A comprehensive longitudinal analysis of changes during Attention Deficit Hyperactive Disorder pharmacological...

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.