July 16, 2024

expert reaction to NICE draft guidance on digital technologies for assessing ADHD in children and young people

Scientists react to NICE draft guidance on technologies for assessing ADHD.

Dr Jessica Eccles, Chair of the Royal College of Psychiatrists’ Neurodevelopmental Special Interest Group, said:

“People who suspect they may have ADHD often have to wait months or even years for an assessment which can prevent them from accessing timely and effective care. Any new evidence-based tools should be used to reduce these unacceptable waiting times and improve the availability of support.

“It’s critical that these tests are administered by a fully trained and qualified professional who can accurately interpret the information they provide. They must not be used in isolation but as part of a broader assessment.

“The challenges facing ADHD services will not be solved by new technology alone. There is still a clear need for targeted resources to help them meet rising demand and provide vital care.”

Dr Maddie Groom, Associate Professor in Applied Developmental Cognitive Neuroscience, Institute of Mental Health at the University of Nottingham, said:

“In the AQUA Trial we found that including QbTest alongside other assessment tools increased the likelihood of a diagnostic decision being reached within 6 months (without sacrificing diagnostic accuracy), reduced appointment length, and clinicians reported greater confidence in the diagnostic decision. Our findings from this trial and other research suggests that QbTest provides another source of information about the child’s difficulties which may supplement the information gathered from traditional assessment measures such as rating scales and interviews. Specifically, QbTest measures the child’s attention, impulse control, and physical activity during a 15-20 minute test whereas more traditional measures gather observational information about the child from those around them, such as parents and teachers, and the child themselves. All sources of information may be important when trying to reach a diagnostic decision.

“It is very important that QbTest is not used alone – it should not be used to ‘triage’ cases for diagnostic assessment, and it should not be used as a standalone tool to reach a diagnostic decision. It has only been designed to be used alongside other clinical assessment tools. The NICE guidance also emphasises this.

“The NICE guidance draws on the AQUA trial and other evidence so that there is clarity for clinicians on the use of QbTest. This has been lacking up to now and it is helpful to have this guideline which clearly states that it should only be used as part of a standard clinical assessment by a healthcare professional. Further work is needed to guide clinicians on how to combine QbTest with other sources of information such as questionnaires and interviews,  to ensure it is incorporated into standard diagnostic assessment appropriately.”

NICE draft guidance:’’ Digital technologies for assessing attention deficit hyperactivity disorder’ was published at 00:01 UK time on Tuesday 16^th July. The draft guidance is available here: https://www.nice.org.uk/guidance/indevelopment/gid-dg10088/documents

Declared interests

Dr Maddie Groom:  I was one of the authors on the AQUA trial and have I have also led/been involved in other research to evaluate the role of the QbTest in augmenting diagnostic assessment for ADHD. I am also a co-author on a systematic review recently published on the role of QbTest in aiding diagnostic assessment of ADHD. I can therefore offer a perspective on this guidance from NICE but my role as a co-author may be perceived as a conflict of interest.