Guidance

1 Recommendations

1 Recommendations

Use as an option

1.1

Use QbTest as an option to help diagnose attention deficit hyperactivity disorder (ADHD) in people aged 6 to 17 years. It should only be used with standard clinical assessment by a healthcare professional.

Can only be used in research

For people with suspected ADHD

1.2

More research is needed on using the following digital technologies to help diagnose ADHD:

  • QbTest in people 18 years and over

  • EFSim Test

  • EFSim Test Web Version

  • Nesplora Attention Adults Aquarium

  • Nesplora Attention Kids Aula

  • QbCheck.

For people with ADHD

1.3

More research is needed on using the following digital technologies to evaluate response to treatment:

  • QbTest

  • EFSim Test

  • EFSim Test Web Version

  • Nesplora Attention Adults Aquarium

  • Nesplora Attention Kids Aula

  • QbCheck.

More research

1.4

More research is needed on:

  • how the digital technologies are used in, and their impact on, decision making in ADHD diagnosis, including for more complex cases

  • the impact of the digital technologies in section 1.2 when used to help diagnose ADHD

  • the impact of the digital technologies in section 1.3 for people with a diagnosis of ADHD when used:

    • during dose titration

    • as part of longer-term treatment monitoring.

1.5

Access to the digital technologies for the uses described in sections 1.2 and 1.3 should be through company, research, or non-core NHS funding, and clinical or financial risks should be appropriately managed.

Why the committee made these recommendations

The diagnostic process for ADHD requires clinical judgement. Healthcare professionals need training on and experience in the process to apply the diagnostic criteria correctly. Waiting lists for an ADHD assessment can be long, and the process of reaching a diagnostic decision can take a long time. Additional information from digital technologies may help people to get diagnostic decisions quicker and help healthcare professionals be more confident in their decisions.

The clinical trial evidence suggests that information from QbTest helps to reduce the time it takes for people aged 6 to 17 years to get a diagnostic decision compared with standard clinical assessment by a healthcare professional. Economic modelling using data from this trial suggests that QbTest is cost effective compared with standard clinical assessment for these people.

For people under 18, there is limited evidence for technologies other than QbTest. The other technologies are different to QbTest in how they measure ADHD traits, so it is unclear whether they would have a similar impact. So, it was not possible to assess the cost effectiveness of the technologies other than QbTest when used to help diagnose ADHD for people aged 6 to 17 years, and further research is needed.

For adults, there is limited evidence for any of the technologies, and the evidence from people under 18 is not generalisable to adults. So, more research is needed in this group.

After an ADHD diagnosis, the technologies could also be used to help evaluate response to treatment, which may aid decisions about continuing or changing treatment. This could help make sure people are having the best possible medication and dosage to manage symptoms and reduce side effects, and reduce overprescribing. Little evidence is available on whether any technologies are clinically or cost effective for evaluating response to treatment. More research is needed to help assess this.