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  • Measure Summary
  • NQMC:009985
  • Mar 2012

Diagnosis and management of attention deficit hyperactivity disorder (ADHD) in primary care for school-age children and adolescents: percentage of patients newly diagnosed with ADHD whose medical record contains documentation of screening for other primary conditions and comorbidities, as defined in the guideline (for example, depression, anxiety, oppositional-defiant disorder).

Institute for Clinical Systems Improvement (ICSI). Quality improvement support: diagnosis and management of attention deficit hyperactivity disorder in primary care for school-age children and adolescents. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2012 Mar. 8 p.

View the original measure documentation External Web Site Policy

This is the current release of the measure.

This measure updates a previous version: Institute for Clinical Systems Improvement (ICSI). Diagnosis and management of attention deficit hyperactivity disorder in primary care for school-age children and adolescents. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2012 Mar. 79 p.

The measure developer reaffirmed the currency of this measure in January 2016.

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Primary Measure Domain

Clinical Quality Measures: Process

Secondary Measure Domain

Does not apply to this measure

Description

This measure is used to assess the percentage of patients age 4 through 18 years newly diagnosed with attention deficit hyperactivity disorder (ADHD) whose medical record contains documentation of screening for other primary conditions and comorbidities, as defined in the guideline (for example, depression, anxiety, oppositional-defiant disorder).

Rationale

The priority aim addressed by this measure is to increase screening for other comorbidities in patients newly diagnosed with attention deficit hyperactivity disorder (ADHD).

The American Academy of Pediatrics (AAP) recommendation is fully endorsed by the Institute for Clinical Systems Improvement (ICSI) ADHD work group:

"The primary care clinician should initiate an evaluation for ADHD for any child 4 through 18 years of age who presents with academic or behavioral problems and symptoms of inattention, hyperactivity, or impulsivity."

Evidence for Rationale

Institute for Clinical Systems Improvement (ICSI). Diagnosis and management of attention deficit hyperactivity disorder in primary care for school-age children and adolescents. Endorsement. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 3 p.

Institute for Clinical Systems Improvement (ICSI). Quality improvement support: diagnosis and management of attention deficit hyperactivity disorder in primary care for school-age children and adolescents. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2012 Mar. 8 p.

Subcommittee on Attention-Deficit/Hyperactivity Disorder, Steering Committee on Quality Improvement and Management, Wolraich M, Brown L, Brown RT, DuPaul G, Earls M, Feldman HM, Ganiats TG, Kaplanek B, Meyer B, Perrin J, Pierce K, Reiff M, Stein MT, Visser S. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics. 2011 Nov;128(5):1007-22. [70 references] PubMed External Web Site Policy

Primary Health Components

Attention deficit hyperactivity disorder (ADHD); other primary conditions; comorbidities; screening; children; adolescents

Denominator Description

Number of patients newly diagnosed with attention deficit hyperactivity disorder (ADHD) (see the related "Denominator Inclusions/Exclusions" field)

Numerator Description

Number of patients newly diagnosed with attention deficit hyperactivity disorder (ADHD) whose medical record contains documentation that patients were screened for other primary conditions and comorbidities (see the related "Numerator Inclusions/Exclusions" field)

Type of Evidence Supporting the Criterion of Quality for the Measure

  • A clinical practice guideline or other peer-reviewed synthesis of the clinical research evidence

Additional Information Supporting Need for the Measure

Unspecified

Extent of Measure Testing

Unspecified

State of Use

Current routine use

Current Use

Internal quality improvement

National Quality Strategy Aim

Better Care

National Quality Strategy Priority

Prevention and Treatment of Leading Causes of Mortality

IOM Care Need

Living with Illness

IOM Domain

Effectiveness

Case Finding Period

The time frame pertaining to data collection is monthly.

Denominator Sampling Frame

Patients associated with provider

Denominator (Index) Event or Characteristic

Clinical Condition

Patient/Individual (Consumer) Characteristic

Denominator Time Window

Does not apply to this measure

Denominator Inclusions/Exclusions

Inclusions
Number of patients newly diagnosed with attention deficit hyperactivity disorder (ADHD)

Patients diagnosed in the past 6 months from the measurement date.

Population Definition: Patients age 4 through 18 years.

Data Collection:

  • Query electronic medical records (EMR) for all patients diagnosed with ADHD in the past 6 months from the measurement date.
  • Depending upon the size of the medical group's ADHD population, data may be collected on a less frequent basis.

Exclusions
Unspecified

Exclusions/Exceptions

Unspecified

Numerator Inclusions/Exclusions

Inclusions
Number of patients newly diagnosed with attention deficit hyperactivity disorder (ADHD) whose medical record contains documentation that patients were screened for other primary conditions and comorbidities

Patients diagnosed in the past 6 months from the measurement date.

Exclusions
Unspecified

Numerator Search Strategy

Fixed time period or point in time

Data Source

Electronic health/medical record

Type of Health State

Does not apply to this measure

Instruments Used and/or Associated with the Measure

Unspecified

Measure Specifies Disaggregation

Does not apply to this measure

Scoring

Rate/Proportion

Interpretation of Score

Desired value is a higher score

Allowance for Patient or Population Factors

Unspecified

Standard of Comparison

Internal time comparison

Original Title

Percentage of patients newly diagnosed with ADHD whose medical record contains documentation of screening for other primary conditions and comorbidities, as defined in the guideline (for example, depression, anxiety, oppositional-defiant disorder).

Measure Collection Name

Diagnosis and Management of Attention Deficit Hyperactivity Disorder in Primary Care for School-age Children and Adolescents

Submitter

Institute for Clinical Systems Improvement - Nonprofit Organization

Developer

Institute for Clinical Systems Improvement - Nonprofit Organization

Funding Source(s)

The Institute for Clinical Systems Improvement's (ICSI's) work is funded by the annual dues of the member medical groups and five sponsoring health plans in Minnesota and Wisconsin.

Composition of the Group that Developed the Measure

Work Group Members: Colleen L. Dobie, MS, RN, CNP, PMHS (Work Group Leader); W. Brooks Donald, MD, MPH; Karen Elhai, MD, MPH; JoAnne Hoffman-Jecha, MD; John Huxsahl, MD; Robert Karasov, MD (Work Group Leader); Carolyn Kippes, MD; Lynne Steiner, MD; Mary T. Wild Crea, MD

Financial Disclosures/Other Potential Conflicts of Interest

The Institute for Clinical Systems Improvement (ICSI) has long had a policy of transparency in declaring potential conflicting and competing interests of all individuals who participate in the development, revision and approval of ICSI guidelines and protocols.

In 2010, the ICSI Conflict of Interest Review Committee was established by the Board of Directors to review all disclosures and make recommendations to the board when steps should be taken to mitigate potential conflicts of interest, including recommendations regarding removal of work group members. This committee has adopted the Institute of Medicine Conflict of Interest standards as outlined in the report Clinical Practice Guidelines We Can Trust (2011).

Where there are work group members with identified potential conflicts, these are disclosed and discussed at the initial work group meeting. These members are expected to recuse themselves from related discussions or authorship of related recommendations, as directed by the Conflict of Interest committee or requested by the work group.

The complete ICSI policy regarding Conflicts of Interest is available at the ICSI Web site External Web Site Policy.

2013-2014 Institute for Clinical Systems Improvement (ICSI) Attention Deficit Hyperactivity Disorder (ADHD): Diagnosis and Management of ADHD in Primary Care for School-age Children and Adolescent Work Group, and Statement of Declared Potential Conflicts of Interest

Colleen L. Dobie, MS, RN, CNP, PMHS (Work Group Leader)
Pediatric Nurse Practitioner, Pediatrics, Allina Medical Clinic
National, Regional, Local Committee Affiliations: National Association of Pediatric Nurse Practitioners Expert Panel Psychosocial/Mental Health (ADHD)
Guideline Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: Received honorarium for presentation on ADHD medications to Washington County School District

W. Brooks Donald, MD, MPH (Work Group Member)
Developmental Behavioral Specialist, Pediatrics, HealthPartners Medical Group and Regions Hospital
National, Regional, Local Committee Affiliations: Learning Disabilities Association of Minnesota Board Member
Guideline Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Karen Elhai, MD, MPH (Work Group Member)
Pediatrician, Pediatrics, HealthPartners Medical Group and Regions Hospital
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

JoAnne Hoffman-Jecha, MD (Work Group Member)
Director of Mental Health Services, Pediatrics, South Lake Pediatrics
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: Served on the ADHD, Anxiety and Depression toolkit work groups with Children's Physician Network
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

John Huxsahl, MD (Work Group Member)
Physician, Psychiatry, Mayo Clinic
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Robert Karasov, MD (Work Group Leader)
Pediatrician, Pediatrics, Park Nicollet Health Services
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: ICSI Board Member
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Carolyn Kippes, MD (Work Group Member)
Medical Director, Developmental and Behavioral Pediatrics, Park Nicollet Health Services
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Lynne Steiner, MD (Work Group Member)
Physician, Family Medicine, HealthPartners Medical Group and Regions Hospital
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Mary T. Wild Crea, MD (Work Group Member)
Pediatrician, Pediatrics, Fairview Health Services
National, Regional, Local Committee Affiliations: None
Guideline Related Activities: None
Research Grants: None
Financial/Non-Financial Conflicts of Interest: None

Adaptation

This measure was not adapted from another source.

Date of Most Current Version in NQMC

2012 Mar

Measure Maintenance

Unspecified

Date of Next Anticipated Revision

Unspecified

Measure Status

This is the current release of the measure.

This measure updates a previous version: Institute for Clinical Systems Improvement (ICSI). Diagnosis and management of attention deficit hyperactivity disorder in primary care for school-age children and adolescents. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2012 Mar. 79 p.

The measure developer reaffirmed the currency of this measure in January 2016.

Source(s)

Institute for Clinical Systems Improvement (ICSI). Quality improvement support: diagnosis and management of attention deficit hyperactivity disorder in primary care for school-age children and adolescents. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2012 Mar. 8 p.

Measure Availability

Source available from the Institute for Clinical Systems Improvement (ICSI) Web site External Web Site Policy.

For more information, contact ICSI at 8009 34th Avenue South, Suite 1200, Bloomington, MN 55425; Phone: 952-814-7060; Fax: 952-858-9675; Web site: www.icsi.org External Web Site Policy; E-mail: icsi.info@icsi.org.

NQMC Status

This NQMC summary was completed by ECRI Institute on February 25, 2013.

This NQMC summary was updated by ECRI Institute on April 27, 2015.

The information was reaffirmed by the measure developer on January 13, 2016.

Copyright Statement

This NQMC summary (abstracted Institute for Clinical Systems Improvement [ICSI] Measure) is based on the original measure, which is subject to the measure developer's copyright restrictions.

The abstracted ICSI Measures contained in this Web site may be downloaded by any individual or organization. If the abstracted ICSI Measures are downloaded by an individual, the individual may not distribute copies to third parties.

If the abstracted ICSI Measures are downloaded by an organization, copies may be distributed to the organization's employees but may not be distributed outside of the organization without the prior written consent of the Institute for Clinical Systems Improvement, Inc.

All other copyright rights in the abstracted ICSI Measures are reserved by the Institute for Clinical Systems Improvement, Inc. The Institute for Clinical Systems Improvement, Inc. assumes no liability for any adaptations or revisions or modifications made to the abstracts of the ICSI Measures.

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