Machine learning of clinical phenotypes facilitates autism screening and identifies novel subgroups with distinct transcriptomic profiles

Autism spectrum disorder (ASD) presents significant challenges in diagnosis and intervention due to its diverse clinical manifestations and underlying biological complexity. This study explored machine learning approaches to enhance ASD screening accuracy and identify meaningful subtypes using clinical assessments from AGRE database integrated with molecular data from GSE15402. Analysis of ADI-R scores from a large cohort of 2794 individuals demonstrated that deep learning models could achieve exceptional screening accuracy of 95.23% (CI 94.32-95.99%). Notably, comparable performance was maintained using a streamlined set of just 27 ADI-R sub-items, suggesting potential for more efficient diagnostic tools. Clustering analyses revealed three distinct subgroups identifiable through both clinical symptoms and gene expression patterns. When ASD were grouped based on clinical features, stronger associations emerged between symptoms and underlying molecular profiles compared to grouping based on gene expression alone. These findings suggest that starting with detailed clinical observations may be more effective for identifying biologically meaningful ASD subtypes than beginning with molecular data. This integrated approach combining clinical and molecular data through machine learning offers promising directions for developing more precise screening methods and personalized intervention strategies for individuals with ASD.