Putting ADHD to the (Qb)Test
Attention Deficit Hyperactivity Disorder (ADHD) affects 4-8% of school aged children and is characterised by symptoms of inattention, impulsivity and hyperactivity inappropriate for the person’s age.
ADHD diagnosis has grown significantly over the last 30 years with the number of children recognised and treated for ADHD in the UK increasing almost 10 fold from the early 1980s.
Assessing a child for ADHD has typically relied on the clinician’s judgement alongside teacher and parent reports with contradictions in these often leading to delays in diagnosis. ADHD also has high co-occurrence with other disorders, which adds to the complexity of diagnosis.
Aiding diagnosis with technology
QbTest is a commercially available computer test that measures ADHD symptoms through the combination of a cognitive test designed to measure attention and impulse control, and a motion tracking system to measure hyperactivity. There is some preliminary evidence to suggest that QbTest can reduce the number of appointments needed to make a diagnostic decision and therefore the time to initiate appropriate treatment for ADHD.
Supported by the NIHR, the AQUA trial set out to put QbTest through its paces asking whether its use could indeed accelerate time to diagnosis. Alongside this the team also planned to explore attitudes of healthcare professionals (HCPs) and families towards QbTest, which was done through interviews and surveys with families and HCPs from across nine NHS trusts.
Providing objective assessment
Qualitative interviews and survey data stemming from this research found the test was particularly valued for providing an objective assessment of symptoms. The clinicians were unanimous about the usefulness of the test, finding it helpful to understand symptoms. Less than half of the families however felt the test helped them to understand the clinician’s decision-making around diagnosis and medication.
The tool was perceived by clinicians to be of particular value in streamlining the ADHD care pathway. They also found it helped with patient communication. Parents found the tool helpful for communication with their clinician, and with schools, but in some cases found the results difficult to understand. These results demonstrate a need for clinicians to be mindful to explain clearly when discussing results with families.
Further analysis is ongoing to understand the cost benefit but it was clear from the research that there is a potential role of the test to streamline the care pathway and help reduce delays in diagnosis and treatment. The researchers also conclude that these findings could be used to support the integration of similar technological devices to aid diagnosis in other conditions.
The AQUA trial was funded by the NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) East Midlands with support from the NIHR MindTech Healthcare Technology Co-operative (HTC). The Chief Investigator, Professor Chris Hollis and the lead investigator, Dr Charlotte Hall are both based at the University of Nottingham.
If you’ve got a solution that could address unmet clinical need in mental health through medical technology you may be interested in applying for the 2018 NIHR Invention for Innovation (i4i) Challenge Award, open until 4 April.