• 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); 2007 Mar. 68 p. [135 references]

Does not apply to this measure

This measure is used to assess the percentage of patients newly diagnosed with attention deficit hyperactivity disorder (ADHD) whose medical record contains documentation of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) or Diagnostic and Statistical Manual for Primary Care (DSM-PC) criteria being addressed.

The priority aim addressed by this measure is to increase the use of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) or Diagnostic and Statistical Manual for Primary Care (DSM-PC) criteria for patients newly diagnosed with attention deficit hyperactivity disorder (ADHD).

Attention deficit hyperactivity disorder (ADHD); Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) or Diagnostic and Statistical Manual for Primary Care (DSM-PC) criteria

Total number of medical records of newly diagnosed attention deficit hyperactivity disorder (ADHD) patients reviewed (see the related "Denominator Inclusions/Exclusions" field in the Complete Summary)

Number of medical records of newly diagnosed attention deficit hyperactivity disorder (ADHD) patients with documentation of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) or Diagnostic and Statistical Manual for Primary Care (DSM-PC) criteria being addressed (see the related "Numerator Inclusions/Exclusions" field in the Complete Summary)

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

Unspecified

Current routine use

Internal quality improvement

Physician Group Practices/Clinics

Physicians

Group Clinical Practices

Age 5 to 18 years

Either male or female

Unspecified

Attention deficit hyperactivity disorder (ADHD) is a high prevalence condition ranging in school aged children from 3% to 5%, based on previous diagnostic criteria, to 11% to 12%, based on more recent Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition/Diagnostic and Statistical Manual for Primary Care (DSM-IV/DSM-PC) criteria.

• 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); 2007 Mar. 68 p. [135 references]

Unspecified

Unspecified

Unspecified

Unspecified

Living with Illness

Effectiveness

Users of care only

All children and adolescents from kindergarten through 12th grade (ages 5 to 18) diagnosed with attention deficit hyperactivity disorder (ADHD)

Medical groups may identify their patient samples in several ways. One way is to use available information systems to identify patients with ADHD from all payers. A minimum sample of 10 charts is suggested.

Suggested data collection time frame is monthly.

Note: Depending upon the size of the medical group's ADHD population, data may be collected on a less frequent basis.

Patients associated with provider

Inclusions
Total number of medical records of newly diagnosed attention deficit hyperactivity disorder (ADHD) patients reviewed*

*ADHD is defined as International Classification of Diseases, Ninth Revision (ICD-9) codes of 314.00 or 314.01. Newly diagnosed is defined as documented ADHD in past 6 months and no documentation of ADHD codes in the previous 6 to 12 months.

Exclusions
Unspecified

All cases in the denominator are equally eligible to appear in the numerator

Clinical Condition
Encounter

Time window precedes index event

Inclusions
Number of medical records of newly diagnosed attention deficit hyperactivity disorder (ADHD) patients with documentation* of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) or Diagnostic and Statistical Manual for Primary Care (DSM-PC) criteria being addressed

*Documented is defined as any evidence in the medical record that DSM-IV or DSM-PC criteria were addressed. DSM-IV or DSM-PC criteria include evaluation for:

• symptoms
• onset
• duration
• pervasiveness
• impairment

Exclusions
Unspecified

The measure results are somewhat or substantially under the control of the health care professionals, organizations and/or policymakers to whom the measure applies.

Encounter or point in time

Administrative data
Medical record

Individual Case

Unspecified

Rate

Better quality is associated with a higher score

Unspecified

Internal time comparison

Unspecified

Percentage of patients newly diagnosed with ADHD whose medical record contains documentation of DSM-IV or DSM-PC criteria being addressed.

Institute for Clinical Systems Improvement

The following Minnesota health plans provide direct financial support: Blue Cross and Blue Shield of Minnesota, HealthPartners, Medica, Metropolitan Health Plan, PreferredOne, and UCare Minnesota. In-kind support is provided by the Institute for Clinical Systems Improvement's (ICSI) members.

Work Group Members: Kathy Moore, PhD (Work Group Leader) (Allina Medical Clinic) (Psychology); W. Brooks Donald, MD, MPH (HealthPartners Medical Group) (Behavioral Pediatrician); Judson B. Reaney, MD (Park Nicollet Health Services) (Behavioral Pediatrician); Michael Crandell, MD (Sioux Valley Hospitals & Health System) (Family Practice); Bruce Kuhlmann, DO (CentraCare Health System) (Family Practice); John Huxsahl, MD (Mayo Clinic) (Psychiatry); Colleen Dobie, RN, CNP, MS (Allina Medical Clinic) (Pediatrics); Steve Elias, MD (Columbia Park Medical Group) (Pediatrics); Bernadine Lee, RN (Olmsted Medical Center) (Nursing); Laura Hay, PharmD (Gillette Childrens Specialty Healthcare) (Pharmacy); Penny Fredrickson (Institute for Clinical Systems Improvement) (Measurement Advisor); Pam Pietruszewski, MA (Institute for Clinical Systems Improvement) (Facilitator)

National Quality Forum

Measure was not adapted from another source.

2005 Jan

2007 Mar

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); 2005 Jan 69 p.

• 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); 2007 Mar. 68 p. [135 references]

This NQMC summary was completed by ECRI on March 15, 2005. This summary was updated by ECRI Institute on September 25, 2007.

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.

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