Making a case for an autism-specific multimorbidity index: a comparative cohort study

Sosenko, F. , Nijhof, D., McKernan Ward, L., Cairns, D., Hughes, L. and Rydzewska, E. (2024) Making a case for an autism-specific multimorbidity index: a comparative cohort study. MedRxiv, (doi: 10.1101/2024.02.23.24303273)

Abstract

Autistic people experience challenges in healthcare, including disparities in health outcomes and multimorbidity patterns distinct from the general population. This study investigated the efficacy of existing multimorbidity indices in predicting COVID-19 mortality among autistic adults and proposes a bespoke index, the ASD-MI, tailored to their specific health profile. Using data from the CVD-COVID-UK/COVID-IMPACT Consortium, encompassing England's entire population, we identified 1,027 autistic adults hospitalized for COVID-19, among whom 62 died due to the virus. Employing logistic regression with 5-fold cross-validation, we selected diabetes, coronary heart disease, and thyroid disorders as predictors for the ASD-MI, outperforming the Quan Index, a general population-based measure, with an AUC of 0.872 versus 0.828, respectively. Notably, the ASD-MI exhibited better model fit (pseudo-R2 0.25) compared to the Quan Index (pseudo-R2 0.20). These findings underscore the need for tailored indices in predicting mortality risks among autistic individuals. However, caution is warranted in interpreting results, given the limited understanding of morbidity burden in this population. Further research is needed to refine autism-specific indices and elucidate the complex interplay between long-term conditions and mortality risk, informing targeted interventions to address health disparities in autistic adults. This study highlights the importance of developing healthcare tools tailored to the unique needs of neurodivergent populations to improve health outcomes and reduce disparities.

• Item Type: Articles
• Additional Information: Funding Statement: The British Heart Foundation Data Science Centre (grant No SP/19/3/34678, awarded to Health Data Research (HDR) UK) funded co-development (with NHS England) of the Secure Data Environment service for England, provision of linked datasets, data access, user software licences, computational usage, and data management and wrangling support, with additional contributions from the HDR UK Data and Connectivity component of the UK Government Chief Scientific Adviser's National Core Studies programme to coordinate national COVID-19 priority research. Consortium partner organisations funded the time of contributing data analysts, biostatisticians, epidemiologists, and clinicians. The associated costs of accessing data in NHS England's Secure Data Environment service for England, for analysts working on this study, were funded by the Data and Connectivity National Core Study, led by Health Data Research UK in partnership with the Office for National Statistics, which is funded by UK Research and Innovation (grant ref: MC_PC_20058). The Baily Thomas Charitable Fund funded staff (FS) time on this project.
• Keywords: Autism Spectrum Disorder, multimorbidity, Multimorbidity Index, COVID-19, mortality, long-term conditions.
• Status: Published
• Refereed: No
• Glasgow Author(s) Enlighten ID: Sosenko, Dr Filip
• Authors: Sosenko, F., Nijhof, D., McKernan Ward, L., Cairns, D., Hughes, L., and Rydzewska, E.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Journal Name: MedRxiv
• Copyright Holders: Copyright © 2024 The Author(s)
• First Published: First published in MedRxiv
• Publisher Policy: Reproduced under a creative commons licence