A comprehensive longitudinal analysis of changes during Attention Deficit Hyperactive Disorder pharmacological treatments: Relationships between clinical measures, QbCheck and Conners CPT-II.

内容摘要

This study aims to evaluate the clinical value of using QbCheck in routine Attention Deficit Hyperactive Disorder (ADHD) clinics by investigating longitudinal inter-domain relationships between objective neurocognitive outcomes of QbCheck and subjective clinical outcomes: ADHD core symptoms, impairment and quality of life (QoL). The study was conducted alongside the participants' standard pharmacological treatment for their ADHD. Thirty-four clinically diagnosed participants with ADHD completed baseline and follow-up neurocognitive assessments. Bayesian paired t-tests and bivariate correlations were used to examine changes over time and relationships between key variables. Bayesian analyses showed correlations between QbCheck and continuous performance test (CPT)-II for the same constructs, except for omission errors. In the test-retest results of QbCheck, measures remained stable, though moderate evidence supported changes in reaction time variability (BF10 = 5.57) and anecdotal evidence for commission errors (BF10 = 1.72). In measuring treatment effect, there was moderate to extreme evidence for reductions in self- and informant-rated ADHD symptoms and clinician-rated impairment severity. In contrast, informant-rated QoL showed weak evidence for a difference (BF10 = 1.81), and self-rated QoL showed no change (BF10 = 0.67). QbCheck showed moderate to extreme evidence for most changes, with weak evidence for reaction time (BF10 = 1.38), while CPT-II showed strong evidence for commission errors, weak evidence for response time variability, and no evidence for omission errors or reaction time. Weak evidence suggested moderate associations between QbCheck MicroEvent X and informant-rated ADHD symptom severity (BF10 = 2.40, r = 0.47) and CPT-II commission errors and self-rated ADHD symptom severity (BF10 = 2.44, r = 0.39). QbCheck is a valid tool for assessing neurocognitive changes in ADHD treatment but should not replace clinical outcome measures or be used as a proxy for behavioural assessments. Caution is needed when relying on a single outcome measure, emphasizing the need for multi-source assessments to capture the full impact of treatment.