A new clinical trial shows that adding a computerised test of attention and activity (QbTest) to standard assessments can reduce the time needed to make a diagnostic decision on attention-deficit hyperactivity disorder (ADHD), increase the likelihood of excluding ADHD, without compromising diagnostic accuracy.
The randomised, parallel, single-blind controlled AQUA study, carried out in mental health and community paediatric clinics in England, recruited children aged 6-17 years who were referred for ADHD diagnostic assessment. All underwent assessment-as-usual, plus QbTest. Participants and their clinician were randomised to either receive the QbTest report immediately (QbOpen group) or the report was withheld (QbBlind group). The primary outcome was number of consultations until a diagnostic decision confirming/excluding ADHD.
Clinicians with immediate access to the QbTest report (QbOpen) were more likely to reach a diagnostic decision about ADHD (HR, 1.44; 95% CI, 1.04-2.01). At 6 months, 76% of those in the QbOpen group had received a diagnostic decision compared with 50% in the QbBlind group. The QbTest reduced appointment length by 15%, increased clinicians' confidence in their diagnostic decisions (OR, 1.77; 95% CI, 1.09-2.89) and doubled the likelihood of excluding ADHD. There was no difference in diagnostic accuracy.
Presenting the results in the Journal of Child Psychology and Psychiatry, the authors concluded that the QbTest may increase the efficiency of ADHD assessment pathway, allowing greater patient throughput, with clinicians reaching diagnostic decisions faster but without compromising diagnostic accuracy.
