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Clinical Question
What are the best screening tools for the evaluation and diagnosis of attention-deficit/hyperactivity disorder (ADHD)?
Evidence-Based Answer
The Conners Abbreviated Symptom Questionnaire has the best combination of positive and negative likelihood ratios (eTable A). (Strength of Recommendation [SOR]: B, based on a meta-analysis of observational studies.) The Vanderbilt ADHD Diagnostic Teacher and Parent Rating Scales also have moderate sensitivity and specificity in elementary school-aged children. (SOR: B, based on a single cohort study.)
eTABLE A Diagnostic Accuracy of Tests for Attention-Deficit/Hyperactivity Disorder
Test | Studies | Participants | Sensitivity (95% CI) | Specificity (95% CI) | Positive LR | Negative LR |
---|---|---|---|---|---|---|
Child Behavior Checklist-Attention Problems Scale | 14 | 3,296 | 77% (69% to 84%) | 73% (64% to 81%) | 2.9 | 0.3 |
Conners Parent Rating Scale-Revised short form | 4 | 596 | 75% (64% to 84%) | 75% (64% to 84%) | 3.0 | 0.3 |
Conners Teacher Rating Scale-Revised short form | 5 | 733 | 72% (63% to 79%) | 84% (69% to 93%) | 4.6 | 0.3 |
Conners Abbreviated Symptom Questionnaire | 5 | 972 | 83% (59% to 95%) | 84% (68%... |