Queens University, Kingston, ON, Canada.
J Atten Disord. 2023 Oct;27(12):1343-1359. doi: 10.1177/10870547231177470. Epub 2023 Jun 27.
To identify and analyze all studies validating rating scales or interview-based screeners commonly used to evaluate ADHD in adults.
A systematic literature search identified all studies providing diagnostic accuracy statistics, including sensitivity and specificity, supplemented by relevant articles or test manuals referenced in reviewed manuscripts.
Only 20 published studies or manuals provided data regarding sensitivity and specificity when tasked with differentiating those with and without ADHD. While all screening measures have excellent ability to correctly classify non-ADHD individuals (with negative predictive values exceeding 96%), false positive rates were high. At best, positive predictive values in clinical samples reached 61%, but most fell below 20%.
Clinicians cannot rely on scales alone to diagnose ADHD and must undertake more rigorous evaluation of clients who screen positive. Furthermore, relevant classification statistics must be included in publications to help clinicians make statistically defensible decisions. Otherwise, clinicians risk inappropriately diagnosing ADHD.
识别和分析所有验证成人注意力缺陷多动障碍（ADHD）常用量表或基于访谈的筛查器的研究。
系统文献检索确定了所有提供诊断准确性统计数据的研究，包括敏感性和特异性，并补充了在综述文献中引用的相关文章或测试手册。
只有 20 项已发表的研究或手册提供了有关区分有和无 ADHD 个体的敏感性和特异性的数据。虽然所有筛查措施都具有正确分类非 ADHD 个体的出色能力（阴性预测值超过 96%），但假阳性率很高。在临床样本中，阳性预测值最好达到 61%，但大多数低于 20%。
临床医生不能仅凭量表来诊断 ADHD，必须对筛查阳性的患者进行更严格的评估。此外，出版物中必须包含相关的分类统计数据，以帮助临床医生做出具有统计学合理性的决策。否则，临床医生可能会不恰当地诊断出 ADHD。
