The Structure and Diagnostic Accuracy of the QbTest in Pediatric ADHD: A Retrospective Clinical Study

Abstract

Objective: The QbTest that combines a continuous performance task (CPT) with a motion-tracking system may help identify attention deficit hyperactivity disorder (ADHD). This study examined the structure and diagnostic ability of the QbTest in children and adolescents. Method: Retrospective data from 1,274 children and adolescents were analyzed. The study assessed data on a principal component analysis (PCA), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Results: The QbActivity component included the variables micro-events, distance, area, and time active; the QbImpulsivity included normalized commissions and commissions (anticipatory errors were added in a version for 6–12-year-olds only); and the QbInattention included omissions, reaction time, and reaction time variation. Sensitivity ranged between 22% and 50%, specificity 79% and 96%, PPVs 40% and 95%, and NPVs 24% and 66%. Conclusion: The structure of the QbTest with three cardinal parameters and nine/ten CPT and motion analysis variables was supported. The diagnostic accuracy was found to be poor to moderate. Given that this is a retrospective study, the interpretation of diagnostic accuracy should be considered within this context.

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

“…A confounding issue could be that subjects did not contact the health care themselves, instead they were contacted by clinicians through a twin‐register, which may have resulted in an overdiagnosis of ADHD in the selected population. In a recent retrospective study ( n = 1274, age 6–18 years, period covered year 2004–2017 in Sweden) the diagnostic accuracy of QbTest was found to be modest in pediatric ADHD (Stevanovic et al, 2023) (excluded in this review as the number of subjects in clinical control was extremely low compared to the total population). It should be emphasized that QbTest was not used for its intended use i.e.…”

“…used as a support tool in the diagnostic assessment of ADHD. Second, no Q‐scores were presented (evaluation was made on “area under the curve”), approximately 2/3 of the subjects had comorbid disorders in the ADHD group, and only 3% ( n = 40) were considered as clinical controls (no diagnosis assigned) of the entire population in this retrospective chart review research (Stevanovic et al, 2023). Finally, it should be noted that divergent results regarding the diagnostic accuracy of ADHD using different CPTs have been shown in the literature (Baggio et al, 2020; Hall et al, 2016; Valentine et al, 2020).…”

“…explored QbTest to identify ADHD populations as an objective measure of ADHD symptoms, in 69 adults (mean age 33 years) in the clinic (Adamou et al, 2022) (n = 40) were considered as clinical controls (no diagnosis assigned) of the entire population in this retrospective chart review research (Stevanovic et al, 2023). Finally, it should be noted that divergent results regarding the diagnostic accuracy of ADHD using different…”

Onset of Inattention and Hyperactivity in Children and Adolescents With Epilepsy 6 months After the Diagnosis

“…One of the future directions would be to study attention aspects from different perspectives, such as evaluating reports from different sources and considering using more objective measures of attention and hyperactivity (Stevanovic et al, 2023). Certainly, 6 months is a short period, and it would be very useful to continue the research, considering that the diagnosis of epilepsy itself has an impact on the social and emotional aspects of the patient and his family, and we should see, over an extended period of time following the adaptation period, what the situation with the symptoms of attention deficit disorder and hyperactivity are.…”