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First physiological test for autism proves high accuracy in second trial (rpi.edu)
159 points by just_saying_it on June 21, 2018 | hide | past | favorite | 98 comments



This is quite interesting. Being on the spectrum myself, and many of my friends being so as well, it is very important how different everyone on the spectrum truly is. For high functioning people like myself I see Autism more akin to a mental super-power that can be crippled by small things. The difference in thinking is magnificent, and it aids in my success in most things that I do, but is an absolute disaster when it comes to socializing with people near me. In a town of 300 people, there aren't really any tech nerds or otherwise. Which makes socializing awkward since technology and game are a massive portion of my life. Even to just go to the doctor the interaction is anxiety inducing that my heart rate can raise by a good amount. (I've seen 133 on a bad day, when normally I hang out around 100.) Having to rely on analysis of people and memory of what people think is acceptable is absolutely exhausting.

Having a clear test for autism is wonderful, but the spectrum is of infinite width and infinite height.


my son ( 7 ) is like this, his brain lets him do interesting things, like from early on, you could hand him some paper and ask him to write things, then you could rotate the paper any way you like and he'd just carry on writing so it was fine when rotated back to normal. But he has a ton of trouble with socializing and has never made a friend, he is also a super realist. He doesn't like to pretend to be anything but himself. "If you could be an animal what animal woruld you be? - Human Boy". Any suggestion to pretend to be something else tends to be met with a reaction of "why on earth would I want to be anything but who I am". Or even if you over emphasise something like "Wow Ethan,you are super awesome" "no... I'm not awesome, I'm just normal"


It's quite interesting the differences. I wish you and your son the best of times in the future.


I like this kid.


> The difference in thinking is magnificent

How do you know this, having not experienced neurotypical thinking?


Its obvious, based on interactions with others, asking how they think and its well documented in research


To play Devil's Advocate though - confirmation bias is a funny thing, and self-diagnosis is too.

Not saying you or OP are wrong, and I believe the non-neurotypical thing, but these topics are ones where nearly everyone who says they are on the spectrum appear to be 100% vehemently sure they are, but not 100% of those people are correct.


^ this. People without a sense of smell still know that the smell of feaces is not enjoyable, just by observing and learning from other people's experiences.


Same with ADHD too.


> spectrum is of infinite width and infinite height

If this were true, everyone is diagnosable.


It was more for the aesthetic of the sentence, but if you have a spectrum including 'normalcy' that is infinite width and infinite height, with x being ability (a combined measurement of communication ability, sensitivities, etc) and y being level of function, it is possible to include 'normalcy' as it is defined at the farthest top right corner.

This could even have more dimensions to it, represented as 0-1 on each. If we're creating a diagnosis of a spectrum that directly affects function, does it not make sense for the general acceptance of normalcy to be represented as either all 1's or a number in-between? If being a savant gives someone greater individual knowledge, should this not be represented in a diagnosis of autism? Do they not instead become above that of normalcy by having this increased ability for specialized knowledge? This almost extends the idea of the spectrum into an extensive representation of a human's ability to function. With the idea of the spectrum being so wide, having a system to classify a human's ability to function over certain categories can aid in the ability to define normalcy and otherwise. The more pieces of information we have in this essentially matrix allows us to have a clear-cut understanding of what most people fall under. To limit this to 3-dimensional space helps as humans to visualize this, but to limit a tool to what we can visualize can hamper its ability.

(I am not a doctor)


This is wrong twice I'm afraid.

First: a graph with two infinite dimensions doesn't have a top right point, it has a top right extent.

Second: when graphing, you don't get to pick what the normal is. That's a property of the graph. It is not the (impossible) property you've described.


Choosing the normal in this case would mean the most common among the population would it not?


Precisely, the highest point on the curve where the derivative is zero.


I feel like two different definitions of 'normal' are at odds here. 'Normal' in the context of a graph, and 'normal' to mean typical or usual


The semantics are chosen to be as close to identical as is feasible given data.


That seams reasonable enough.

I have two thoughts: a) this risks become a personality test, which are notoriously poor as a medical diagnosis tool, and b) I don’t think we (society) should be in a hurry to slap a medical diagnosis on everything.


I don't agree with slapping a diagnosis on anything either, but I think it could be a reasonable tool for people who are in the process of being diagnosed, or looking to better understand their character traits combined while going through the sometimes complicated process of being diagnosed.


Good points.

I always upvote thoughtful responses even if I generally disagree with the overall theme.

As is typically the case, I’m probably wrong and will end up, over time, holding opinions opposed to my present collection, so I try not to stifle divergent opinions.


It is never possible to predict changes in perception or possible realizations one might have, even from personal experience. I think it is always good to have a fully open discussion.


This is a side note to your insightful comment, but is your heart rate 100 at rest, or is 100 the normal number you see under the elevated stress of seeing a doctor? I ask because 100 resting heart rate is really not healthy for most people. Diet and exercise can really bring it down for you. Mine used to be 95 at rest. Today is in the low 60s and dropping over over time thanks to a restricted diet and moderate exercise (5h a week). I don't know your individual situation and hope you didn't find my comment to be inopportune unsolicited advice.


Just at the doctor, I have a heart monitor for when I stream games for friends to see when I become the most stressed. When I pay attention I normally rest at around 70-85.

I absolutely appreciate the insight and comment. I had feared that the time I saw 120 twice in a row at a doctors visit, so I started measuring it at home.


Having high blood pressure only when visiting the doctor is common enough it has a name and a Wikipedia page and has been the subject of clinical studies.

https://en.wikipedia.org/wiki/White_coat_hypertension


A resting heart rate of 100 bpm? That is definitely not normal. Is that also anxiety related?


it is definitely not resting. It must be while walking. 138 is around the 5 flour by using stairs.


This was at my peak anxiety point after having hallucinations the night before, taken by a nurse before I was to see everyone my psychiatrist. Resting normally and not anxious or having a panic attack I rest around 70-85.


If this test becomes widespread, I'd love to take it. I bet many of us in the tech industry have some sort of autism markers. It is a spectrum, after all.


I doubt most (vast majority) have more than a statistically meaningless set of any hypothetical autism markers. A predilection for technology, math or science and social immaturity are commonly identified items techies use to contend they "may" be on the spectrum, but the reality is even mild autism includes so much more abnormality than that.


And yet tech hubs are crawling with people who are on the spectrum, and have autistic children. Of course not everyone on the spectrum works in tech industry and not working in tech is on the spectrum, but correlation can be seen.


There is also this recently published work: http://stm.sciencemag.org/content/9/393/eaag2882

This one uses machine learning and brain scans to predict the diagnoses for someone as young as 6 months old. It also predicts the severity.

What's also interesting is how it differentiate between people who are at-risk, but without a diagnoses, and those who are at-risk, and have a diagnoses.

I also wonder if there are more to be studied with the Broad Autism Phenotype (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2746421/)


Very surprising result. I don't think I've ever heard of a blood test for a mental disorder -- at least, not one that actually works.


> I don't think I've ever heard of a blood test for a mental disorder

Autism, and all the other pseudo-mental disorders, have always had underlying physiological considerations. It is a mistake to treat people with these diagnoses as having a 'chronic' condition that can't be cured.

For example, cortisol deficiency has been associated with psychosis [0] since the 1950's [1], but the mental health industry has been treating this condition with awful palliative drugs since they were approved by the FDA (also in the 1950's).

Traditionally the diagnosis of autism has been based on an assessment of symptoms. It was assumed that the symptoms are related to the child having inherited "bad genes". There is no cure for "bad genes", so palliative therapy was thought appropriate. This study basically confirms that Autism has metabolic considerations, which can be addressed with appropriate interventions.

[0] https://psychcentral.com/news/2016/06/04/low-morning-cortiso...

[1] https://www.esquire.com/news-politics/a12775932/sackler-fami...


Be careful about that kind of wording. I and friends who're on the spectrum don't consider it a "mental disorder". It's simply a physiological difference, one that theoretically can be tested for.


> Be careful about that kind of wording

I have friends on the spectrum. I happen to agree that mildly autistic behaviour is more akin to a personality difference than a disorder.

That said, I don't think it's fair to admonish someone for using the colloquial norm. The comment might read better if stated less as "careful, you're doing something wrong" and more in the tone of "here is another viewpoint you may find helpful and interesting."


To add to your comment, I wish that high-functioning ASD people would stop ignoring the more severe end of the spectrum. If you are high-functioning, then maybe ASD just makes you quirky and different. But for the lower functioning people, ASD can profoundly affect their lives in extremely negative ways. For example, my son almost starved himself to death because of sensory difficulties. He is four years old and still cannot feed himself. For my son, ASD is not just a small difference that the world has not accepted yet. It's something that possibly could have killed him if he had had less devoted parents and/or lived in less privileged circumstances.

And my son is not even a particularly extreme case. With lots of therapy and a little luck, he may be considered high-functioning someday. Other kids might be in diapers forever, never talk, and live in a group home their entire adult lives.

So I struggle to take seriously the high-functioning people who throw fits about what language we use to describe our situation. I've had people get mad at me for saying that I have a son with autism when I apparently should have said that I have an autistic son. I'm sorry, I'm too busy keeping my son alive to care!


> I've had people get mad at me for saying that I have a son with autism when I apparently should have said that I have an autistic son.

It has become exhausting trying walk the ever shifting minefield of acceptable verbiage. I'm not sure how you would apply this to other situations. If you have a son with red hair should he be called your red headed son? That sounds more offensive right?


Absolutely. One of the biggest problems in autism advocacy is high-functioning people (like me) and (the guardians of) low-functioning people constantly talking past each other. Some people are perfectly happy as they are and don't want to be changed, some people are desperately unhappy and could really benefit from treatment or even a "cure". The spectrum is far too broad for a single approach to work.

> I've had people get mad at me for saying that I have a son with autism when I apparently should have said that I have an autistic son.

I honestly can't remember which one of those I'm "supposed" to be. I could make a case against either: "person with autism" might sound like it's some outside affliction, "autistic person" might sound like the condition matters more than the person. But extreme concern over small details is a defining trait of autism, and I do it too on other subjects, so I suppose I can't be too judgmental...


I think the trend these days is to use People-first language: https://en.wikipedia.org/wiki/People-first_language (that is, saying "person with autism" - because it puts the person first)


> People-first language ... is a type of linguistic prescription to avoid marginalization or dehumanization ... when discussing people with a health issue or disability.

The argument for "autistic person" or even "autist" is that it's not a health issue or disability.


That's the error I was addressing in my earlier post. For me, autism is not a disability. For someone like BadCookie's son, it definitely is. I personally don't care either way about "person with autism" vs. "autistic person", but it's dangerous to assume that autism is never a disability because high-functioning people exist.


If it's not affecting you in a negative way then it's not a disorder. If it is then it can be. If it doesn't have serious negative impacts then you're just non-neurotypical which is fine. People have the same opinions around ADHD but when you need accommodation or treatment it's worth classifying it as something that needs some level of accommodation or treatment.


"Normal" people get all sorts of accommodations and treatments - the world is set up to support their needs. People with different needs, who need different accommodations are then labeled as having a "disorder". It's a biased system which doesn't allow for normal variations between types of people.


And other people suffer from an inability to engage and thrive in the world. If you don't have a disorder, that's great. Some do.


Doesn't that reasoning apply to any disorder? Medically, a disorder is simply "a disruption of normal physical or mental functions." So, having any disorder makes one abnormal, unique, special, and possibly above average or below average, but certainly not average.

"Disorder" and "special physiological difference" are synonyms.


Disorder is deviation from a declared healthy norm. "Difference" is more symmetric.

A disorder is a condition that causes suffering.


But that suffering may be the result of attempting to function in a system set up for a different type of person. "Disorder" is, in many cases, a biased way to look at it.


Is that the psychiatric definition of disorder?

My understanding is that it has to be disagreeable to the person who has it or put others at risk (in extreme instances).

So for example, someone with synesthesia might be considered disordered only if it prevents them from being happy or taking care of themselves, while many people with synesthesia seem to enjoy it.


A clinically important syndrome; that is, it's a collection of symptoms (these can be behavioral or psychological) that causes the person disability or distress in social, personal, or occupational functioning.


“Disorder” is explicitly pejorative.

I’m not sure where I stand wrt the position that autism is just a non-inferior neurovariant, but let’s not pretend we don’t understand the difference between asserting it’s a value-neutral variant and a disease.


No, "disorder" is explicitly clinical. The words "retarded", "dumb", and "stupid" are pejorative.

Calling autism a disorder is an accurate paychiatric description, not a value judgement designed to insult a person's identity. An insult can be targeted at a person's autism, but not simply by describing it according to clinical terminology.

I sympathize with people who don't believe autism should be considered a disorder, but that doesn't mean discussion needs to be encumbered by walking on eggshells. In particular, admonishing someone for using established clinical terminology is unproductive.


"retarded" and "dumb" are also clinical terms. They only stopped being clinical terms because people attached connotations.

https://en.wiktionary.org/wiki/euphemism_treadmill


Alright, if you'd like me to excessively specify my point: "retarded" and "dumb" are adjectives not used in the DSM 5, which means they are not modern clinical terms. They have also been abolished completely. "Disorder" is still in common use, not only for autism but across the DSM as a common term meaning "atypical and diagnosable." So yes, "disorder" is an appropriate term at the moment. Whether it will continue to be in the future is irrelevant for present conversation.

For what it's worth, if you're arguing that "disorder" should not be used on the basis of precedents like "dumb" and "retarded", the page you cited is an exceptionally poor reference. The quotes appear to be mocking this phenomenon.


> "Disorder" is still in common use, not only for autism but across the DSM as a common term meaning "atypical and diagnosable." So yes, "disorder" is an appropriate term at the moment.

In a clinical context, yes. But there are probably close to zero clinicians in this thread.

One problem with the term "disorder" here is that quite often, it's applied to someone who has difficulty thriving under the many accommodations given to neurotypical people. If the autism spectrum was the norm, neurotypicals would have a similar disorder.

> Whether it will continue to be in the future is irrelevant for present conversation.

Not necessarily. It's perfectly possible for society to lead clinicians on issues like this, which is what seems to have happened with words like "society" and "dumb".


Yes this happens over time as clinical terms are used in a derogatory manner over a period of several decades. This will always happen and some clinical terms will continually need to be revised over time. It doesn't mean that "disorder" isn't appropriate in 2018. It just means it may not be appropriate in 2058.


I have family diagnosed with ASD (all high-functioning). They're obviously different and abnormal, and they know it. In fact that specific knowledge that they're abnormal is a source of anxiety in individuals with ASD. I think it's perfectly reasonable to call it a disorder, and they seem fine with it also.


Be careful about that kind of wording. Those of us with loved ones who have severe autism consider it a "mental disorder" and not simply a psychological difference. We'd really love for all of the "neurodivergent" people to have their own diagnosis.


Thanks, but I care more about what a person with autism says than somebody who simply knows one.


Many people with autism don't have enough communication skills to do that.


You are correct because your statement doesn't quantify it in any meaningful way, which is the least useful kind of correct. For example, I can also say that "many people with autism do have enough communication skills to do that". We both understand how a lot of readers will interpret these two statements if made in isolation, even though that is wrong. They can both be true at the same time (and in this case I'd say they are), which is why it's not a useful statement to make. They appear to contradict, but don't actually do so because they don't claim anything of value.


You can learn more about certain people with autism by talking to people who care for them than by talking to them, especially online. That's all there is to my statement.


I'll try to get my little brother to sign up to a hacker news account. If we get that far without me doing it for him, we'll see if you can make sense of his response.

He doesn't have a great ability to write because he's severely autistic. You know, the disorder kind that makes it difficult to learn to read and write?


> I and friends who're on the spectrum don't consider it a "mental disorder".

If you lack the capability to simulate the mental state of another human being based on observation, you're deficient in a key aspect of what we consider to be a normal functioning mind.

This is not a judgement on your character! Don't confuse the two. We don't think people with Down's or any other disorder are bad, or unworthy of a good life and plenty of opportunities to succeed.

But it is a disorder, especially for those who are much more profoundly impacted than yourself, and if it can be addressed with treatment or prevented entirely during pregnancy, it should be.


My sister is on the spectrum, and she agrees with the idea that autism is a mental disorder. What she disagrees with is calling anyone on the spectrum "disordered". So she'd agree with you that most autistic people shouldn't be labeled that way, but disagree that no autistic people should be.

Even at her low end of the spectrum, it can cause a lot of distress and pain. I guess it just depends on a person's particular case and the circumstances of their life.


I hear you but the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) classifies it as a mental disorder.

Autism Spectrum Disorder 299.00 (F84.0)


DSM-5 also forgoes Asperger's and just includes it into autism now, which a _lot_ of people with either diagnosis tend to disagree with. There are many different ways autism and its variations present, and trying to "homogenize" them all into a single narrow label masks the complex nature of the condition (IMO).


There seems to be a ton of debate on lumping and splitting various disorders in the DSM. If I remember correctly academics like to split, practicing clinicians like to lump. There is so much overlap in many conditions that psychologists and psychiatrists that actually deal directly with patients question the need to split every small permutation of symptoms into a distinct disorder. I'm not saying the DSM-5 is absolutely free of issues as I'm sure DSM-6,7,8,20 will be an improvement.


I wouldn't use this as a supporting argument. Didn't DSM-3 classify homosexuality as a disorder?


Really? A widely recognized reference manual is blanket discredited because it made a mistake in the past (1952-1974, not DSM-3)?


That makes it a book in which some statements are social reflections rather than statements rooted in good science, which makes other such statements somewhat suspect.

It doesn't mean you should reject the whole thing out of hand but it might be a good idea to try to figure out how much of it is todays bias rather than good science in cases where that is warranted.


I'd contend that the most useful ground state for most of us, being people with no knowledge in the field whatsoever, is to assume that the DSM is broadly correct. From there you can, given some evidence, conclude that parts might not be.


I'm not sure, but I bet you're right. It is a medical reference that will change over time as better information becomes available. It's still the definitive manual for classifying mental and personality disorders.


That's political. Of course it's a disorder in the sense that it causes abnormal poor performance (reproduction is harder!). Peadophilia is also still called a disorder but only if it negatively affects the person's life. It hardly matters how we classify them. Everyone has some inferiority that they might want to improve, so we could all say we have disorders. Or we could all accept everyone as just-how-they-are.


Essentially all psychological differences vary from a behavioral quirk to a disabling disorder. The distinguishing line between psychological difference and psychological disorder can (probably) vary from person to person: the only valid distinction is if the psychological difference causes problems for the person.


Perhaps I missed it, but I did not see anything about controlling for the potential effects of those persons with ASD having taken drugs to mitigate symptoms. Couldn't the biochemical effects of ASD drugs themselves be the primary indicating factor? I've seen studies on biochemical indicators for schizophrenia also make this same mistake.


No, read the source article.

The validation data are taken at baseline from three previously published studies investigating pharmaceutical interventions to normalize metabolic abnormalities of children with ASD31: (1) a combination of methylcobalamin and low dose folinic acid32, 33 (2) high dose folinic acid,34 and (3) sapropternin.35 Given that these studies all focused on evaluating treatment strategies for ASD, all participants had a confirmed diagnosis of ASD. FOCM/TS metabolites were available for 154 (76% male) participants with ASD with a mean age of 8.8 years (range 2–17 years). These ages are different than reported by Delhey et al.34 because this study only required that measurements be available at baseline, rather than both at baseline as well as the conclusion of the treatment phase. Furthermore, stratifying patients by age or gender did not reveal any differences in the univariate metabolite distributions. The first two studies were approved by the IRB at the University of Arkansas for Medical Sciences and the third study was approved by the IRB at the University of Texas Health Science Center at Houston. All parents gave written, signed consent and patients provided assent when appropriate.

2.3 Metabolites

The metabolites under investigation are presented in Table 1 and additional details of these measurements and derivations are presented in Melnyk, et al.30 This is only a subset of the measurements investigated previously29 because “% DNA methylation” and “8‐OHG” were absent from the validation data set and were therefore removed from this study to ensure that a consistent set of metabolites are used for training and testing.

(Table 1 - 22 metabolic variables considered)

https://onlinelibrary.wiley.com/doi/full/10.1002/btm2.10095

I’m curious if these metabolic abnormalities apply to adults as well. I had an ADOS at the UCD MIND Institute come back with a 7 (1-14 scale IIRC) about 10 years ago.

PS: PKU treatment sapropterin (Kuvan) costs $100k USD/yr


> Hahn said the difference between the original accuracy rate and that of the new study can likely be attributed to several factors, the most important being that two of the metabolites were unavailable in the second dataset. Each of the two metabolites had been strong indicators in the previous study.

Another issue could be overfitting.


It sounds like they were using leave-one-out cross validation. My machine learning is a bit rusty, but I don't think that overfitting is the issue.


Does this also work in reverse? I.e. take supplements/drugs until the test is negative, and then be (temporarily) autism-free?


I don't know, but there's preliminary evidence that autism can be reversed by dosing children with oxytocin and by using TMS on adults.

Because those approaches are considered to be fairly low-risk, I suspect research will continue in those directions until they hit a wall of some kind.


I have not heard of using oxytocin for children on the specturm. Are there articles, resources, or papers that talk about this?


I'm on my phone, so it's hard to search and link to articles. Here's the result of a quick search:

https://www.spectrumnews.org/news/oxytocin-spray-boosts-soci...

Hopefully that serves as a jumping off point.


What does it even mean to “reverse autism”?


Most famous example: https://well.blogs.nytimes.com/2016/03/18/an-experimental-au...

It allows people to read faces and emotional context in a way they couldn't before. Some people find that their decision-making becomes less logical and more emotional. For others, nothing changes.

If you search "tms autism" there are other firsthand accounts that you might find interesting.


Have there been any scientific experiments already to validate this method?


As of 2 years ago, there were more than a dozen clinical trials. Evidence is preliminary -- populations are small, and measuring how autistic someone is is not easy.

https://www.autismspeaks.org/blog/2016/03/25/transcranial-ma...


it is like moonwalk but more autistic /s


No particular reason to thing so, until an experiment indicates the direction of cause and effect.

If you want to remove your autism today, you can try transcranial magnetic stimulation.

https://www.psychologytoday.com/us/blog/sister-the-edge-auti...

https://en.wikipedia.org/wiki/Transcranial_magnetic_stimulat...


If you mean it in the sense that one could cheat the results and not be diagnosed, then absolutely. Most of their metabolites could linked to dietary deficiency. We did have a metabolite panel done and my kid would have been a false negative.

As a parent of kid with Autism I experienced it first hand. However, instead of doing like many parents (including those with neurotypicals) we did not cave-in, but build a lot of incentive and rewards and it paid off very early. But this is my n=1, so I don't know if it is because of our parenting style or something else.


Out of interest, what was your parenting style like? Was it just a matter of clear expectations and consistent rewards and punishments?

Did you have a source for all this or did you work it out by yourself?


Does nobody care about specificity?


Statistical reporting is often pretty frustrating.

> “We are able to predict with 88 percent accuracy whether children have autism,” said Juergen Hahn, lead author

> It is estimated that approximately 1.7 percent of all children are diagnosed with ASD

    def has_autism(child):
      return False
apparently has 98% accuracy.


It's 88% correct classification on a validation data set consisting of 154 patients diagnosed with ASD. Their validation dataset did not contain a "typically developing" population since there's only one dataset for that data and it was consumed in their model generation. Their training data resulted in a 5% misclassification rate of their controls - that is 5% of patients that were not diagnosed with ASD in current tests would be classified as having ASD in this scheme.

The full paper is here: https://onlinelibrary.wiley.com/doi/10.1002/btm2.10095


If you give the test to everyone, your results are:

~4.9% incorrectly diagnosed with autism (0.05 x .983)

~1.5% correctly diagnosed with autism (0.88 x 0.017)

Thus, 76% of those diagnosed would be diagnosed incorrectly.


That's true in a statistical sense. Or it's possible that the human-observers are less accurate about autism than this brain scan.

It's unclear if those who have the odd brain structure but aren't diagnosed are entirely asymptomatic.

Also they may be non-autistic in spite of this brain pattern, but nonetheless have a genetic predisposition to pass it on. Big step.


It's not a genetic test, and it isn't a test for something that defines autism, so you're begging the question IMO. Sure, human observers are imperfect, but that doesn't mean you can choose an arbitrary test that is precise and make it the standard just because. "We need something better than human judgement, and this is something, thus it is better"


I would hope that there's more rigor than that. I mean if you're willing to be that dishonest with your sample selection you could select only people who don't have autism and get 100% accuracy.


Isn't it hard to define the accuracy without knowing more about the condition?


The generally accepted definition of autism spectrum disorder is that in DSM-V. This physiological test is compared against ASD diagnoses based on DSM-V, and based on that comparison, the accuracy of the test (for the given sample tested) is calculated.

As more is known about the condition, the diagnostic criteria listed in the DSM could be updated, which would mean that this test would then need to be evaluated again. But that doesn't prevent its current accuracy being measured.




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