Abstract
BackgroundDiagnostic guidelines recommend using a variety of methods to assess and diagnose ADHD. Applying subjective measures always incorporates risks such as informant biases or large differences between ratings obtained from diverse sources. Furthermore, it has been demonstrated that ratings and tests seem to assess somewhat different constructs. The use of objective measures might thus yield valuable information for diagnosing ADHD. This study aims at evaluating the role of objective measures when trying to distinguish between individuals with ADHD and controls. Our sample consisted of children (n = 60) and adults (n = 76) diagnosed with ADHD and matched controls who completed self- and observer ratings as well as objective tasks. Diagnosis was primarily based on clinical interviews. A popular pattern recognition approach, support vector machines, was used to predict the diagnosis.ResultsWe observed relatively high accuracy of 79% (adults) and 78% (children) applying solely objective measures. Predicting an ADHD diagnosis using both subjective and objective measures exceeded the accuracy of objective measures for both adults (89.5%) and children (86.7%), with the subjective variables proving to be the most relevant.ConclusionsWe argue that objective measures are more robust against rater bias and errors inherent in subjective measures and may be more replicable. Considering the high accuracy of objective measures only, we found in our study, we think that they should be incorporated in diagnostic procedures for assessing ADHD.
Highlights
Diagnostic guidelines recommend using a variety of methods to assess and diagnose Attention deficit/hyperactivity disorder (ADHD)
In conclusion, we took a sophisticated statistical approach in this study to examine the diagnostic contributions of various measures assessing ADHD and to assess their classification accuracy
The present findings are highly relevant for clinicians, and can help to improve the workup for diagnosing ADHD
Summary
Diagnostic guidelines recommend using a variety of methods to assess and diagnose ADHD. Assessment of ADHD using ratings and tests Most diagnostic guidelines (e.g., [15,16,17]) require that ADHD be assessed and diagnosed by relying on information provided via a variety of methods The discrepancies between different informants can be of clinical relevance [21], the use of objective measures in addition to subjective ratings might yield valuable information facilitating the diagnosis of ADHD. We aimed to investigate the role of objective measures when trying to distinguish between individuals with ADHD and controls. The combination of objective and subjective measures may provide additional information than objective measures alone as it has been argued that tests and ratings may capture at least partly different constructs [22, 23] and should not be used interchangeably. Whilst the value of including subjective measures in a classifier alongside objective measures has been explored, developing an objective statistical method using only subjective data would not be expected to produce a robust classifier that would generalize to corresponding data acquired by other operators
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