Source: Psychiatrist.com / J Clin Psychiatry 2025;86(3):25m15846

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Abstract

Objective: To compare the results of a proprietary online assessment of adult attention-deficit/hyperactivity disorder (ADHD) with the current standard of care, a clinical interview, among a real-world population of adults seeking online ADHD assessment.

Methods: Participants recruited from a population of adults seeking online ADHD assessment completed a virtual clinical interview followed by the online self-report assessment between July and November 2024. Agreement was calculated using a 2×2 matrix, and disagreement was further examined: first, a licensed clinician reviewed both assessments and rendered a “full data” diagnosis using all available results, and then, factors associated with disagreement (eg, psychiatric comorbidities, ADHD presentation) were explored.

Results: The sample (N = 345) was predominantly female, with an approximate age of 35 years. The most common ADHD presentations were combined and inattentive. The agreement between assessments was 78% (positive predictive value: 94.9%, negative predictive value: 15.1%, sensitivity: 80.6%, specificity: 44.0%, and κ: 0.13). Over 80% of cases in which there was disagreement between the assessments were found to have ADHD on clinical interview, whereas the initial online assessment did not confirm a diagnosis of ADHD and recommended further assessment.

Conclusions: This is the first study to validate an online asynchronous ADHD assessment relative to the current standard of care among individuals seeking online behavioral health care. The online assessment correctly identified over 80% of ADHD-positive cases. Compared with the clinical interview, the online assessment was more conservative in rendering ADHD-positive diagnoses, allaying possible concerns about overdiagnosis. Due to the high prevalence of ADHD in the study sample, these results are not yet generalized to a broader clinical setting.

J Clin Psychiatry 2025;86(3):25m15846

Barry K. Herman, MD, MMM; Stephen V. Faraone, PhD; Andrew J. Cutler, MD; Jeffrey H. Newcorn, MD; Emily M. LaFrance, PhD; Michelle Ripper Lewis, BSN; Charles Ruetsch, PhD

Article Information

Published Online: September 8, 2025. https://doi.org/10.4088/JCP.25m15846
© 2025 Physicians Postgraduate Press, Inc.

Submitted: February 19, 2025; accepted May 21, 2025.

To Cite: Herman BK, Faraone SV, Cutler AJ, et al. Validity of an online assessment of attention-deficit/hyperactivity disorder among a real-world sample of adults seeking web-based mental health care. J Clin Psychiatry 2025;86(3):25m15846.

Author Affiliations: Mentavi Health, Grand Rapids, Michigan (Herman, Ripper Lewis); Department of Psychiatry, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, New York (Faraone, Cutler); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York (Newcorn); Health Analytics, LLC, Clarksville, Maryland (LaFrance, Ruetsch).