ADHD digital test approved for NHS use in England and Wales

The NHS has been told it can start using a new digital test to speed up the diagnosis of ADHD in children and young people, which up to now could often take several years.

The National Institute for Health and Care Excellence (Nice) has issued draft guidance approving the use of the QbTest by psychiatrists and specialist children’s doctors. The computer-based test measures the three main characteristics of ADHD : inattention, impulsivity and hyperactivity.

Clinicians can use the results alongside other information they have gathered to help them diagnose, or rule out, that a young person has the condition. Nice said the test could be used when diagnosing six- to 17-year-olds in England and Wales.

Experts welcomed the move, saying the QbTest would help doctors diagnose more people within six months of them first being assessed.

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Dr Jessica Eccles, the 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.”

Anywhere between 1% and 9% of school-age children in the UK have ADHD, according to estimates using different diagnostic criteria.

Nice said evidence from the AQUA clinical trial held in Nottingham “showed that using the QbTest alongside a standard clinical assessment for ADHD resulted in a diagnostic decision being made for a larger proportion of people within six months of their first assessment appointment when QbTest results were available, compared with when they were not.”

A rise in recent years in the number of under-18s and adults thought to have ADHD has left NHS services overwhelmed and unable to cope.

While some people get diagnosed within months, 24% have to wait between up to two years and 10% for between two and three years, the Nuffield Trust thinktank reported in April.

It said delays could seriously damage under-18s. “The impact on children should not be underestimated. Without a formal diagnosis, children and young people with suspected autism or ADHD may not be getting the support they need at school, which can significantly affect their life trajectory,” its report said.

Thea Stein, the thinktank’s chief executive, said: “Speeding up the diagnosis of ADHD for young people is undoubtedly a good thing and the results of this test would appear to be encouraging. Six months for a diagnosis will still be a significant portion of a young person’s life, so while faster diagnosis is good, it is only one piece of a complicated process to get the support young people and families need.”

Eccles cautioned that the test would only help relieve the challenges facing ADHD services and that more funding and staff were also needed. “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,” she said.

Dr Maddie Groom, an associate professor in applied developmental cognitive neuroscience at Nottingham University, who helped to develop the test, said: “The 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.”