Incremental clinical utility of continuous performance tests in childhood ADHD - an evidence-based assessment approach

Abstract

Despite extensive research on attention deficit hyperactivity disorder (ADHD), there are still uncertainties regarding the clinical utility of different ADHD assessment methods. This study aimed to examine the incremental clinical utility of Conners' continuous performance test (CPT) II and QbTest in diagnostic assessments and treatment monitoring of attention deficit hyperactivity disorder (ADHD). Retrospective data from child and adolescent psychiatric records of two populations were studied. The diagnostic clinical utility of Conners' CPT II and QbTest was analysed using receiver operator characteristics (ROC) and post-test probability in 80 children with and 38 without ADHD. Dose titrations of central stimulants in 56 children with ADHD were evaluated using QbTest and the Swanson, Nolan, Pelham, version IV (SNAP-IV) scale. Conners' CPT II, but not QbTest, had incremental clinical utility in diagnostic assessment of children with ADHD when teacher and parent ratings were inconclusive. QbTest proved useful in titration of central stimulant treatment when parent ratings were inconclusive. Continuous performance tests were found to be clinically useful when rating scales were inconclusive.

Keywords: ADHD; CPT; assessment; central stimulants; child psychiatry; evidence-based.