Weber; Douglas MacFadden; Leonard Rappaport; Louis Kunkel; Jonathan Bickel; Nich Wattanasin; Sarah Spence; Shawn Murphy; Susanne Churchill Journal: PLoS One Date: 2012-04-12 Impact factor: 3.240
Authors: A Ingason; D Rujescu; S Cichon; E Sigurdsson; T Sigmundsson; O P H Pietiläinen; J E Buizer-Voskamp; E Strengman; C Francks; P Muglia; A Gylfason; O Gustafsson; P I Olason; S Steinberg; T Hansen; K D Jakobsen; H B Rasmussen; I Giegling; H-J Möller; A Hartmann; C Crombie; G Fraser; N Walker; J Lonnqvist; J Suvisaari; A Tuulio-Henriksson; E Bramon; L A Kiemeney; B Franke; R Murray; E Vassos; T Toulopoulou; T W Mühleisen; S Tosato; M Ruggeri; S Djurovic; O A Andreassen; Z Zhang; T Werge; R A Ophoff; M Rietschel; M M Nöthen; H Petursson; H Stefansson; L Peltonen; D Collier; K Stefansson; D M St Clair Journal: Mol Psychiatry Date: 2009-09-29 Impact factor: 15.992
Authors: Evangeline C Kurtz-Nelson; Jennifer S Beighley; Caitlin M Hudac; Jennifer Gerdts; Arianne S Wallace; Kendra Hoekzema; Evan E Eichler; Raphael A Bernier Journal: Child Health Care Date: 2020-03-17
Authors: Scott D Grosse; Phyllis Nichols; Kwame Nyarko; Matthew Maenner; Melissa L Danielson; Lindsay Shea Journal: J Autism Dev Disord Date: 2021-09-28
Authors: Matthew M Engelhard; Samuel I Berchuck; Jyotsna Garg; Ricardo Henao; Andrew Olson; Shelley Rusincovitch; Geraldine Dawson; Scott H Kollins Journal: Sci Rep Date: 2020-10-19 Impact factor: 4.379
Authors: Tania Akter; Mohammad Hanif Ali; Md Imran Khan; Md Shahriare Satu; Md Jamal Uddin; Salem A Alyami; Sarwar Ali; Akm Azad; Mohammad Ali Moni Journal: Brain Sci Date: 2021-05-31