Loomes, R;
Hull, L;
Mandy, WPL;
(2017)
What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis.
Journal of the American Academy of Child & Adolescent Psychiatry
, 56
(6)
pp. 466-474.
10.1016/j.jaac.2017.03.013.
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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 (I(2) = 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.
| Type: | Article |
|---|---|
| Title: | What Is the Male-to-Female Ratio in Autism Spectrum Disorder? A Systematic Review and Meta-Analysis |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.jaac.2017.03.013 |
| Publisher version: | http://doi.org/10.1016/j.jaac.2017.03.013 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Autism spectrum disorder, epidemiology, male-to-female ratio, meta-analysis, sex difference |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1558343 |
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