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Recent research into therapeutic outcome measures

Author/s
Dave Coghill
Citation
Issue 2 Spring 2012
CEPiP.2012.1.87-92
Abstract

Accurate measurement of clinical outcomes forms an important part of evidence-based practice. When measuring treatment outcomes in ADHD, clinicians have tended to focus on symptoms. In the past these were generally assessed by using parent-rated or teacher-rated questionnaires. Recently, however, the focus has switched to clinician-rated measures, often using symptom questionnaires like the ADHD-IV RS and the SNAP-IV as the basis of a semi-structured interview. Helpful clinically-relevant cut-offs have been described but need further validation. Similar interviews can be used for gathering information from schools. There are also, however, several instruments, such as the SKAMP, that are specifically designed for use with teachers that can be integrated into clinic protocols. In addition, a range of disorder-specific and generic measures of impairment and quality of life can provide valuable information about broader outcomes. Recent research suggests that the relationships between symptoms and cognition in ADHD are complex. However, whilst this suggests that it may be useful to think about measuring neuropsychological performance alongside symptom scores, this is currently difficult to achieve as it is not clear which measures would be the most appropriate to use.

Cite as: Cutting Edge Psychiatry in Practice 2012, 2(1):87-92; https://doi.org/10.65031/pyms1867

References

  1. Scottish Intercollegiate Guidelines Network. Management of attention deficit and hyperkinetic disorders in children and young people: A national clinical guideline. Edinburgh: SIGN; 2009. Report No.: 112.           
  2. National Collaborating Centre for Mental Health. Attention deficit hyperactivity disorder: Diagnosis and management of ADHD in children, young people and adults: NICE clinical guideline 72. London: National Institute for Health and Clinical Excellence; 2009. Report No.: 72. https://doi.org/10.1159/000258452
  3. Kollins SH, Sparrow EP. Guide to Assessment Scales in Attention-deficit/Hyperactivity Disorder. London UK: Springer Healthcare; 2010. https://doi.org/10.1007/978-1-907673-42-9
  4. C.K.Conners. Conners Third Edition [Conners 3]. North Tonawanda NY: Multi-Health Systems; 2008. https://doi.org/10.1007/springerreference_184233
  5. DuPaul G, Power T, Anastopoulos AD, Reid R. ADHD Rating Scale-IV:Checklist, Norms, and Clinical Interpretation. New York: Guilford Press; 1998.
  6. Bussing R, Fernandez M, Harwood M, Wei H, Garvan CW, Eyberg SM, et al. Parent and teacher SNAP-IV ratings of attention deficit hyperactivity disorder symptoms: psychometric properties and normative ratings from a school district sample. Assessment 2008 Sep;15(3):317-28. https://doi.org/10.1177/1073191107313888
  7. Dopfner M, Steinhausen HC, Coghill D, Dalsgaard S, Poole L, Ralston SJ, et al. Cross-cultural reliability and validity of ADHD assessed by the ADHD Rating Scale in a pan-European study. Eur Child Adolesc Psychiatry 2006 Dec;15 Suppl 1:I46-I55. https://doi.org/10.1007/s00787-006-1007-8
  8. Jacobson NS, Truax P. Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol 1991 Feb;59(1):12-9. https://doi.org/10.1037/0022-006x.59.1.12
  9. Murray DW, Bussing R, Fernandez M, Wei H, Garvan CW, Swanson JM, et al. Psychometric properties of teacher SKAMP ratings from a community sample. Assessment 2009 Jun;16(2):193-208. https://doi.org/10.1177/1073191108326924
  10. Swanson J. School-Based Assessments and Interventions for ADD. Irvine Ca: KC Publishing; 1992.     
  11. Swanson JM, Wigal T, Lakes K, Volkow ND. Attention Deficit Hyperactivity disorder: Defining a spectrum disorder and considering neuroethical implications. In: Illes J, Sahakian BJ, editors. Oxford Handbook of Neuroethics.Oxford: OUP; 2011. p. 309-40. https://doi.org/10.1093/oxfordhb/9780199570706.013.0075
  12. Coghill D. Pragmatic measures in paediatric psychopharmacology--are we getting it right? Eur Neuropsychopharmacol 2011 Aug;21(8):571-83. https://doi.org/10.1016/j.euroneuro.2010.11.007
  13. Coghill D. The impact of medications on quality of life in attention-deficit hyperactivity disorder: a systematic review. CNS Drugs 2010 Oct 1;24(10):843-66. https://doi.org/10.2165/11537450-000000000-00000
  14. Danckaerts M, Sonuga-Barke EJ, Banaschewski T, Buitelaar J, Dopfner M, Hollis C, et al. The quality of life of children with attention deficit/hyperactivity disorder: a systematic review. Eur Child Adolesc Psychiatry 2010 Feb;19(2):83-105. https://doi.org/10.1007/s00787-009-0046-3
  15. Coghill D, Danckaerts M, Sonuga-Barke E, Sergeant J. Practitioner review: Quality of life in child mental health--conceptual challenges and practical choices. J Child Psychol Psychiatry 2009 May;50(5):544-61. https://doi.org/10.1111/j.1469-7610.2009.02008.x
  16. Shaffer D, Gould MS, Brasic J, Ambrosini P, Fisher P, Bird H, et al. A children’s global assessment scale (CGAS). Arch Gen Psychiatry 1983 Nov;40(11):1228-3. https://doi.org/10.1037/t05648-000
  17. Riley AW, Coghill D, Forrest CB, Lorenzo MJ, Ralston SJ, Spiel G. Validity of the health-related quality of life assessment in the ADORE study: Parent Report Form of the CHIP-Child Edition. Eur Child Adolesc Psychiatry 2006 Dec;15 Suppl 1:I63-I71. https://doi.org/10.1007/s00787-006-1009-6
  18. Escobar R, Montoya A, Polavieja P, Cardo E, Artigas J, Hervas A, et al. Evaluation of patients’ and parents’ quality of life in a randomized placebo-controlled atomoxetine study in attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharmacol 2009 Jun;19(3):253-63. https://doi.org/10.1089/cap.2008.0109
  19. Varni JW, Burwinkle TM. The PedsQL as a patient-reported outcome in children and adolescents with Attention-Deficit/ Hyperactivity Disorder: a population-based study. Health & Quality of Life Outcomes 4:26, 2006. https://doi.org/10.1186/1477-7525-4-26
  20. Coghill DR, Rhodes SM, Matthews K. The neuropsychological effects of chronic methylphenidate on drug-naive boys with attention-deficit/hyperactivity disorder. Biol Psychiatry 2007 Nov 1;62(9):954-62. https://doi.org/10.1016/j.biopsych.2006.12.030