Systematic Review and Meta-analysis: Screening Tools for Attention-Deficit/Hyperactivity Disorder in Children and Adolescents - 27/07/22
Doi : 10.1016/j.jaac.2021.11.031
Melissa Mulraney, PhD a, b, c, ⁎ 
, Gonzalo Arrondo, PhD d, e, Hande Musullulu, MPsych d, e, Iciar Iturmendi-Sabater, MPsych d, f, g, Samuele Cortese, MD e, h, i, j, Samuel J. Westwood, PhD k, l, m, Federica Donno, PhD o, p, Tobias Banaschewski, MD q, Emily Simonoff, MD k, n, Alessandro Zuddas, MD o, p, Manfred Döpfner, PhD r, s, Stephen P. Hinshaw, PhD t, u, David Coghill, MD a, b
, Gonzalo Arrondo, PhD d, e, Hande Musullulu, MPsych d, e, Iciar Iturmendi-Sabater, MPsych d, f, g, Samuele Cortese, MD e, h, i, j, Samuel J. Westwood, PhD k, l, m, Federica Donno, PhD o, p, Tobias Banaschewski, MD q, Emily Simonoff, MD k, n, Alessandro Zuddas, MD o, p, Manfred Döpfner, PhD r, s, Stephen P. Hinshaw, PhD t, u, David Coghill, MD a, b a Murdoch Children’s Research Institute, Melbourne, Australia
b University of Melbourne, Australia
c Institute for Social Neuroscience, Ivanhoe, Australia
d University of Navarra, Pamplona, Spain
e University of Southampton, Southampton, United Kingdom
f University College London, United Kingdom
g University of Toronto, Canada
h Solent NHS Trust, Southampton, United Kingdom
i New York University, New York
j University of Nottingham, United Kingdom
k University of Westminster, London United Kingdom
l King’s College London, United Kingdom
m University of Wolverhampton, United Kingdom
n NIHR South London and Maudsley Biomedical Research Centre for Mental Health, London, United Kingdom
o University of Cagliari, Italy
p ”A. Cao” Pediatric Hospital, “G. Brotzu” Hospital Trust, Cagliari, Italy
q University of Heidelberg, Mannheim, Germany
r University Cologne (AKiP), Germany
s University of Cologne, Germany
t University of California, Berkeley
u University of California, San Francisco
∗Correspondence to Melissa Mulraney, PhD, ISN Innovations, Institute for Social Neuroscience, 443 Upper Heidelberg Road, Ivanhoe, VIC 3079, AustraliaISN InnovationsInstitute for Social Neuroscience443 Upper Heidelberg RoadIvanhoeVIC3079Australia
Abstract |
Objective |
This systematic review and meta-analysis aimed to determine the accuracies of a broad range of screening tools for attention-deficit/hyperactivity disorder (ADHD) in children and adolescents, and to compare the diagnostic accuracy of tools between population-based and clinical/high-risk samples, and across reporters.
Method |
MEDLINE, PsycINFO, EMBASE, and PubMed were searched up until February 20, 2020, with no language restrictions. Studies reporting diagnostic accuracy of a screening tool against a diagnosis of ADHD in children and adolescents <18 years of age were eligible for inclusion. Meta-analyses were undertaken to provide pooled estimates of the area under the curve (AUC), and sensitivity and specificity of groups of measures.
Results |
A total of 75 studies published between 1985 and 2021 reporting on 41 screening tools that were grouped into 4 categories (Achenbach System of Empirically Based Assessment [ASEBA], DSM-IV symptom scales, SDQ, and Other Scales) were retained. The pooled AUC for studies using a combined ADHD symptoms score was 0.82 (95% CI = 0.78−0.86), although this varied considerably across reporters (0.67-0.92) and populations (CI = 0.60−0.95). None of the measures met minimal standards for acceptable sensitivity (0.8) and specificity (0.8).
Conclusion |
Most tools have excellent overall diagnostic accuracy as indicated by the AUC. However, a single measure completed by a single reporter is unlikely to have sufficient sensitivity and specificity for clinical use or population screening.
Le texte complet de cet article est disponible en PDF.Key words : attention-deficit/hyperactivity disorder, screening, psychometrics, rating scales
Plan
| Drs. Mulraney and Arrondo shared first authorship of this article. |
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| This article was reviewed under and accepted by Ad Hoc Editor Jonathan Posner, MD. |
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| The authors have reported no funding for this work. |
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| This article is part of a special series devoted to the subject of child and adolescent attention-deficit/hyperactivity disorder (ADHD). The series covers a range of topics in the area including genetics, neuroimaging, treatment, and others. The series was edited by Guest Editor Jonathan Posner, MD along with Deputy Editor Samuele Cortese, MD, PhD. |
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| This work has been prospectively registered: display_record.php?ID=CRD42020168091. |
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| Author Contributions |
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| Conceptualization: Mulraney, Cortese, Banaschewski, Simonoff, Zuddas, Döpfner, Hinshaw, Coghill |
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| Data curation: Mulraney, Arrondo, Musullulu, Iturmendi-Sabater, Westwood, Donno |
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| Formal analysis: Mulraney |
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| Investigation: Mulraney, Arrondo, Musullulu |
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| Methodology: Mulraney, Arrondo, Musullulu, Iturmendi-Sabater, Cortese, Westwood, Simonoff, Coghill |
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| Project administration: Mulraney, Arrondo |
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| Resources: Banaschewski |
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| Supervision: Cortese, Coghill |
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| Writing – original draft: Mulraney |
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| Writing – review and editing: Mulraney, Arrondo, Musullulu, Iturmendi-Sabater, Cortese, Westwood, Donno, Banaschewski, Simonoff, Zuddas, Döpfner, Hinshaw, Coghill |
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| Disclosure: Dr. Mulraney has received consulting income and research funds from the International Consortium for Health Outcomes Measurement, The Royal Children's Hospital Foundation, and ISN Innovations. Dr. Arrondo has received funding from the Spanish Ministry of Science, Innovation and Universities to facilitate the mobility of researchers to foreign higher education and research centers (Ref. CAS19/00249). Prof. Cortese has served on the advisory board of the Association for Child and Adolescent Mental Health (ACAMH). He has received honoraria from ACAMH and the British Association for Psychopharmacology. He has served as deputy editor of Evidence-Based Mental Health, associate editor of Child and Adolescent Mental Health, and on the editorial boards of the Journal of Child Psychology and Psychiatry, the Journal of Child and Adolescent Psychopharmacology, and CNS Drugs. Prof. Banaschewski has served in an advisory or consultancy role for ADHS digital, Infectopharm, Lundbeck, Medice, Neurim Pharmaceuticals, Oberberg GmbH, Roche, and Takeda/Shire. He has received conference support or speaker’s fee by Medice and Takeda/Shire. He has received royalties from Hogrefe, Kohlhammer, CIP Medien, and Oxford University Press; the present work is unrelated to these relationships. Prof. Simonoff has received grant or research support from the National Institute for Health Research, the Psychiatry Research Trust, the Guy’s and St. Thomas’ Charitable Foundation, the Economic and Social Research Council, the Medical Research Council, the National Institute of Health Research Biomedical Research Centre at South London and Maudsley Foundation Trust, and the European Commission. She has served on the advisory boards of the European ADHD Guidelines Group, Eunethydis, the Autistica Mental Health Steering Group, the National Autism Project Board, the Medical Research Council Neuroscience and Mental Health Board, the Central Institute for Mental Health, Manheim, Germany, and the Oak Foundation. She is author of the assessment tools Assessment of Consuming Behaviour (copyright, Santosh and Simonoff, manuscript in preparation) and Observation Schedule for Children with Autism (in preparation). She has served on the editorial board of the British Journal of Psychiatry. She has received honoraria from the Royal College of Physicians as Senior Clinical Advisor for the National Institute of Health and Care Excellence. Prof. Zuddas has reported personal fees for being on advisory boards from Angelini, Servier, and Shire/Takeda; research grants from Angelini, Janssen, Lundbeck, Otsuka, and Servier; and royalties from Giunti OS and Oxford University Press, outside the submitted work. Prof. Döpfner has received consulting income and research support from Lilly, Medice, Shire, Takeda, and Vifor and research support from the German Research Foundation, the German Ministry of Education and Research, the German Ministry of Health, and Innovation Fund. He has received income as head, supervisor, and lecturer of the School of Child and Adolescent Cognitive Behaviour Therapy at the University Hospital Cologne and as consultant for Child Behaviour Therapy at the National Association of Statutory Health Insurance Physicians (Kassenärztliche Bundesvereinigung). He has received royalties from treatment manuals, books, and psychological tests published by Beltz, Elsevier, Enke, Guilford, Hogrefe, Huber, Kohlhammer, Schattauer, Springer, and Wiley. Prof. Hinshaw has received grant funding from the National Institute of Mental Health (R01MH45064) and royalties from St. Martin’s Press and Oxford University Press. Prof. Coghill has received research support and/or honoraria from Shire/Takeda, Medice, Novartis, and Servier and royalties from Oxford University Press and Cambridge University Press. Drs. Westwood and Donno, Mrs. Musullulu, and Ms. Iturmendi-Sabater have reported no biomedical financial interests or potential conflicts of interest. |
© 2021
American Academy of Child and Adolescent Psychiatry. Publié par Elsevier Masson SAS. Tous droits réservés.
Vol 61 - N° 8
P. 982-996 - août 2022 Retour au numéro
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