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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 tr

Hall, Charlotte L.; Walker, Gemma M.; Valentine, Althea Z.; Guo, Boliang; Kaylor-Hughes, Catherine; James, Marilyn; Daley, David; Sayal, Kapil; Hollis, Chris

Authors

Gemma M. Walker

Catherine Kaylor-Hughes

MARILYN JAMES MARILYN.JAMES@NOTTINGHAM.AC.UK
Professor of Health Economics

DAVID DALEY david.daley@nottingham.ac.uk
Professor of Psychological Intervention_ and Behaviour Change

KAPIL SAYAL kapil.sayal@nottingham.ac.uk
Professor of Child and Adolescentpsychiatry

CHRIS HOLLIS chris.hollis@nottingham.ac.uk
Professor of Child and Adolescent Psychiatry



Abstract

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 standard’ 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 randomised 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 England. 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 randomised 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 submitted for publication in peer-reviewed journals. The study has received ethical approval.

Journal Article Type Article
Publication Date Dec 1, 2014
Journal BMJ open
Electronic ISSN 2044-6055
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 4
Issue 12
Article Number e006838
APA6 Citation Hall, C. L., Walker, G. M., Valentine, A. Z., Guo, B., Kaylor-Hughes, C., James, M., …Hollis, C. (2014). 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. BMJ Open, 4(12), https://doi.org/10.1136/bmjopen-2014-006838
DOI https://doi.org/10.1136/bmjopen-2014-006838
Publisher URL http://bmjopen.bmj.com/content/4/12/e006838
Copyright Statement Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0

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Copyright Statement
Copyright information regarding this work can be found at the following address: http://creativecommons.org/licenses/by/4.0





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