Does the Format of the Adult ADHD Self-Report Scale Impact the Results

Not Applicable

Completed

• Conditions: Attention Deficit Hyperactivity Disorder
• Interventions: Other: Altered ASRS format, without shading and with grouping; Other: Altered ASRS format, with shading and without grouping; Other: Altered ASRS format, without shading and without grouping

• Registration Number: NCT06530758
• Lead Sponsor: University of Alberta

Brief Summary

The World Health Organization Adult ADHD Self-Report Scale v1.1 (ASRS) is frequently used in family medicine clinics to screen for ADHD. Numerous studies have found the ASRS has a low positive predictive value. Compounding this concern is the format of the ASRS. Specifically, the answers on the ASRS that lead to screen positive results are shaded in gray and grouped together, which may make it easy for patients to discern which responses should be selected for a positive screen.

Detailed Description

The ASRS is used widely to screen for ADHD in adults. It has 18 questions, with response options "never," "rarely," "sometimes," "often," and "very often." The 6 questions considered most predictive of ADHD are grouped together in Part A and questions that are meant to provide additional cues are grouped together in Part B. The options that are considered a positive response vary between questions; for some questions the option is at least "sometimes," while for others it is at least "often." The positive response options are shaded on the ASRS. A person is considered to have a positive screen if 4 of the 6 questions in Part A are positive.

The objective of this trial is to determine if the shading and grouping on the ASRS impacts screening results. This trial has a 2x2 factorial design set in a family medicine clinic(s). When a patients check in for an appointment, clinic staff will offer them a survey that includes 1) demographic questions and 2) 1 of the 4 versions of the ASRS, the version they receive is randomized (with programming). Most patients will take approximately 5 minutes to complete the survey prior to them seeing the family physician.

Study Timeline

• Study First Submitted: 2024-07-26
• Study Start: 2024-07-29
• Study First Submitted QC: 2024-07-30
• Study First Posted: 2024-07-31
• Primary Completion: 2024-10-31
• Study Completion: 2024-10-31
• Status Verified: 2024-12
• Last Update Submitted: 2024-12-26
• Last Update Posted: 2024-12-30

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 587

Inclusion Criteria

• 19 - 65 years old
• Patients who are registering for their appointment at the family medicine clinic
• Patients who are expected to be in the reception area for ≥5 minutes before going to a clinic room

Exclusion Criteria

• Any patients who do not have the capacity to complete the form (e.g., cognitive impairment, unable to read English, unable to use a computer)

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: FACTORIAL

Arm && Interventions

Group	Intervention	Description
ASRS without shading and with grouping	Altered ASRS format, without shading and with grouping	These participants will receive the ASRS form that does not have shading for the screen positive response options and has the questions grouped (ie, the headings "Part A" and "Part B" will remain on the form).
ASRS with shading and without grouping	Altered ASRS format, with shading and without grouping	These participants will receive the ASRS form that has the screen positive response options shaded and has the questions ungrouped (ie, the headings "Part A" and "Part B" are removed).
ASRS without shading and without grouping	Altered ASRS format, without shading and without grouping	These participants will receive the ASRS form that does not have shading for the screen positive response options and has the questions ungrouped (ie, the headings "Part A" and "Part B" are removed).

Primary Outcome Measures

Name	Time	Method
Screen positive rate	Through study completion, estimated to be 2 months	Poisson regression to determine the relative risk of a screen positive among the different versions of the form. We will include the following covariates: shading, grouping, shading x grouping, suspect ADHD without diagnosis, ADHD diagnosis, sex, and age.

Trial Locations

Locations (1)

Shifa Medical Clinic; 🇨🇦 Edmonton, Alberta, Canada