Aperçu: G.M.
Cinquante-quatre
études ont été analysées, avec 13 784 284 participants, dont 53 712
avaient un TSA (43 972 garçons et 9 740 filles).
La
mesure de résultat combinée était le rapport de cote entre hommes et
femmes (MFOR), à savoir la probabilité d'être masculin dans le groupe
avec TSA par rapport à un groupe non-TSA. En effet, il s'agit du rapport TSA masculin-féminin, qui contrôle le rapport homme-femme entre les participants sans TSA.
Le
MFOR combiné global était de 4,20 (IC 95%: 3,84 à 4,60), mais il y
avait une variabilité entre les études très importante (I2 = 90,9%). Les études de haute qualité avaient un MFOR inférieur (3,32; IC à 95%: 2,88 à 3,84). Les
études qui ont examiné la population en général pour identifier les
participants, indépendamment qu'ils aient déjà eu un diagnostic de TSA, ont montré un
MFOR inférieur (3,25; IC à 95%: 2,93-3,62) comparé aux études qui ont
seulement déterminé les participants avec un diagnostic TSA préexistant
(MFOR 4,56; 95 % CI 4.10-5.07).
J Am Acad Child Adolesc Psychiatry. 2017 Jun;56(6):466-474. doi: 10.1016/j.jaac.2017.03.013. Epub 2017 Apr 5.
What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis
Author information
- 1
- University College London, UK.
- 2
- University College London, UK. Electronic address: w.mandy@ucl.ac.uk.
Abstract
OBJECTIVE:
To derive the first systematically calculated estimate of the relative proportion of boys and girls with autism spectrum disorder (ASD) through a meta-analysis of prevalence studies conducted since the introduction of the DSM-IV and the International Classification of Diseases, Tenth Revision.METHOD:
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The Medline, Embase, and PsycINFO databases were searched, and study quality was rated using a risk-of-bias tool. Random-effects meta-analysis was used. The pooled outcome measurement was the male-to-female odds ratio (MFOR), namely the odds of being male in the group with ASD compared with the non-ASD group. In effect, this is the ASD male-to-female ratio, controlling for the male-to-female ratio among participants without ASD.RESULTS:
Fifty-four studies were analyzed, with 13,784,284 participants, of whom 53,712 had ASD (43,972 boys and 9,740 girls). The overall pooled MFOR was 4.20 (95% CI 3.84-4.60), but there was very substantial between-study variability (I2 = 90.9%). High-quality studies had a lower MFOR (3.32; 95% CI 2.88-3.84). Studies that screened the general population to identify participants regardless of whether they already had an ASD diagnosis showed a lower MFOR (3.25; 95% CI 2.93-3.62) than studies that only ascertained participants with a pre-existing ASD diagnosis (MFOR 4.56; 95% CI 4.10-5.07).CONCLUSION:
Of children meeting criteria for ASD, the true male-to-female ratio is not 4:1, as is often assumed; rather, it is closer to 3:1. There appears to be a diagnostic gender bias, meaning that girls who meet criteria for ASD are at disproportionate risk of not receiving a clinical diagnosis.
Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
- PMID: 28545751
- DOI: 10.1016/j.jaac.2017.03.013
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