Commentary: Using QbTest for monitoring pharmacological treatment response in ADHD - are we there yet? / Alessio BELLATO ; Valeria PARLATINI ; Madeleine J. GROOM ; Charlotte L. HALL ; Chris HOLLIS ; Emily SIMONOFF ; Anita THAPAR ; Samuele CORTESE in Journal of Child Psychology and Psychiatry, 66-2 (February 2025)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 66-2 (February 2025) . - p.266-270 Titre : Commentary: Using QbTest for monitoring pharmacological treatment response in ADHD - are we there yet? : Journal of Child Psychology and Psychiatry Type de document : texte imprimé Auteurs : Alessio BELLATO, Auteur ; Valeria PARLATINI, Auteur ; Madeleine J. GROOM, Auteur ; Charlotte L. HALL, Auteur ; Chris HOLLIS, Auteur ; Emily SIMONOFF, Auteur ; Anita THAPAR, Auteur ; Samuele CORTESE, Auteur Article en page(s) : p.266-270 Langues : Anglais (eng) Mots-clés : ADHD  activity level  biomarkers  continuous performance test  outcome  pharmacotherapy Index. décimale : PER Périodiques Résumé : Individuals with attention-deficit/hyperactivity disorder (ADHD) exhibit varied responses to pharmacological treatments (e.g. stimulants and non-stimulants). Accurately and promptly detecting treatment-related improvements, response failure, or deterioration poses significant challenges, as current monitoring primarily relies on subjective ratings. In this commentary, we critically evaluate the evidence supporting the use of QbTest for objectively monitoring ADHD treatment response in clinical practice. We also offer recommendations for future research, advocating for rigorous clinical trials and longitudinal studies to further explore the potential utilisation of QbTest and other tools for monitoring treatment responses in individuals with ADHD. En ligne : https://doi.org/10.1111/jcpp.14071 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=545 [article] Commentary: Using QbTest for monitoring pharmacological treatment response in ADHD - are we there yet? : Journal of Child Psychology and Psychiatry [texte imprimé] / Alessio BELLATO, Auteur ; Valeria PARLATINI, Auteur ; Madeleine J. GROOM, Auteur ; Charlotte L. HALL, Auteur ; Chris HOLLIS, Auteur ; Emily SIMONOFF, Auteur ; Anita THAPAR, Auteur ; Samuele CORTESE, Auteur . - p.266-270. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 66-2 (February 2025) . - p.266-270 Mots-clés : ADHD  activity level  biomarkers  continuous performance test  outcome  pharmacotherapy Index. décimale : PER Périodiques Résumé : Individuals with attention-deficit/hyperactivity disorder (ADHD) exhibit varied responses to pharmacological treatments (e.g. stimulants and non-stimulants). Accurately and promptly detecting treatment-related improvements, response failure, or deterioration poses significant challenges, as current monitoring primarily relies on subjective ratings. In this commentary, we critically evaluate the evidence supporting the use of QbTest for objectively monitoring ADHD treatment response in clinical practice. We also offer recommendations for future research, advocating for rigorous clinical trials and longitudinal studies to further explore the potential utilisation of QbTest and other tools for monitoring treatment responses in individuals with ADHD. En ligne : https://doi.org/10.1111/jcpp.14071 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=545

Long-term clinical and cost-effectiveness of a therapist-supported online remote behavioural intervention for tics in children and adolescents: extended 12- and 18-month follow-up of a single-blind randomised controlled trial / Chris HOLLIS in Journal of Child Psychology and Psychiatry, 64-6 (June 2023)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 64-6 (June 2023) . - p.941-951 Titre : Long-term clinical and cost-effectiveness of a therapist-supported online remote behavioural intervention for tics in children and adolescents: extended 12- and 18-month follow-up of a single-blind randomised controlled trial Type de document : texte imprimé Auteurs : Chris HOLLIS, Auteur ; Charlotte L. HALL, Auteur ; Kareem KHAN, Auteur ; Rebecca JONES, Auteur ; Louise MARSTON, Auteur ; Marie LE NOVERE, Auteur ; Rachael HUNTER, Auteur ; Per ANDRÉN, Auteur ; Sophie D. BENNETT, Auteur ; Beverley J. BROWN, Auteur ; Liam R. CHAMBERLAIN, Auteur ; E. Bethan DAVIES, Auteur ; Amber EVANS, Auteur ; Natalia KOUZOUPI, Auteur ; Caitlin MCKENZIE, Auteur ; Charlotte SANDERSON, Auteur ; Isobel HEYMAN, Auteur ; Joseph KILGARIFF, Auteur ; Cristine GLAZEBROOK, Auteur ; David MATAIX-COLS, Auteur ; Eva SERLACHIUS, Auteur ; Elizabeth MURRAY, Auteur ; Tara MURPHY, Auteur Article en page(s) : p.941-951 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Background Little is known about the long-term effectiveness of behavioural therapy for tics. We aimed to assess the long-term clinical and cost-effectiveness of online therapist-supported exposure and response prevention (ERP) therapy for tics 12 and 18 months after treatment initiation. Methods ORBIT (online remote behavioural intervention for tics) was a two-arm (1:1 ratio), superiority, single-blind, multicentre randomised controlled trial comparing online ERP for tics with online psychoeducation. The trial was conducted across two Child and Adolescent Mental Health Services in England. Participants were recruited from these two sites, across other clinics in England, or by self-referral. This study was a naturalistic follow-up of participants at 12- and 18-month postrandomisation. Participants were permitted to use alternative treatments recommended by their clinician. The key outcome was the Yale Global Tic Severity Scale Total Tic Severity Score (YGTSS-TTSS). A full economic evaluation was conducted. Registrations are ISRCTN (ISRCTN70758207); ClinicalTrials.gov (NCT03483493). Results Two hundred and twenty-four participants were enrolled: 112 to ERP and 112 to psychoeducation. The sample was predominately male (177; 79%) and of white ethnicity (195; 87%). The ERP intervention reduced baseline YGTSS-TTSS by 2.64 points (95% CI: 4.48 to 0.79) with an effect size of 0.36 (95% CI: 0.61 to 0.11) after 12 months and by 2.01 points (95% CI: 3.86 to 0.15) with an effect size of 0.27 (95% CI -0.52 to 0.02) after 18 months, compared with psychoeducation. Very few participants (<10%) started new tic treatment during follow-up. The cost difference in ERP compared with psychoeducation was £304.94 ( 139.41 to 749.29). At 18 months, the cost per QALY gained was £16,708 for ERP compared with psychoeducation. Conclusions Remotely delivered online ERP is a clinical and cost-effective intervention with durable benefits extending for up to 18 months. This represents an efficient public mental health approach to increase access to behavioural therapy and improve outcomes for tics. En ligne : http://dx.doi.org/https://doi.org/10.1111/jcpp.13756 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=504 [article] Long-term clinical and cost-effectiveness of a therapist-supported online remote behavioural intervention for tics in children and adolescents: extended 12- and 18-month follow-up of a single-blind randomised controlled trial [texte imprimé] / Chris HOLLIS, Auteur ; Charlotte L. HALL, Auteur ; Kareem KHAN, Auteur ; Rebecca JONES, Auteur ; Louise MARSTON, Auteur ; Marie LE NOVERE, Auteur ; Rachael HUNTER, Auteur ; Per ANDRÉN, Auteur ; Sophie D. BENNETT, Auteur ; Beverley J. BROWN, Auteur ; Liam R. CHAMBERLAIN, Auteur ; E. Bethan DAVIES, Auteur ; Amber EVANS, Auteur ; Natalia KOUZOUPI, Auteur ; Caitlin MCKENZIE, Auteur ; Charlotte SANDERSON, Auteur ; Isobel HEYMAN, Auteur ; Joseph KILGARIFF, Auteur ; Cristine GLAZEBROOK, Auteur ; David MATAIX-COLS, Auteur ; Eva SERLACHIUS, Auteur ; Elizabeth MURRAY, Auteur ; Tara MURPHY, Auteur . - p.941-951. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 64-6 (June 2023) . - p.941-951 Index. décimale : PER Périodiques Résumé : Background Little is known about the long-term effectiveness of behavioural therapy for tics. We aimed to assess the long-term clinical and cost-effectiveness of online therapist-supported exposure and response prevention (ERP) therapy for tics 12 and 18 months after treatment initiation. Methods ORBIT (online remote behavioural intervention for tics) was a two-arm (1:1 ratio), superiority, single-blind, multicentre randomised controlled trial comparing online ERP for tics with online psychoeducation. The trial was conducted across two Child and Adolescent Mental Health Services in England. Participants were recruited from these two sites, across other clinics in England, or by self-referral. This study was a naturalistic follow-up of participants at 12- and 18-month postrandomisation. Participants were permitted to use alternative treatments recommended by their clinician. The key outcome was the Yale Global Tic Severity Scale Total Tic Severity Score (YGTSS-TTSS). A full economic evaluation was conducted. Registrations are ISRCTN (ISRCTN70758207); ClinicalTrials.gov (NCT03483493). Results Two hundred and twenty-four participants were enrolled: 112 to ERP and 112 to psychoeducation. The sample was predominately male (177; 79%) and of white ethnicity (195; 87%). The ERP intervention reduced baseline YGTSS-TTSS by 2.64 points (95% CI: 4.48 to 0.79) with an effect size of 0.36 (95% CI: 0.61 to 0.11) after 12 months and by 2.01 points (95% CI: 3.86 to 0.15) with an effect size of 0.27 (95% CI -0.52 to 0.02) after 18 months, compared with psychoeducation. Very few participants (<10%) started new tic treatment during follow-up. The cost difference in ERP compared with psychoeducation was £304.94 ( 139.41 to 749.29). At 18 months, the cost per QALY gained was £16,708 for ERP compared with psychoeducation. Conclusions Remotely delivered online ERP is a clinical and cost-effective intervention with durable benefits extending for up to 18 months. This represents an efficient public mental health approach to increase access to behavioural therapy and improve outcomes for tics. En ligne : http://dx.doi.org/https://doi.org/10.1111/jcpp.13756 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=504

Practitioner Review: Clinical utility of the QbTest for the assessment and diagnosis of attention-deficit/hyperactivity disorder - a systematic review and meta-analysis / Charlotte L. HALL ; Madeleine J. GROOM ; Emily SIMONOFF ; Anita THAPAR ; Chris HOLLIS ; Samuele CORTESE in Journal of Child Psychology and Psychiatry, 65-6 (June 2024)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 65-6 (June 2024) . - p.845-861 Titre : Practitioner Review: Clinical utility of the QbTest for the assessment and diagnosis of attention-deficit/hyperactivity disorder - a systematic review and meta-analysis Type de document : texte imprimé Auteurs : Charlotte L. HALL, Auteur ; Madeleine J. GROOM, Auteur ; Emily SIMONOFF, Auteur ; Anita THAPAR, Auteur ; Chris HOLLIS, Auteur ; Samuele CORTESE, Auteur Année de publication : 2024 Article en page(s) : p.845-861 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Background Several computerised cognitive tests (e.g. continuous performance test) have been developed to support the clinical assessment of attention-deficit/hyperactivity disorder (ADHD). Here, we appraised the evidence-base underpinning the use of one of these tests - the QbTest - in clinical practice, by conducting a systematic review and meta-analysis investigating its accuracy and clinical utility. Methods Based on a preregistered protocol (CRD42022377671), we searched PubMed, Medline, Ovid Embase, APA PsycINFO and Web of Science on 15th August 2022, with no language/type of document restrictions. We included studies reporting accuracy measures (e.g. sensitivity, specificity, or Area under the Receiver Operating Characteristics Curve, AUC) for QbTest in discriminating between people with and without DSM/ICD ADHD diagnosis. Risk of bias was assessed with the Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2). A generic inverse variance meta-analysis was conducted on AUC scores. Pooled sensitivity and specificity were calculated using a random-effects bivariate model in R. Results We included 15 studies (2,058 participants; 48.6% with ADHD). QbTest Total scores showed acceptable, rather than good, sensitivity (0.78 [95% confidence interval: 0.69; 0.85]) and specificity (0.70 [0.57; 0.81]), while subscales showed low-to-moderate sensitivity (ranging from 0.48 [0.35; 0.61] to 0.65 [0.52; 0.75]) and moderate-to-good specificity (from 0.65 [0.48; 0.78] to 0.83 [0.60; 0.94]). Pooled AUC scores suggested moderate-to-acceptable discriminative ability (Q-Total: 0.72 [0.57; 0.87]; Q-Activity: 0.67 [0.58; 0.77); Q-Inattention: 0.66 [0.59; 0.72]; Q-Impulsivity: 0.59 [0.53; 0.64]). Conclusions When used on their own, QbTest scores available to clinicians are not sufficiently accurate in discriminating between ADHD and non-ADHD clinical cases. Therefore, the QbTest should not be used as stand-alone screening or diagnostic tool, or as a triage system for accepting individuals on the waiting-list for clinical services. However, when used as an adjunct to support a full clinical assessment, QbTest can produce efficiencies in the assessment pathway and reduce the time to diagnosis. En ligne : https://doi.org/10.1111/jcpp.13901 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=529 [article] Practitioner Review: Clinical utility of the QbTest for the assessment and diagnosis of attention-deficit/hyperactivity disorder - a systematic review and meta-analysis [texte imprimé] / Charlotte L. HALL, Auteur ; Madeleine J. GROOM, Auteur ; Emily SIMONOFF, Auteur ; Anita THAPAR, Auteur ; Chris HOLLIS, Auteur ; Samuele CORTESE, Auteur . - 2024 . - p.845-861. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 65-6 (June 2024) . - p.845-861 Index. décimale : PER Périodiques Résumé : Background Several computerised cognitive tests (e.g. continuous performance test) have been developed to support the clinical assessment of attention-deficit/hyperactivity disorder (ADHD). Here, we appraised the evidence-base underpinning the use of one of these tests - the QbTest - in clinical practice, by conducting a systematic review and meta-analysis investigating its accuracy and clinical utility. Methods Based on a preregistered protocol (CRD42022377671), we searched PubMed, Medline, Ovid Embase, APA PsycINFO and Web of Science on 15th August 2022, with no language/type of document restrictions. We included studies reporting accuracy measures (e.g. sensitivity, specificity, or Area under the Receiver Operating Characteristics Curve, AUC) for QbTest in discriminating between people with and without DSM/ICD ADHD diagnosis. Risk of bias was assessed with the Quality Assessment of Diagnostic Accuracy Studies tool (QUADAS-2). A generic inverse variance meta-analysis was conducted on AUC scores. Pooled sensitivity and specificity were calculated using a random-effects bivariate model in R. Results We included 15 studies (2,058 participants; 48.6% with ADHD). QbTest Total scores showed acceptable, rather than good, sensitivity (0.78 [95% confidence interval: 0.69; 0.85]) and specificity (0.70 [0.57; 0.81]), while subscales showed low-to-moderate sensitivity (ranging from 0.48 [0.35; 0.61] to 0.65 [0.52; 0.75]) and moderate-to-good specificity (from 0.65 [0.48; 0.78] to 0.83 [0.60; 0.94]). Pooled AUC scores suggested moderate-to-acceptable discriminative ability (Q-Total: 0.72 [0.57; 0.87]; Q-Activity: 0.67 [0.58; 0.77); Q-Inattention: 0.66 [0.59; 0.72]; Q-Impulsivity: 0.59 [0.53; 0.64]). Conclusions When used on their own, QbTest scores available to clinicians are not sufficiently accurate in discriminating between ADHD and non-ADHD clinical cases. Therefore, the QbTest should not be used as stand-alone screening or diagnostic tool, or as a triage system for accepting individuals on the waiting-list for clinical services. However, when used as an adjunct to support a full clinical assessment, QbTest can produce efficiencies in the assessment pathway and reduce the time to diagnosis. En ligne : https://doi.org/10.1111/jcpp.13901 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=529

The impact of a computerised test of attention and activity (QbTest) on diagnostic decision-making in children and young people with suspected attention deficit hyperactivity disorder: single-blind randomised controlled trial / Chris HOLLIS in Journal of Child Psychology and Psychiatry, 59-12 (December 2018)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 59-12 (December 2018) . - p.1298-1308 Titre : The impact of a computerised test of attention and activity (QbTest) on diagnostic decision-making in children and young people with suspected attention deficit hyperactivity disorder: single-blind randomised controlled trial Type de document : texte imprimé Auteurs : Chris HOLLIS, Auteur ; Charlotte L. HALL, Auteur ; Boliang GUO, Auteur ; Marilyn JAMES, Auteur ; Janet BOADU, Auteur ; Madeleine J. GROOM, Auteur ; Nikki BROWN, Auteur ; Catherine KAYLOR-HUGHES, Auteur ; Maria MOLDAVSKY, Auteur ; Althea Z. VALENTINE, Auteur ; Gemma M. WALKER, Auteur ; David DALEY, Auteur ; Kapil SAYAL, Auteur ; Richard MORRISS, Auteur Article en page(s) : p.1298-1308 Langues : Anglais (eng) Mots-clés : QbTest  assessment  attention deficit hyperactivity disorder  continuous performance test Index. décimale : PER Périodiques Résumé : BACKGROUND: Diagnosis of attention deficit hyperactivity disorder (ADHD) relies on subjective methods which can lead to diagnostic uncertainty and delay. This trial evaluated the impact of providing a computerised test of attention and activity (QbTest) report on the speed and accuracy of diagnostic decision-making in children with suspected ADHD. METHODS: Randomised, parallel, single-blind controlled trial in mental health and community paediatric clinics in England. Participants were 6-17 years-old and referred for ADHD diagnostic assessment; all underwent assessment-as-usual, plus QbTest. Participants and their clinician were randomised to either receive the QbTest report immediately (QbOpen group) or the report was withheld (QbBlind group). The primary outcome was number of consultations until a diagnostic decision confirming/excluding ADHD within 6-months from baseline. Health economic cost-effectiveness and cost utility analysis was conducted. Assessing QbTest Utility in ADHD: A Randomised Controlled Trial was registered at ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT02209116). RESULTS: One hundred and thirty-two participants were randomised to QbOpen group (123 analysed) and 135 to QbBlind group (127 analysed). Clinicians with access to the QbTest report (QbOpen) were more likely to reach a diagnostic decision about ADHD (hazard ratio 1.44, 95% CI 1.04-2.01). At 6-months, 76% of those with a QbTest report had received a diagnostic decision, compared with 50% without. QbTest reduced appointment length by 15% (time ratio 0.85, 95% CI 0.77-0.93), increased clinicians' confidence in their diagnostic decisions (odds ratio 1.77, 95% CI 1.09-2.89) and doubled the likelihood of excluding ADHD. There was no difference in diagnostic accuracy. Health economic analysis showed a position of strict dominance; however, cost savings were small suggesting that the impact of providing the QbTest report within this trial can best be viewed as 'cost neutral'. CONCLUSIONS: QbTest may increase the efficiency of ADHD assessment pathway allowing greater patient throughput with clinicians reaching diagnostic decisions faster without compromising diagnostic accuracy. En ligne : http://dx.doi.org/10.1111/jcpp.12921 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=371 [article] The impact of a computerised test of attention and activity (QbTest) on diagnostic decision-making in children and young people with suspected attention deficit hyperactivity disorder: single-blind randomised controlled trial [texte imprimé] / Chris HOLLIS, Auteur ; Charlotte L. HALL, Auteur ; Boliang GUO, Auteur ; Marilyn JAMES, Auteur ; Janet BOADU, Auteur ; Madeleine J. GROOM, Auteur ; Nikki BROWN, Auteur ; Catherine KAYLOR-HUGHES, Auteur ; Maria MOLDAVSKY, Auteur ; Althea Z. VALENTINE, Auteur ; Gemma M. WALKER, Auteur ; David DALEY, Auteur ; Kapil SAYAL, Auteur ; Richard MORRISS, Auteur . - p.1298-1308. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 59-12 (December 2018) . - p.1298-1308 Mots-clés : QbTest  assessment  attention deficit hyperactivity disorder  continuous performance test Index. décimale : PER Périodiques Résumé : BACKGROUND: Diagnosis of attention deficit hyperactivity disorder (ADHD) relies on subjective methods which can lead to diagnostic uncertainty and delay. This trial evaluated the impact of providing a computerised test of attention and activity (QbTest) report on the speed and accuracy of diagnostic decision-making in children with suspected ADHD. METHODS: Randomised, parallel, single-blind controlled trial in mental health and community paediatric clinics in England. Participants were 6-17 years-old and referred for ADHD diagnostic assessment; all underwent assessment-as-usual, plus QbTest. Participants and their clinician were randomised to either receive the QbTest report immediately (QbOpen group) or the report was withheld (QbBlind group). The primary outcome was number of consultations until a diagnostic decision confirming/excluding ADHD within 6-months from baseline. Health economic cost-effectiveness and cost utility analysis was conducted. Assessing QbTest Utility in ADHD: A Randomised Controlled Trial was registered at ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT02209116). RESULTS: One hundred and thirty-two participants were randomised to QbOpen group (123 analysed) and 135 to QbBlind group (127 analysed). Clinicians with access to the QbTest report (QbOpen) were more likely to reach a diagnostic decision about ADHD (hazard ratio 1.44, 95% CI 1.04-2.01). At 6-months, 76% of those with a QbTest report had received a diagnostic decision, compared with 50% without. QbTest reduced appointment length by 15% (time ratio 0.85, 95% CI 0.77-0.93), increased clinicians' confidence in their diagnostic decisions (odds ratio 1.77, 95% CI 1.09-2.89) and doubled the likelihood of excluding ADHD. There was no difference in diagnostic accuracy. Health economic analysis showed a position of strict dominance; however, cost savings were small suggesting that the impact of providing the QbTest report within this trial can best be viewed as 'cost neutral'. CONCLUSIONS: QbTest may increase the efficiency of ADHD assessment pathway allowing greater patient throughput with clinicians reaching diagnostic decisions faster without compromising diagnostic accuracy. En ligne : http://dx.doi.org/10.1111/jcpp.12921 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=371

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