A Quality Improvement Initiative for Detection of Attention-Deficit/Hyperactivity Disorder in an Urban, Academic Safety Net Hospital.
Mona Doss Roberts, J Krystel Loubeau, Syeda Hasan and 8 others
PMID 38552001WHAT IT FOUND
In children with positive attention screens, clinicians more often acknowledged the result and sent Vanderbilt forms.
But families did not return more forms, so the initiative did not clearly improve completed evaluations.
Key findings
01Clinician acknowledgement of a positive PSC-AS improved from 41.5% to 65.3% (p < 0.001).
02In the intervention period, 30.6% of patients with a positive PSC-AS were given a parent or teacher VADRS, compared with 17.7% in the control period (p = 0.0059).
03VADRS return was 12.9% during intervention and 9.2% during control, with no significant increase (p = 0.269).
STILL TO COME
How it was doneWhat they found
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What it does not show
The study was done in one clinic, so results may not apply elsewhere. It did not assess whether more ADHD diagnoses were made. It did not separate children already diagnosed with ADHD from those not diagnosed. It did not account for children already under specialty ADHD care. Outcomes were measured by manual chart review, so human error was possible. The intervention lasted only 10 months because COVID-19 interrupted visits.
Declared interests
The supplied text does not include a conflicts-of-interest declaration. Publication types list NIH extramural support.
The easy way to misread this
Do not conclude that the initiative increased ADHD diagnoses or completed evaluations. The improvements were in clinician acknowledgement and Vanderbilt distribution, while Vanderbilt return did not significantly increase and diagnosis rates were not assessed.