Using Computers to Assist in the Diagnosis and Treatment of Attention-deficit/Hyperactivity Disorder (ADHD)
Condition: Attention Deficit Hyperactivity Disorder
MeSH terms: Hyperkinesis; Attention Deficit Disorder with Hyperactivity
Study type: Interventional

Summary: 
      Attention-deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed behavioral
      disorder in children. Prevalence rates in the United States range from 2% to 18% depending on
      diagnostic criteria and population studied. Primary care physicians, especially
      pediatricians, have historically played a large role in the diagnosis and treatment of ADHD.
      Despite the existence of authoritative guidelines to assist primary care physicians, ample
      evidence demonstrates that they continue to diagnose and treat this disorder suboptimally.
      This is due, in part, to a lack of training and cumbersome delivery system designs. Modern
      computer decision support strategies offer the best hope of equipping general practitioners
      to deal with the mental health epidemic of ADHD.

      The investigators have developed a novel decision support system for implementing clinical
      guidelines in pediatric practice. CHICA (Child Health Improvement through Computer
      Automation) combines three elements: (1) pediatric guidelines encoded in Arden Syntax; (2) a
      dynamic, scannable paper user interface; and (3) an HL7-compliant interface to existing
      electronic medical record systems. The result is a system that both delivers "just-in-time"
      patient-relevant guidelines to physicians during the clinical encounter, and accurately
      captures structured data from all who interact with it. Preliminary work with CHICA has
      demonstrated the feasibility of using the system to implement and evaluate clinical
      guidelines. The investigators propose to expand CHICA to include ADHD diagnosis and treatment
      guidelines. The investigators hypothesize that implementation of the ADHD guidelines will
      result in better outcomes, including higher rates of adherence to recommendations and
      improved patient functioning.
    

Detailed description: 
      Attention-deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed behavioral
      disorder in children. Prevalence rates in the United States range from 2% to 18% depending on
      diagnostic criteria and population studied. Primary care physicians, especially
      pediatricians, have historically played a large role in the diagnosis and treatment of ADHD.
      Despite the existence of authoritative guidelines to assist primary care physicians, ample
      evidence demonstrates that they continue to diagnose and treat this disorder suboptimally.
      This is due, in part, to a lack of training and cumbersome delivery system designs. Modern
      computer decision support strategies offer the best hope of equipping general practitioners
      to deal with the mental health epidemic of ADHD.

      The investigators have developed a novel decision support system for implementing clinical
      guidelines in pediatric practice. CHICA (Child Health Improvement through Computer
      Automation) combines three elements: (1) pediatric guidelines encoded in Arden Syntax; (2) a
      dynamic, scannable paper user interface; and (3) an HL7-compliant interface to existing
      electronic medical record systems. The result is a system that both delivers "just-in-time"
      patient-relevant guidelines to physicians during the clinical encounter, and accurately
      captures structured data from all who interact with it. Preliminary work with CHICA has
      demonstrated the feasibility of using the system to implement and evaluate clinical
      guidelines. The investigators propose to expand CHICA to include ADHD diagnosis and treatment
      guidelines. The investigators hypothesize that implementation of the ADHD guidelines will
      result in better outcomes, including higher rates of adherence to recommendations and
      improved patient functioning.

      The specific research aims of this proposal are:

      Aim 1: Expand and modify an existing computer-based decision support system (CHICA) to
      include ADHD treatment and diagnosis guideline rules as well as the capability to fax data
      directly into the medical record.

      Aim 2: Evaluate the effect of the CHICA system on the processes of ADHD care in pediatric
      practices, including adherence to guidelines for ADHD treatment and diagnosis.
    

Intervention name(s): CHICA ADHD Module
Intervention type(s): Other
Intervention description(s): This module was added to CHICA to help diagnose and manage ADHD
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Health Services Research
Keywords: ADHD