Abstracts
3427187
(#2) Validity of an Online Assessment of ADHD Among a Real-World Sample of Adults Seeking Web-Based Mental Healthcare
Abstract: Objective: To compare the results of a proprietary online assessment of adult attention-deficit/hyperactivity disorder (ADHD) with the current standard of care, a clinical interview, among a real-world population of adults seeking online ADHD assessment.
Methods: Participants recruited from a population of adults seeking online ADHD assessment completed a virtual clinical interview followed by the online self-report assessment between July and November 2024. Agreement was calculated using a 2×2 matrix, and disagreement was further examined: first, a licensed clinician reviewed both assessments and rendered a "full data" diagnosis using all available results, and then, factors associated with disagreement (eg, psychiatric comorbidities, ADHD presentation) were explored.
Results: The sample (N = 345) was predominantly female, with an approximate age of 35 years. The most common ADHD presentations were combined and inattentive. The agreement between assessments was 78% (positive predictive value: 94.9%, negative predictive value: 15.1%, sensitivity: 80.6%, specificity: 44.0%, and κ: 0.13). Over 80% of cases in which there was disagreement between the assessments were found to have ADHD on clinical interview, whereas the initial online assessment did not confirm a diagnosis of ADHD and recommended further assessment.
Conclusions: This is the first study to validate an online asynchronous ADHD assessment relative to the current standard of care among individuals seeking online behavioral health care. The online assessment correctly identified over 80% of ADHD-positive cases. Compared with the clinical interview, the online assessment was more conservative in rendering ADHD-positive diagnoses, allaying possible concerns about overdiagnosis.
Short Description: Access to ADHD assessment and treatment in the US is variable and often inadequate. Online diagnostic evaluations may help address access barriers, but their accuracy and validity is unknown.
These results from this prospective, real world observational study lend credibility to online mental health assessments as reliable, accurate, and valid tools for diagnosing ADHD in adults and suggest that they hold significant potential to help address mental health care access barriers globally.
Name of Sponsoring Organization(s): Mentavi Health
Methods: Participants recruited from a population of adults seeking online ADHD assessment completed a virtual clinical interview followed by the online self-report assessment between July and November 2024. Agreement was calculated using a 2×2 matrix, and disagreement was further examined: first, a licensed clinician reviewed both assessments and rendered a "full data" diagnosis using all available results, and then, factors associated with disagreement (eg, psychiatric comorbidities, ADHD presentation) were explored.
Results: The sample (N = 345) was predominantly female, with an approximate age of 35 years. The most common ADHD presentations were combined and inattentive. The agreement between assessments was 78% (positive predictive value: 94.9%, negative predictive value: 15.1%, sensitivity: 80.6%, specificity: 44.0%, and κ: 0.13). Over 80% of cases in which there was disagreement between the assessments were found to have ADHD on clinical interview, whereas the initial online assessment did not confirm a diagnosis of ADHD and recommended further assessment.
Conclusions: This is the first study to validate an online asynchronous ADHD assessment relative to the current standard of care among individuals seeking online behavioral health care. The online assessment correctly identified over 80% of ADHD-positive cases. Compared with the clinical interview, the online assessment was more conservative in rendering ADHD-positive diagnoses, allaying possible concerns about overdiagnosis.
Short Description: Access to ADHD assessment and treatment in the US is variable and often inadequate. Online diagnostic evaluations may help address access barriers, but their accuracy and validity is unknown.
These results from this prospective, real world observational study lend credibility to online mental health assessments as reliable, accurate, and valid tools for diagnosing ADHD in adults and suggest that they hold significant potential to help address mental health care access barriers globally.
Name of Sponsoring Organization(s): Mentavi Health
