QbTest in the clinical assessment of attention deficit hyperactivity disorder: A review of the evidence

Abstract

The technology described in this review is QbTest. This evaluation focuses on QbTest in the clinical assessment of attention deficit hyperactivity disorder (ADHD), with emphasis on studies designed to evaluate the performance of QbTest as a decision support tool, that is, the intended use, and studies designed to evaluate discriminatory ability as a diagnostic test. A literature search of publications was made until May 2023. For the first part, studies investigating QbTest as a decision support tool were included. For the second part, studies designed to evaluate QbTest as a stand-alone test were included if sufficient information for a weighted average calculation of discriminatory power was included in the publication. Eleven studies on participants with ADHD were included for which QbTest was used in the diagnostic procedures of the disorder. One prospective randomized controlled study designed to evaluate QbTest when used for its intended purpose demonstrated a reduced time to diagnosis and increased diagnostic confidence. Ten studies designed to evaluate QbTest as a diagnostic test were identified. QbTest performed well with a weighted average sensitivity of 0.89 and specificity of 0.87 across studies with normative controls. In the challenging group of population with differential diagnosis (participants referred to a secondary or tertiary clinical care level), QbTest performed with a weighted average of 0.79 and 0.71 for both sensitivity and specificity. When including only studies of robust sample size (each study arm ≥50), the weighted averages were 0.83 and 0.86 for specificity and sensitivity, respectively. The addition of a QbTest reduced the time to a diagnostic decision without compromising diagnostic accuracy in a randomized control trial. When QbTest was evaluated for discriminative ability, an overall satisfactory weighted average sensitivity and specificity was found. The intended use of QbTest is to be used as a support tool rather than a standalone test in the clinical assessment of ADHD.