A Clinical Decision Support System for Adult ADHD Diagnostics Process

Kemppinen, Juha; Korpela, Jukka; Partners, Roce; Elfvengren, Kalle; Salmisaari, Timo; Polkko, Jussi; Tuominen, Markku

doi:10.1109/hicss.2013.30

Cited by 12 publications

(5 citation statements)

References 18 publications

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“…Amongst the few existing CDSSs, some have been developed to diagnose either a single disorder ( e.g . schizophrenia, attention-deficit/hyperactivity disorder) 18 19 or common mental disorders 16 . Other CDSSs have been developed to guide treatment decisions alone 20 21 for one or more disorders.…”

Section: Discussionmentioning

confidence: 99%

Telepsychiatry clinical decision support system used by non-psychiatrists in remote areas

Malhotra¹,

Chakrabarti²,

Shah³

et al. 2017

Indian Journal of Medical Research

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Background & objectives:A knowledge-based, logically-linked online telepsychiatric decision support system for diagnosis and treatment of mental disorders was developed and validated. We evaluated diagnostic accuracy and reliability of the application at remote sites when used by non-psychiatrists who underwent a brief training in its use through video-conferencing.Methods:The study was conducted at a nodal telepsychiatry centre, and three geographically remote peripheral centres. The diagnostic tool of application had a screening followed by detailed criteria-wise diagnostic modules for 18 psychiatric disorders. A total of 100 consecutive consenting adult outpatients attending remote telepsychiatry centres were included. To assess inter-rater reliability, patients were interviewed face to face by non-specialists at remote sites using the application (active interviewer) and simultaneously on online application via video-conferencing by a passive assessor at nodal centre. Another interviewer at the nodal centre rated the patient using Mini-International Neuropsychiatric Interview (MINI) for diagnostic validation.Results:Screening sub-module had high sensitivity (80-100%), low positive predictive values (PPV) (0.10-0.71) but high negative predictive value (NPV) (0.97-1) for most disorders. For the diagnostic sub-modules, Cohen's kappa was >0.4 for all disorders, with kappa of 0.7-1.0 for most disorders. PPV and NPV were high for most disorders. Inter-rater agreement analysis revealed kappa >0.6 for all disorders.Interpretation & conclusions:Diagnostic tool showed acceptable to good validity and reliability when used by non-specialists at remote sites. Our findings show that diagnostic tool of the telepsychiatry application has potential to empower non-psychiatrist doctors and paramedics to diagnose psychiatric disorders accurately and reliably in remote sites.

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Section: Discussionmentioning

confidence: 99%

Telepsychiatry clinical decision support system used by non-psychiatrists in remote areas

Malhotra¹,

Chakrabarti²,

Shah³

et al. 2017

Indian Journal of Medical Research

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“…The old adult ADHD process [28] developed for the new patient group faced at the MTPA is presented in Figure 2. The new adult ADHD process was iterated according to the TOC principles.…”

Section: Results From Applying Toc and 5fs To The Cdssassisted Adult mentioning

confidence: 99%

“…It would be impossible to send them with referrals to the tertiary level university clinic for diagnostic purposes. Thus, we generated a CDSS to assist in the adult ADHD diagnostic process [28]. The purpose of the clinical decision support system was to implement a new diagnostic process in an efficiently and procedurally readily adopted way.…”

Section: 32017mentioning

confidence: 99%

Improving the productivity and efficiency of an integrated mental and addiction care

Kemppinen¹,

Korpela²,

Elfvengren³

et al. 2017

FinJeHeW

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This paper suggests that the productivity and efficiency of social and health care services can be improved considerably by redesigning and streamlining the processes. The paper presents the theory of constraint (TOC) and fivefocusing step (5FS) solution to the productivity and efficiency problems of an integrated mental and addiction care outpatient clinic (MTPA-model) team. The MTPA is an integrated walk-in clinic where clinical decisions on key patient groups are supported by a clinical decision support system (CDSS). One of the critical service processes of the MTPA is a CDSS-assisted adult ADHD diagnostics process.The aim of the paper is to describe the improvement of productivity and efficiency of a typical multidiscipline team of MTPA-model. A combination of the action research approach and design science research was applied to solve the emerging service process problems and create a CDSS. The paper outlines the principles of the TOC applied for the established CDSS-assisted adult ADHD diagnostics process. The bottlenecks or constraints of an adult ADHD process are defined. The data from the designed CDSS and the currently used electronic health record provided material for applying the 5FS methodology for improving the productivity and efficiency of the adult ADHD process.We suggest that applying the 5FS-process of TOC to mental and addiction care processes generally, and to the multi-professional team especially, is an effective way to negotiate constructively about the bottlenecks or constraints of the process and improve the productivity and efficiency of integrated mental health and addiction care services and operations. Based on the results, a general framework for improving the productivity and efficiency of a multi-professional team and health care services organization by applying the 5FS methodology is proposed.

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“…Concerning ADHD, only one study introducing e-health systems into its diagnostic process has been identified. Kemppinen et al developed a clinical decision support system (CDSS) specially designed for adults, which facilitates a novel assessment of patients encompassing both diagnostic and treatment processes [29]. Furthermore, this CDSS ensures that the multidisciplinary team adopts a comprehensive and algorithmic approach to the treatment of adult patients with a confirmed diagnosis.…”

Section: Adhd and E-healthmentioning

confidence: 99%

The Potential of Digital Screening Tools for Childhood ADHD in School Environments: A Preliminary Study

Gabaldón-Pérez,

Martín-Ruiz,

Díez-Muñoz

et al. 2023

Healthcare

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Attention deficit hyperactivity disorder (ADHD) is a highly prevalent developmental disorder in children. However, accurately identifying ADHD in early childhood remains a crucial challenge. Electronic health (e-health) systems offer promising possibilities to enhance the diagnostic process for ADHD, particularly concerning the executive functions (EFs) that play a direct role. This study aims to validate an evidence-based tool for screening ADHD through EFs in the school environment. The tool, named Sendero Gris, is designed for tablet devices and is based on a previously validated test with the same name. To ensure its validity, a comparison was made between the results obtained from the tool to be validated and the original format of the test. The analysis revealed no statistically significant differences between the two approaches at a 90% confidence level (p-value = 0.49). Moreover, a user experience study focusing on usability was conducted to assess the children’s inclination to use the developed tool, yielding highly positive results. The implementation of Sendero Gris on a tablet device, with its objective and versatile nature, seems to maintain the potential of the original format as a screening tool for ADHD.

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A Clinical Decision Support System for Adult ADHD Diagnostics Process

Cited by 12 publications

References 18 publications

Telepsychiatry clinical decision support system used by non-psychiatrists in remote areas

Telepsychiatry clinical decision support system used by non-psychiatrists in remote areas

Improving the productivity and efficiency of an integrated mental and addiction care

The Potential of Digital Screening Tools for Childhood ADHD in School Environments: A Preliminary Study

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