Clustering of co-occurring conditions in autism spectrum disorder during early childhood: A retrospective analysis of medical claims data
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Individuals with autism spectrum disorder (ASD) are frequently affected by co‐occurring medical conditions (COCs), which vary in severity, age of onset, and pathophysiological characteristics. The presence of COCs contributes to significant heterogeneity in the clinical presentation of ASD between individuals and a better understanding of COCs may offer greater insight into the etiology of ASD in specific subgroups while also providing guidance for diagnostic and treatment protocols. This study retrospectively analyzed medical claims data from a private United States health plan between years 2000 and 2015 to investigate patterns of COC diagnoses in a cohort of 3,278 children with ASD throughout their first 5 years of enrollment compared to 279,693 children from the general population without ASD diagnoses (POP cohort). Three subgroups of children with ASD were identified by k ‐means clustering using these COC patterns. The first cluster was characterized by generally high rates of COC diagnosis and comprised 23.7% ( n = 776) of the cohort. Diagnoses of developmental delays were dominant in the second cluster containing 26.5% ( n = 870) of the cohort. Children in the third cluster, making up 49.8% ( n = 1,632) of the cohort, had the lowest rates of COC diagnosis, which were slightly higher than rates observed in the POP cohort. A secondary analysis using these data found that gastrointestinal and immune disorders showed similar longitudinal patterns of prevalence, as did seizure and sleep disorders. These findings may help to better inform the development of diagnostic workup and treatment protocols for COCs in children with ASD. Autism Res 2019, 12: 1272–1285 . © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary: Medical conditions that co‐occur with autism spectrum disorder (ASD) vary significantly from person to person. This study analyzed patterns in diagnosis of co‐occurring conditions from medical claims data and observed three subtypes of children with ASD. These results may aid with screening for co‐occurring conditions in children with ASD and with understanding ASD subtypes.
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Prevalence of GI syndromes in ASD children varied from 0.0% for inflammatory bowel disorders in females with ASD aged 0-18y to 67.80% of children in Vargason et al.
“Prevalence of GI varied from 0.0% for inflammatory bowel disorders in female with ASD aged 0–18y (41) to 67.80% of children in Vargason et al. (46) (Figure 7 and Supplementary Material 6).”
From Prevalence of Autism Spectrum Disorder and Co-morbidities in Children and Adolescents: A Systematic Literature Review (2021) · cites this paper as [46]
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- Authors
- Vargason, T., Frye, R. E., McGuinness, D. L., & Hahn, J.
- Affiliations
- Rensselaer Polytechnic Institute (US)
- Phoenix Children's Hospital (US)
- Corresponding author
- Hahn, Juergen
- Venue
- Autism Research
- Publisher
- Wiley
- Published
- 2019-05-31
- Volume
- 12
- Issue
- 8
- Pages
- 1272-1285
- ISSN
- 1939-3792 (ISSN-L)
- 1939-3806
- PMC
- PMC6688922
- OpenAlex
- W2947642158
- Cited by
- 59
- References
- 61
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 12 · 2023: 7 · 2022: 8 · 2021: 13 · 2020: 9 · 2019: 1
- FWCI
- 4.50
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Autism Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- UA Campus Repository (The University of Arizona) (acceptedVersion)
- Funders
- National Institutes of Health (R01AI110642)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
- Keywords
- autism spectrum disorder, early childhood, ASD subtypes, developmental delay, gastrointestinal diseases, immune disorders, epilepsy, sleep disorders, health insurance claims data, K-means clustering
- MeSH terms
- Autism Spectrum Disorder, Child, Child, Preschool, Epilepsy, Female, Gastrointestinal Diseases, Humans, Immune System Diseases, Insurance Claim Review, Male, Retrospective Studies, Sleep Wake Disorders, Cohort Studies, Cluster Analysis
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