Researchers at Regenstrief Institute and Indiana School of Medicine have developed a system called Child Health Improvement through Computer Automation (CHICA) that they claim has increased the autism screening rate at 24 months of age from 0 to 100 percent. The results of their study were published in the journal JAMA Network Open. A report from Medical Xpress.com this month described CHICA as a “computerized decision support tool” that can interface with any electronic health record system. Parents in the waiting room can answer questions on a tablet computer, alerting CHICA to produce evidence-based, personalized recommendations. This allows pediatricians to focus on what the specific patient really needs, such as screening for autism, depression, tuberculosis, or anemia. CHICA has “completely automated the screening process, potentially making a difference for so many children and their families,” Regenstrief Research Scientist Dr. Stephen Downs said. “We know that children on the autism spectrum can be identified as young as 18 months; with CHICA we can get them evaluated and enrolled in early intervention programs which could improve their lives and save society millions, perhaps billions, of dollars." Downs added that children in the U.S. are typically diagnosed with autism at four and a half years, two and a half years later than optimal. He explained that autism is under-diagnosed in under-represented racial and ethnic minorities in the United States. “Automating the screening process as we did with CHICA avoids these kinds of biases and decreases health inequities,” he said. CHICA communicates with a child’s Electronic Health Record (EHR), analyzes the child’s demographics, diagnoses, and medications, and selects the 20 highest-priority yes-or-no questions covering a variety of primary care issues to ask the family in English or Spanish. After analyzing the responses to these questions, CHICA conducts a tailored health risk assessment and determines the six most important prompts for the physician. These are then assembled into a patient’s current visit agenda for the doctor, and stored for future decision support. “We built CHICA to optimize care,” Downs explained. “We call it an 'everything system' because it has a universe of guidelines and is able to sort out which ones are of most value to the specific patient and prioritize these items," he said. "But CHICA could also automate the referral process for diagnostic evaluation so more young children with autism are identified and can get early ABA therapy that can result in significant increases in IQ, even into the normal range with improved likelihood of mainstreaming in school." Source: https://medicalxpress.com/news/2020-02-autism-screening-soars-chica.html