Attention Deficit Hyperactivity Disorder (ADHD): Clinical Outcomes Measurement Development

Rattanasak Santitadakul Msc*, Pornchai Sithisarankul MD*, Somrat Lertmaharit Msc*, Nuttorn Piyaratstian MD**

Affiliation : * Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand ** Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

Objective : To develop a reliable and valid treatment outcome checklist for the measurement of ADHD treatment for children in a clinical setting. Material and Method: The behavior indicators to assess the treatment outcomes of ADHD children were researched and developed by using multi-informants perspectives. The present study involved a qualitative study and two rounds of the Modified Delphi Techniques. In the first process, 11 parents/guardians of ADHD children aged 6 to 18 years were given a semi-structured interview on their expectation towards treatment outcomes at the Child and Adolescent Mental Health Rajanagarindra Institute. Items from literature reviews were also added before the first and second round evaluations using the Delphi by five different expert fields (six experts from each field). Final indicators from expert consensus were assessed from 180 ADHD patients, which were assessed by three child and adolescent psychiatrists. All items were analyzed for internal coefficient reliability. The Receiver Operating Characteristic (ROC) was used to calculate the cut off score.
Results : Thirteen indicators were assessed by experts as good content validity for clinical outcomes of ADHD treatment with the reliability of 0.60. The optimal cut-off point was 4 (sensitivity: 0.80; specificity: 0.76). The Area under curve (AUC) of total score was considered at a good level (0.83).
Conclusion : The ADHD clinical outcome checklist with 13 items has shown good validity and fair reliability. It can be a useful tool for ADHD treatment outcome assessment in clinical setting.

Keywords : Attention-deficit/hyperactivity, Clinical outcome measurement

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