Predicting timely transfer to adult care in a cohort of autistic adolescents and young adults.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2023
2023
Historique:
received:
16
06
2023
accepted:
28
07
2023
medline:
15
9
2023
pubmed:
13
9
2023
entrez:
13
9
2023
Statut:
epublish
Résumé
The transition from pediatric to adult care is a challenge for autistic adolescents and young adults. Data on patient features associated with timely transfer between pediatric and adult health care are limited. Our objective was to describe the patient features associated with timely transfer to adult health care (defined as </ = 6 months between first adult visit and most recent prior pediatric visit) among a cohort of autistic adolescents and young adults. We analyzed pediatric and adult electronic medical record data from a cohort of adolescents and young adults who established with a primary-care based program for autistic adolescents and young adults after they transferred from a single children's hospital. Using forward feature selection and logistic regression, we selected an optimal subset of patient characteristics or features via five repetitions of five-fold cross validation over varying time-frames prior to the first adult visit to identify patient features associated with a timely transfer to adult health care. A total of 224 autistic adolescents and young adults were included. Across all models, total outpatient encounters and total encounters, which are very correlated (r = 0.997), were selected as the first variable in 91.2% the models. These variables predicted timely transfer well, with an area under the receiver-operator curve ranging from 0.81 to 0.88. Total outpatient encounters and total encounters in pediatric care showed good ability to predict timely transfer to adult health care in a population of autistic adolescents and young adults.
Sections du résumé
BACKGROUND
The transition from pediatric to adult care is a challenge for autistic adolescents and young adults. Data on patient features associated with timely transfer between pediatric and adult health care are limited. Our objective was to describe the patient features associated with timely transfer to adult health care (defined as </ = 6 months between first adult visit and most recent prior pediatric visit) among a cohort of autistic adolescents and young adults.
METHODS AND FINDINGS
We analyzed pediatric and adult electronic medical record data from a cohort of adolescents and young adults who established with a primary-care based program for autistic adolescents and young adults after they transferred from a single children's hospital. Using forward feature selection and logistic regression, we selected an optimal subset of patient characteristics or features via five repetitions of five-fold cross validation over varying time-frames prior to the first adult visit to identify patient features associated with a timely transfer to adult health care. A total of 224 autistic adolescents and young adults were included. Across all models, total outpatient encounters and total encounters, which are very correlated (r = 0.997), were selected as the first variable in 91.2% the models. These variables predicted timely transfer well, with an area under the receiver-operator curve ranging from 0.81 to 0.88.
CONCLUSIONS
Total outpatient encounters and total encounters in pediatric care showed good ability to predict timely transfer to adult health care in a population of autistic adolescents and young adults.
Identifiants
pubmed: 37703269
doi: 10.1371/journal.pone.0289982
pii: PONE-D-23-18578
pmc: PMC10499209
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0289982Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR002733
Pays : United States
Informations de copyright
Copyright: © 2023 Hart et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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