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The objective of this study was to determine the extent to which the increased prevalence of autism in California has been driven by changes in diagnostic practices, diagnostic substitution and diagnostic accretion.
In it she points out that the rise in autism diagnoses dates to before internet use became common, that autism usually emerges in toddlers "long before children become avid users of Twitter or Facebook," and that much of the rise in autism cases can be explained by "changes in diagnostic criteria".
For 4 of the 5 participants, treatment gains were evidenced by changes in diagnostic status, significant reductions in measures of avoidance, and improvements on self- and parent-report measures of anxiety symptomology.
Previously, we reported that the sudden increase in pertussis notifications in 1996 was largely due to a genuine increase in clinical pertussis cases and could only partly be explained by changes in diagnostic practice [2].
For example, trends in STEC O157 infections can be influenced by changes in diagnostic practices.
Classification of individuals (exposure or outcome status) can also be affected by changes in diagnostic procedures.
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Among the study's limitations, we note that lymphoma subtype classifications were derived from cancer registry abstractions of medical records, which may not have been standard and may have been affected by changes in lymphoma diagnostic practice over time.
The rise in hospital admissions for heart failure and the decrease in mortality from this cause could partly be explained by temporary changes in diagnostic coding, but there is evidence that the reduced mortality could also be due to adherence to clinical practice guidelines.
3, 4 This impressive rise in incidence may be due to several factors, including behavioral changes, better early detection by screening instruments, changes in diagnostic criteria in histopathology, and perhaps also the change in the medico-legal climate.
15 16 17 In an ambulatory setting, the goal is to provide a warning sign for worsening HF, by detecting changes in diagnostics different from normal, to prevent an index HF hospitalization.
Waning immunity conferred by vaccines, increased recognition, changes in diagnostic testing and reporting, and adaptation of the agent to immunity induced by vaccines are some of the factors that may have contributed to this increase [ 5].
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com