Department of Child Psychiatry, Cambridge Health Alliance, 1493 Cambridge Street, Cambridge, MA 02139, USA.
Departments of Psychiatry and Behavioral Sciences, and Pediatrics, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356560, Seattle, WA 98195-6560, USA.
Child Adolesc Psychiatr Clin N Am. 2022 Jul;31(3):363-372. doi: 10.1016/j.chc.2022.03.010. Epub 2022 May 11.
Measurement-informed care is a cornerstone of evidence-based practice and shared decision-making. A structured diagnostic interview specific to ADHD provides a globally agreed-on standard of evaluation. These interviews are accessible in the public domain in multiple languages and are helpful to clinicians new to the diagnosis of ADHD. Broad-based rating scales looking at multiple domains of psychopathology are critical to assuring recognition of comorbid diagnoses, which might otherwise be missed, differential diagnoses, and identification of the most prominent or treatable diagnosis. Recent innovations in computerized adaptive testing have improved the efficiency and accuracy of diagnostic screening. Rating scales specific to ADHD and disruptive behavior disorders establish the severity of the disorder and response to intervention. Age- and gender-normed symptom rating scales for ADHD capture clinically salient differences between what is normative in different demographic groups. An evaluation of functional impairment in ADHD has been critical to understanding the patient's perspective of the presenting problem. Best practice care for ADHD treatment goes beyond improvement to well-defined standards for both symptom and functional remission. Studies of executive function, emotional regulation, mind-wandering, and sluggish cognitive tempo have led to a richer understanding of the breadth and depth of associated deficits commonly experienced by ADHD patients. Psychometrically validated tools are available to complement every aspect of ADHD care and provide global standards for research.
以测量为基础的医疗照护是循证实践和共同决策的基石。专门针对 ADHD 的结构化诊断访谈提供了全球公认的评估标准。这些访谈以多种语言在公共领域提供，对新接触 ADHD 诊断的临床医生很有帮助。广泛的多领域精神病学量表对于确保识别合并诊断、鉴别诊断以及确定最突出或可治疗的诊断非常重要。最近在计算机化自适应测试方面的创新提高了诊断筛选的效率和准确性。针对 ADHD 和破坏性行为障碍的特定量表可确定疾病的严重程度以及对干预的反应。针对 ADHD 的年龄和性别标准化症状量表可捕捉到不同人群中正常和异常之间的临床差异。对 ADHD 中的功能障碍进行评估对于理解患者对现有问题的看法至关重要。 ADHD 治疗的最佳实践护理不仅仅是改善症状和功能缓解的明确标准。对执行功能、情绪调节、思维漫游和认知迟钝的研究使我们对 ADHD 患者常见的相关缺陷的广度和深度有了更深入的理解。有心理计量学验证的工具可用于补充 ADHD 护理的各个方面，并为研究提供全球标准。
