1-minute summary: ADHD can often be a complex diagnosis to navigate. Board-certified psychiatric mental health nurse practitioner and founder of Sulcata Psychiatry, Stoni Johnston, details how switching to QbTest evaluations helped improve efficiencies and streamline her practice.
As high boredom proneness has been considered one of the core symptoms in individuals with ADHD, it’s important to measure attention levels accurately and with clinical utility.
The tool we previously used to test for ADHD was ‘gamified’
Gamification adds elements that create a more engaging test-taking experience – one of the main risks with this is performance hindrance. Game elements are known to normalise the performance of people with ADHD, which means test takers are able to pay higher levels of attention than usual. This increases the risk of false negative results.
Shorter cognitive tests with real-time feedback or on-screen timers aren’t always appropriate because they give patients the ability to anticipate deadlines and transitions.
The previous tool didn’t always give us accurate results. There was a lot that was open to interpretation and not enough evidence to pass a formal diagnosis or rule out ADHD from its series of quick 5-minute cognitive tests.
No training or clinical support
Since there was no formal training or clinical support their at-home performance results had lower scores than in-person tests. Lack
of substantial resources meant unclear instructions and difficulty for patients to set up the test at home. There was a risk of inaccurate outcomes.
Time-consuming for providers
The reports of our previous tool, though visual, were not clear. Often, multiple clinicians would have to look at the reports to interpret results accurately. The process was becoming very time-consuming.
We also needed a tool that would help us determine whether a patient needed medication and if so, the ideal dosage. We had an influx of patients requesting stimulants and we needed something that could help us manage our pathway better. This is when we started looking for an objective test since they are more sensitive to medication effects than patient self-rating.
How QbTest transformed my clinic’s ADHD evaluation process
Normative database for ADHD testing
To have patient data compared to a normative control group of the same age and sex at birth who don’t have ADHD is a significant improvement. A 6-year old’s test result looks different from a 45-year-old.
Parents might look at their child’s results from our previously used tool and think their child is ‘out of bounds’. But when you have access to the normative data, they see that their child isn’t deviating too far from their age bracket.
This is one of the many ways in which QbTest helped free my providers’ time and made our evaluation process more effective and streamlined.
The ability to monitor treatment effects
With retesting, we now have the option to monitor treatment response in patients. The visual test and re-test ADHD reports help us, and our patients see a decline in the prevalence of their ADHD symptoms.
Easy to interpret reports
Interpreting reports became faster after the switch to QbTest. Data is presented in clear reports, showing the three core symptom areas visually and statistically. It makes it easier for both a patient and clinician to understand a diagnosis.
Our team highly values test results. If according to QbTest, together with other relevant clinical information, a patient doesn’t present with ADHD related symptoms, we consider other causes like anxiety, or depression to explain behaviour. And in cases where results suggest ADHD, it helps us move forward with treatment quicker, allowing for a much smoother assessment process.
Another clinician from our team pointed out: “If a patient has got low scores on spatial abstraction, but not on the focus test, do you still give them the ADHD diagnosis? There was a lot open to interpretation before the switch [to QbTest].”
Clinical support and training
We were offered comprehensive clinical support from installation and onboarding to refresher training and report consultation. We could access this as and when needed in each individual evaluation.
It has been immensely beneficial for our entire team to have a tool specifically tailored for ADHD. And for us to be given training on how to interpret data improved our confidence. It no longer depends on only our subjective view while examining – there is objective data to back us.
Improved clinician-patient relationships
At my clinic, patient-centred care isn’t just a buzzword, it’s our ethos. My team and I prioritise building meaningful connections with patients, taking the time to understand their individual needs and circumstances. Post QbTest, I’ve had patients tell me how they appreciate how in-depth the assessment process is. It makes the length of the test worth it, they say. They finally see how ADHD affects their lives.
For my providers, it helps confidently rule out or diagnose ADHD. The visual representation of hyperactivity was missing from the old cognitive test. We now have a powerful medical device that measures hyperactivity up to 1mm.
About Sulcata Psychiatry
Sulcata Psychiatry offers personalised and integrated experiences for patients with mental health needs. The clinic provides individualized diagnosis, treatment, and therapy for various conditions, including depression, anxiety, autism, ADHD, and bipolar disorders. To offer better outcomes and support for patients, they incorporated QbTest into their clinical pathway. Stoni Johnston is a board-certified psychiatric mental health nurse practitioner. She offers comprehensive and individualised care for children, teens, and adults ages 3-50 at her office in Houston, Texas.
Learn more about the risks of using ADHD tests without FDA clearance in your service and why gamification can skew your patient’s results.