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Consensus diagnostic criteria for fetal alcohol spectrum disorders in Australia: a modified Delphi study

Watkins, Rochelle E., Elliott, Elizabeth J., Mutch, Raewyn C., Payne, Janet M., Jones, Heather M., Latimer, Jane, Russell, Elizabeth, Fitzpatrick, James P., Hayes, Lorian, Burns, Lucinda, Halliday, Jane, D'Antoine, Heather, Wilkins, Amanda, Peadon, Elizabeth, Miers, Sue, Carter, Maureen, O'Leary, Colleen M., McKenzie, Anne and Bower, Carol (2012). Consensus diagnostic criteria for fetal alcohol spectrum disorders in Australia: a modified Delphi study. BMJ Open,2(5):1-9.

Document type: Journal Article
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NHMRC Grant No. CB 634341
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Title Consensus diagnostic criteria for fetal alcohol spectrum disorders in Australia: a modified Delphi study
Author Watkins, Rochelle E.
Elliott, Elizabeth J.
Mutch, Raewyn C.
Payne, Janet M.
Jones, Heather M.
Latimer, Jane
Russell, Elizabeth
Fitzpatrick, James P.
Hayes, Lorian
Burns, Lucinda
Halliday, Jane
D'Antoine, Heather
Wilkins, Amanda
Peadon, Elizabeth
Miers, Sue
Carter, Maureen
O'Leary, Colleen M.
McKenzie, Anne
Bower, Carol
Journal Name BMJ Open
Publication Date 2012
Volume Number 2
Issue Number 5
ISSN 2044-6055   (check CDU catalogue open catalogue search in new window)
Scopus ID 2-s2.0-84869854856
Start Page 1
End Page 9
Total Pages 9
Place of Publication United Kingdom
Publisher B M J Group
HERDC Category C1 - Journal Article (DIISR)
Abstract Objective To evaluate health professionals' agreement with components of published diagnostic criteria for fetal alcohol spectrum disorders (FASD) in order to guide the development of standard diagnostic guidelines for Australia.

Design
A modified Delphi process was used to assess agreement among health professionals with expertise or experience in FASD screening or diagnosis. An online survey, which included 36 Likert statements on diagnostic methods, was administered over two survey rounds. For fetal alcohol syndrome (FAS), health professionals were presented with concepts from the Institute of Medicine (IOM), University of Washington (UW), Centers for Disease Control (CDC), revised IOM and Canadian diagnostic criteria. For partial FAS (PFAS), alcohol-related neurodevelopmental disorder (ARND), and alcohol-related birth defects (ARBD), concepts based on the IOM and the Canadian diagnostic criteria were compared.

Setting/participants
130 Australian and 9 international health professionals.

Results
Of 139 health professionals invited to complete the survey, 103 (74.1%) responded, and 74 (53.2%) completed one or more questions on diagnostic criteria. We found consensus agreement among participants on the diagnostic criteria for FAS, with the UW criteria most commonly endorsed when compared with all other published criteria for FAS. When health professionals were presented with concepts based on the Canadian and IOM diagnostic criteria, we found consensus agreement but no clear preference for either the Canadian or IOM criteria for the diagnosis of PFAS, and no consensus agreement on diagnostic criteria for ARND. We also found no consensus on the IOM diagnostic criteria for ARBD.

Conclusions
Participants indicated clear support for use of the UW diagnostic criteria for FAS in Australia. These findings should be used to develop guidelines to facilitate improved awareness of, and address identified gaps in the infrastructure for, FASD diagnosis in Australia.
DOI http://dx.doi.org/doi:10.1136/bmjopen-2012-001918   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.


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