Evidence-based use of scalable biomarkers to increase diagnostic efficiency and decrease the lifetime costs of autism.
Thomas W Frazier, Daniel L Coury, Kristin Sohl and 4 others
PMID 33682319WHAT IT FOUND
Modeling suggests adding saliva or eye-tracking tests after screening could identify autism earlier.
This approach might save over $37 billion annually by reducing wait times and starting interventions sooner, but the study is a simulation, not a clinical trial.
Key findings
01The study models how scalable diagnostic measures, such as saliva tests and eye tracking, could improve autism identification efficiency when used after initial screening.
02A cost-benefit analysis estimates that using these diagnostic aids could save nearly $580,000 per child over their lifetime.
03The authors state that these tools are not intended to replace initial questionnaire screening but to triage children who have already screened positive.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study is a theoretical model and cost analysis, not a prospective clinical trial testing these tools in practice. The financial projections rely on numerous assumptions about intervention efficacy, cost inflation, and the proportion of children who achieve functional gains. The diagnostic tools were validated in specific samples; the authors note that further validation across diverse settings and populations is required before widespread clinical implementation. Key authors have significant financial conflicts of interest, including roles as developers of the tests analyzed and employees of companies that sell them.
Declared interests
Several authors are developers of the diagnostic tests analyzed or hold financial interests in the companies selling them. Thomas W. Frazier is the developer of the eye-tracking test and has an investor stake in AutismEYES LLC. Steven D. Hicks and Frank A. Middleton are co-developers of the saliva test and members of the advisory board of Quadrant Biosciences, which holds patent rights for the test. Kayla E. Wagner and Richard Uhlig are employees of Quadrant Biosciences.
The easy way to misread this
Do not interpret the $37 billion savings estimate as evidence that these tests are currently effective or available for routine clinical use. The figures are projections from a financial model based on hypothetical implementation, not observed outcomes from a trial.