There were mixed findings with regard to the use of CPTs to assess and manage medication , with contrasting evidence on their ability to support clinical decision-making .
There was a strong evidence base for the use of objective measures of activity to aid ADHD/non-ADHD group differentiation , which appears sensitive to medication effects and would also benefit from further research on their clinical utility .
Attention-deficit hyperactivity disorder ( ADHD ) is typically diagnosed using clinical observation and subjective informant reports .
Once children commence ADHD medication , robust monitoring is required to detect partial or non-responses .
The extent to which neuropsychological continuous performance tests ( CPTs ) and objective measures of activity can clinical ly aid the assessment and titration process in ADHD is not fully understood .
This review describes the current evidence base for the use of CPTs and objective ly measured activity to support the diagnostic procedure and medication management for children with ADHD .
Four data bases ( PsycINFO , Medline , Allied and Complementary Medicine ( AMED ) , and PsycARTICLES ) were systematic ally search ed to underst and the current evidence base for ( 1 ) the use of CPTs to aid clinical assessment of ADHD ; ( 2 ) the use of CPTs to aid medication management ; and ( 3 ) the clinical utility of objective measures of activity in ADHD .
Protocol investigating the clinical utility of an objective measure of activity and attention (QbTest) on diagnostic and treatment decision-making in children and young people with ADHD—‘Assessing QbTest Utility in ADHD’ (AQUA): a randomised controlled trial
Introduction The National Institute for Health and Care Excellence ( NICE ) guidelines for attention deficit/hyperactivity disorder ( ADHD ) state that young people need to have access to the best evidence -based care to improve outcome . The current ‘ gold st and ard ’ ADHD diagnostic assessment combines clinical observation with subjective parent , teacher and self-reports . In routine practice , reports from multiple informants may be unavailable or contradictory , leading to diagnostic uncertainty and delay . The addition of objective tests of attention and activity may help reduce diagnostic uncertainty and delays in initiating treatment leading to improved outcomes . This trial investigates whether providing clinicians with an objective report of levels of attention , impulsivity and activity can lead to an earlier , and more accurate , clinical diagnosis and improved patient outcome . Methods and analysis This multisite r and omised controlled trial will recruit young people ( aged 6–17 years old ) who have been referred for an ADHD diagnostic assessment at Child and Adolescent Mental Health Services ( CAMHS ) and Community Paediatric clinics across Engl and . Routine clinical assessment will be augmented by the QbTest , incorporating a continuous performance test ( CPT ) and infrared motion tracking of activity . The participant will be r and omised into one of two study arms : QbOpen ( clinician has immediate access to a QbTest report ) : QbBlind ( report is withheld until the study end ) . Primary outcomes are time to diagnosis and diagnostic accuracy . Secondary outcomes include clinician 's diagnostic confidence and routine clinical outcome measures . Cost-effective analysis will be conducted , alongside a qualitative assessment of the feasibility and acceptability of incorporating QbTest in routine practice . Ethics and dissemination The findings from the study will inform commissioners , clinicians and managers about the feasibility , acceptability , clinical utility and cost-effectiveness of incorporating QbTest into routine diagnostic assessment of young people with ADHD . The results will be su bmi tted for publication in peer- review ed journals . The study has received ethical approval . Trial registration number NCT02209116
There were mixed findings with regard to the use of CPTs to assess and manage medication , with contrasting evidence on their ability to support clinical decision-making .
There was a strong evidence base for the use of objective measures of activity to aid ADHD/non-ADHD group differentiation , which appears sensitive to medication effects and would also benefit from further research on their clinical utility .
Attention-deficit hyperactivity disorder ( ADHD ) is typically diagnosed using clinical observation and subjective informant reports .
Once children commence ADHD medication , robust monitoring is required to detect partial or non-responses .
The extent to which neuropsychological continuous performance tests ( CPTs ) and objective measures of activity can clinical ly aid the assessment and titration process in ADHD is not fully understood .
This review describes the current evidence base for the use of CPTs and objective ly measured activity to support the diagnostic procedure and medication management for children with ADHD .
Four data bases ( PsycINFO , Medline , Allied and Complementary Medicine ( AMED ) , and PsycARTICLES ) were systematic ally search ed to underst and the current evidence base for ( 1 ) the use of CPTs to aid clinical assessment of ADHD ; ( 2 ) the use of CPTs to aid medication management ; and ( 3 ) the clinical utility of objective measures of activity in ADHD .