title: Diagnostic Accuracy of Rating Scales for Attention-Deficit/Hyperactivity Disorder: A Meta-analysis.
abstract: BACKGROUND
  The Child Behavior Checklist-Attention Problem (CBCL-AP) scale and Conners Rating Scale-Revised (CRS-R) are commonly used behavioral rating scales for diagnosing attention-deficit/hyperactivity disorder (ADHD) in children and adolescents.
  
  
  OBJECTIVE
  To evaluate and compare the diagnostic performance of CBCL-AP and CRS-R in diagnosing ADHD in children and adolescents.
  
  
  METHODS
  PubMed, Ovid Medline, and other relevant electronic databases were searched for articles published up to May 2015.
  
  
  METHODS
  We included studies evaluating the diagnostic performance of either CBCL-AP scale or CRS-R for diagnosing ADHD in pediatric populations in comparison with a defined reference standard.
  
  
  METHODS
  Bivariate random effects models were used for pooling and comparing diagnostic performance.
  
  
  RESULTS
  We identified and evaluated 14 and 11 articles on CBCL-AP and CRS-R, respectively. The results revealed pooled sensitivities of 0.77, 0.75, 0.72, and 0.83 and pooled specificities of 0.73, 0.75, 0.84, and 0.84 for CBCL-AP, Conners Parent Rating Scale-Revised, Conners Teacher Rating Scale-Revised, and Conners Abbreviated Symptom Questionnaire (ASQ), respectively. No difference was observed in the diagnostic performance of the various scales. Study location, age of participants, and percentage of female participants explained the heterogeneity in the specificity of the CBCL-AP.
  
  
  CONCLUSIONS
  CBCL-AP and CRS-R both yielded moderate sensitivity and specificity in diagnosing ADHD. According to the comparable diagnostic performance of all examined scales, ASQ may be the most effective diagnostic tool in assessing ADHD because of its brevity and high diagnostic accuracy. CBCL is recommended for more comprehensive assessments.
authors.affiliation: School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; and.
authors.forename: Ling-Yin
authors.initials: LY
authors.lastname: Chang
authors.affiliation: Department of Nursing, Cardinal Tien Junior College of Healthcare and Management, New Taipei City, Taiwan.
authors.forename: Mei-Yeh
authors.initials: MY
authors.lastname: Wang
authors.affiliation: School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; and ptsai@tmu.edu.tw.
authors.forename: Pei-Shan
authors.initials: PS
authors.lastname: Tsai
mesh_terms: D001288:Attention / Q000502:physiology*; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D012720:Severity of Illness Index