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Loomes (2017) - Male-to-Female Ratio in ASD Systematic Review and Meta-Analysis

This systematic review and meta-analysis aimed to estimate the male-to-female ratio in autism spectrum disorder (ASD) by analyzing 54 studies with over 13 million participants. The findings revealed a pooled male-to-female odds ratio of 4.20, indicating a significant gender disparity, but high-quality studies suggested a more accurate ratio closer to 3:1. The results highlight a diagnostic gender bias, where girls with ASD may be underdiagnosed compared to boys.

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155 views1 page

Loomes (2017) - Male-to-Female Ratio in ASD Systematic Review and Meta-Analysis

This systematic review and meta-analysis aimed to estimate the male-to-female ratio in autism spectrum disorder (ASD) by analyzing 54 studies with over 13 million participants. The findings revealed a pooled male-to-female odds ratio of 4.20, indicating a significant gender disparity, but high-quality studies suggested a more accurate ratio closer to 3:1. The results highlight a diagnostic gender bias, where girls with ASD may be underdiagnosed compared to boys.

Uploaded by

marisa sanchez
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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24/7/2017 What Is the Male-to-Female Ratio in Autism Spectrum Disorder?

A Systematic Review and Meta-Analysis - ScienceDirect

Review

What Is the Male-to-Female Ratio in Autism Spectrum


Disorder? A Systematic Review and Meta-Analysis
Rachel Loomes DClinPsy, Laura Hull MSc, William Polmear Locke Mandy DClinPsy, PhD

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https://doi.org/10.1016/j.jaac.2017.03.013 Get rights and content

Objective
To derive the first systematically calculated estimate of the relative proportion of boys and
girls with autism spectrum disorder (ASD) through a meta-analysis of prevalence studies
conducted since the introduction of the DSM-IV and the International Classification of
Diseases, Tenth Revision.

Method
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines
were followed. The Medline, Embase, and PsycINFO databases were searched, and study
quality was rated using a risk-of-bias tool. Random-effects meta-analysis was used. The
pooled outcome measurement was the male-to-female odds ratio (MFOR), namely the odds
of being male in the group with ASD compared with the non-ASD group. In effect, this is the
ASD male-to-female ratio, controlling for the male-to-female ratio among participants without
ASD.

Results
Fifty-four studies were analyzed, with 13,784,284 participants, of whom 53,712 had ASD
(43,972 boys and 9,740 girls). The overall pooled MFOR was 4.20 (95% CI 3.84–4.60), but
there was very substantial between-study variability (I2 = 90.9%). High-quality studies had a
lower MFOR (3.32; 95% CI 2.88–3.84). Studies that screened the general population to
identify participants regardless of whether they already had an ASD diagnosis showed a
lower MFOR (3.25; 95% CI 2.93–3.62) than studies that only ascertained participants with a
pre-existing ASD diagnosis (MFOR 4.56; 95% CI 4.10–5.07).

Conclusion
Of children meeting criteria for ASD, the true male-to-female ratio is not 4:1, as is often
assumed; rather, it is closer to 3:1. There appears to be a diagnostic gender bias, meaning
that girls who meet criteria for ASD are at disproportionate risk of not receiving a clinical
diagnosis.

Key words
autism spectrum disorder; male-to-female ratio; sex difference; meta-analysis; epidemiology

http://www.sciencedirect.com.sabidi.urv.cat/science/article/pii/S0890856717301521 2/4

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