In their letter to the editor, Øien et al. (
2019) highlight concerns about conducting a meta-analysis on screening instruments for ASD. They focus on lack of information and heterogeneity among the individual studies pooled in the research by Sánchez-García et al. (
2019). The authors do not question the experimental method; even stating that it “
provides us with important knowledge of how screening instruments perform across various studies.” Of course, clinical and methodological heterogeneity could cause statistical heterogeneity leading to inaccurate conclusions in a meta-analysis (Higgins and Altman
2008). Although this should not preclude conducting meta-analytic investigation, since understanding the causes of heterogeneity increases its scientific value and the clinical significance of the results (Thompson
1994). Therefore, it is not a threat or concern to synthesize the available evidence (Lijmer et al.
2002). Having said that, the methodological limitations among studies included in a meta-analysis is not specific to ASD screening; yet, there is a large literature about the viability and importance of diagnostic or screening accuracy meta-analyses. Given empirical support in other disorders, it is logical to apply them to a meta-analysis in screening instruments for ASD. There are three specific points that warrant further consideration. …
