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PSYCHOPHARMACOLOGY
New Brief Screening Tool for Adult ADHD
May 9, 2017   

The brief screening scale is a new version of the widely used Adult ADHD Self-Report Screening Scale (ASRS), updated for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. The process of developing the scale involved use of a novel machine-learning algorithm, RiskSLIM (Risk-Calibrated Supersparse Linear Integer Model), to identify an optimal set of screening questions using the ASRS as a guide. Using optimal integer scoring rules, the machine-learning algorithm was able to build a screening scale of ADHD diagnosis in adults, based on the answers to the following six questions:

Responses can be never, rarely, sometimes, often, or very often. The "never" response is always scored as 0; the highest scores are 5 for questions 1 and 2, 4 for question 5, 3 for question 6, and 2 for question 4, resulting in a scale with scores ranging from 0 to 24

The diagnoses made using the six-question screen were compared with those captured with the ASRS screen, as demonstrated in two national surveys; one from the National Comorbidity Survey, a national face-to-face survey, and one from a large telephone-based survey of the users of a particular healthcare plan. The results of the screen were also evaluated separately in a clinical sample of patients that included a subset who sought evaluations at New York University Langone Medical Center Adult ADHD Program.

Analysis of the new scale showed high specificity and positive predictive values. The scale yielded few false positive results. About 67.3% of participants screened positive in the general population. More than 80% in the specialty treatment sample who screened positive were confirmed as having the disorder, at a threshold that had sensitivity greater than 90%. The new scale is short, easily scored, and can detect nearly all of adult ADHD cases in the general population with high sensitivity and specificity.

>> Ustun B, Adler LA, et al. JAMA Psychiatry. 2017;74(5):520-526.

References:

Ustun B, Adler LA, Rudin C, et al. The World Health Organization Adult Attention-Deficit/Hyperactivity Disorder Self-Report Screening Scale for DSM-5. JAMA Psychiatry. 2017;74(5):520-526.