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5. Interpretation (Intermediate) – Quiz

QbUser Interpretation (Intermediate) - Quiz

Congratulations! You have successfully passed the quiz! Your account is now activated. You are now qualified to both administer QbTest to patients as well as retrieve patient reports from the QAT and interpret the results.

Disclaimer: QbTest is for professional use only. Professionals are defined for this purpose as individuals with relevant qualifications, licences, authorisation or similar, working with those being identified, assessed or treated for ADHD. It is the responsibility of the user to ensure that QbTest is utilised in accordance with its indications.

1. Please review both the Standard and Detailed report for this 10-year-old boy. Choose the answer(s) below that correctly describe(s) the profile:

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Several activity parameters in the Standard Report are Slightly Atypical: Distance (1.3), Microevents (1.2), and Area (1.6). These are in agreement with the cardinal parameter QbActivity, which is Slightly Atypical (1.1). If anything, the activity level for this boy has been slightly underestimated due to the brief obscuring of the marker. The parameters measuring inattention (Omission Errors, Reaction Time and Reaction Time Variation) all show clearly Atypical Q-scores (>1.5) in the Standard Report which is in agreement with the cardinal parameter QbInattention in the Detailed Report (3.6). Although the graph for Attention and Impulse Control (in the Standard Report) shows that this boy performs several Commission Errors during the beginning of the test, the graph and the Q-scores during quartile 1 and 2 in the detailed report show that this is a normal performance for a boy of this age (Q-score<1)

2. Please review both the Standard and Detailed report for this 15-year-old girl. Select the answer(s) that correctly describe(s) the QbTest profile:

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This patient took a long time to adjust to the test which can be seen from the high number of Commission Errors during quartile 1. She stopped performing the test in the beginning of quartile 4 and the test is therefore not valid. The low activity Q-score in quartile 4 in the Detailed Report is invalid since the patient is not performing the test during that period. Since it is clear from the both the graphs on the Standard Report, but not from the Detailed Report, that the child stopped responding in Q4, it is important to review both reports. The test is not valid since the child did not complete the test.

3. Please review both the Standard and Detailed report for this 17-year-old girl. Choose the answer(s) that correctly describe(s) the QbTest profile:

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By only looking at the Q-scores in the Standard Report it seems as though the impulsivity and inattention parameters show similar results and that they are within normal range. However, the QbInattention graph in the Detailed Report clearly show that the patient’s performance with respect to Reaction Time Variation is much better during the first half of the test. Given that the cardinal parameter QbInattention is based on the second half of the test, the patient’s deterioration in attention over time was better captured in the Detailed Report. The Q-score for the cardinal QbInattention was 1.2 (Slightly Atypical) indicating that this person may have problems with attention. The Q-score for the cardinal parameter QbImpulsivity was below 1.0, indicating that impulsivity is less of a problem than inattention during the test. The Q-score for QbActivity was 0.8 which is within the normal performance range (<1.0).

4. Please review both the Standard and Detailed report for this 18-year-old adolescent girl. Choose the answer(s) that correctly describe(s) the QbTest profile:

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The number of Omission Errors during this test is clearly outside of the normal range with a Q-score of 2.5 on the Standard Report. However, the Reaction Time is relatively fast with a normal Reaction Time Variation. Therefore, the cardinal parameter QbInattention is artificially low because this parameter takes Omission Errors, Reaction Time and Reaction Time Variation into account. Thus, in this case, the individual parameters for inattention on the Standard Report yield more detailed and accurate information than the cardinal parameter QbInattention. The activity level, with a Q-score of 1.4 for the cardinal parameter QbActivity, falls in the Slightly Atypical range (1.1–1.5).

5. Please go through the Treatment report below, showing results pre-and post- treatment with medication. Taking into consideration the Cardinal Q-scores for each symptom domain, which of the following correctly describes how the patient, a 16-year-old adolescent girl, has responded to treatment?

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The Treatment Report shows that pre-treatment, QbActivity and QbImpulsivity were in the Atypical range (2.0 and 2.4, respectively) and QbInattention was in the normal range (0.0). Post-treatment, the Q-scores in all domains improved by more than 0.5 (which is considered clinically significant) and are all now within the Normal or Better than normal performance ranges, indicating that symptoms appear to be well controlled.

6. Please go through the Treatment Report below, showing results pre-and post-treatment with medication. Which of the following correctly describes how the patient, an 8-year old boy has responded to treatment?

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There is a marginal change on the QbActivity score from 0.7 to 0.5, and this remains within the normal range. Although the QbImpulsivity score gets significantly worse from 0.2 to 0.7, it also remains within the normal range. The QbInattention score does improve significantly from 2.1 to 1.4, but two factors to consider are 1) the post-treatment Q-score still remains within the Slightly Atypical range which indicates that symptoms may not be well controlled and 2) although there appears to be an overall improvement on pre- and post-treatment QbInattention scores, when evaluating the individual parameters for Inattention, we see that Reaction Time Variation and Omission errors Q-scores actually increase, while Reaction Time Q-score decreases. This sample case illustrates the importance of considering all the information provided on the report about a patient’s performance, including the cardinal parameters as well as the individual parameters that make up those cardinal scores.

7. Please go through the Treatment report below, showing results pre-and post- treatment with medication. Which of the following correctly describes how the patient, a 9-year-old boy, has responded to treatment?

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This patient shows a significant improvement in attention after medicine as measured by the individual parameters Omission Errors and Reaction Time Variation as well as by the cardinal parameter QbInattention (from 1.5 to -0.4). However, there is no change after treatment on impulsivity according to the cardinal parameter QbImpulsivity (Q-score is 1.9 at both time points). Regarding the patient’s activity level, there has also been a significant change in this domain from -0.2 to -1.7, but this now places the patient’s activity levels within the Extreme Performance range, which may indicate hypoactivity and/or the patient being overmedicated.

8. Please go through the Treatment Report below, showing results pre-and post- treatment with medication. Which of the following correctly describes how the patient, a 9-year-old girl, has responded to treatment.

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This patient was markedly inattentive at baseline, as measured by the individual attention parameters and the cardinal parameter QbInattention (Q-score 3.3). After medical treatment, attention was normalized according to the cardinal parameter QbInattention (Q-score 0.2). Her QbActivity score at follow-up is significantly lower, but in the extreme performance range (Q-score= -2.1) suggesting a hypoactive locomotor effect of medication.

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