To evaluate the module-specific diagnostic accuracy of ADOS-2 in real-world clinical referral populations and examine sources of heterogeneity.
Approach:
Method: label
Method: text
Key Findings:
Overall pooled sensitivity was 0.88 (95% CI: 0.83–0.92) and pooled specificity was 0.74 (95% CI: 0.68–0.80), with an HSROC AUC of 0.86, based on six studies providing extractable 2×2 data.
The Toddler Module showed the highest diagnostic performance (sensitivity 0.92; specificity 0.88; AUC 0.94) from the studies included.
Reduced specificity was more frequently observed in higher modules, particularly among verbally fluent adolescents and adults with more psychiatric complexity, as indicated by the meta-regression analysis.
Interpretation:
ADOS-2 demonstrates high overall sensitivity but variable specificity across modules in real-world clinical referral populations.
Limitations:
Heterogeneity in diagnostic performance across different modules and clinical contexts may affect the generalizability of the findings.
Limited number of studies providing extractable 2×2 data for quantitative pooling restricts the robustness of the conclusions drawn.
Conclusion:
ADOS-2 shows high sensitivity but variable specificity.
