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A risk calculator to predict adult attention-deficit/hyperactivity disorder: generation and external validation in three birth cohorts and one clinical sample.

Publication ,  Journal Article
Caye, A; Agnew-Blais, J; Arseneault, L; Gonçalves, H; Kieling, C; Langley, K; Menezes, AMB; Moffitt, TE; Passos, IC; Rocha, TB; Sibley, MH ...
Published in: Epidemiology and psychiatric sciences
May 2019

Few personalised medicine investigations have been conducted for mental health. We aimed to generate and validate a risk tool that predicts adult attention-deficit/hyperactivity disorder (ADHD).Using logistic regression models, we generated a risk tool in a representative population cohort (ALSPAC - UK, 5113 participants, followed from birth to age 17) using childhood clinical and sociodemographic data with internal validation. Predictors included sex, socioeconomic status, single-parent family, ADHD symptoms, comorbid disruptive disorders, childhood maltreatment, ADHD symptoms, depressive symptoms, mother's depression and intelligence quotient. The outcome was defined as a categorical diagnosis of ADHD in young adulthood without requiring age at onset criteria. We also tested Machine Learning approaches for developing the risk models: Random Forest, Stochastic Gradient Boosting and Artificial Neural Network. The risk tool was externally validated in the E-Risk cohort (UK, 2040 participants, birth to age 18), the 1993 Pelotas Birth Cohort (Brazil, 3911 participants, birth to age 18) and the MTA clinical sample (USA, 476 children with ADHD and 241 controls followed for 16 years from a minimum of 8 and a maximum of 26 years old).The overall prevalence of adult ADHD ranged from 8.1 to 12% in the population-based samples, and was 28.6% in the clinical sample. The internal performance of the model in the generating sample was good, with an area under the curve (AUC) for predicting adult ADHD of 0.82 (95% confidence interval (CI) 0.79-0.83). Calibration plots showed good agreement between predicted and observed event frequencies from 0 to 60% probability. In the UK birth cohort test sample, the AUC was 0.75 (95% CI 0.71-0.78). In the Brazilian birth cohort test sample, the AUC was significantly lower -0.57 (95% CI 0.54-0.60). In the clinical trial test sample, the AUC was 0.76 (95% CI 0.73-0.80). The risk model did not predict adult anxiety or major depressive disorder. Machine Learning approaches did not outperform logistic regression models. An open-source and free risk calculator was generated for clinical use and is available online at https://ufrgs.br/prodah/adhd-calculator/.The risk tool based on childhood characteristics specifically predicts adult ADHD in European and North-American population-based and clinical samples with comparable discrimination to commonly used clinical tools in internal medicine and higher than most previous attempts for mental and neurological disorders. However, its use in middle-income settings requires caution.

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Published In

Epidemiology and psychiatric sciences

DOI

EISSN

2045-7979

ISSN

2045-7960

Publication Date

May 2019

Volume

29

Start / End Page

e37

Related Subject Headings

  • Young Adult
  • United Kingdom
  • Social Class
  • Single-Parent Family
  • Sex Factors
  • Risk Assessment
  • Reproducibility of Results
  • Prospective Studies
  • Mothers
  • Male
 

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Caye, A., Agnew-Blais, J., Arseneault, L., Gonçalves, H., Kieling, C., Langley, K., … Rohde, L. A. (2019). A risk calculator to predict adult attention-deficit/hyperactivity disorder: generation and external validation in three birth cohorts and one clinical sample. Epidemiology and Psychiatric Sciences, 29, e37. https://doi.org/10.1017/s2045796019000283
Caye, A., J. Agnew-Blais, L. Arseneault, H. Gonçalves, C. Kieling, K. Langley, A. M. B. Menezes, et al. “A risk calculator to predict adult attention-deficit/hyperactivity disorder: generation and external validation in three birth cohorts and one clinical sample.Epidemiology and Psychiatric Sciences 29 (May 2019): e37. https://doi.org/10.1017/s2045796019000283.
Caye A, Agnew-Blais J, Arseneault L, Gonçalves H, Kieling C, Langley K, et al. A risk calculator to predict adult attention-deficit/hyperactivity disorder: generation and external validation in three birth cohorts and one clinical sample. Epidemiology and psychiatric sciences. 2019 May;29:e37.
Caye, A., et al. “A risk calculator to predict adult attention-deficit/hyperactivity disorder: generation and external validation in three birth cohorts and one clinical sample.Epidemiology and Psychiatric Sciences, vol. 29, May 2019, p. e37. Epmc, doi:10.1017/s2045796019000283.
Caye A, Agnew-Blais J, Arseneault L, Gonçalves H, Kieling C, Langley K, Menezes AMB, Moffitt TE, Passos IC, Rocha TB, Sibley MH, Swanson JM, Thapar A, Wehrmeister F, Rohde LA. A risk calculator to predict adult attention-deficit/hyperactivity disorder: generation and external validation in three birth cohorts and one clinical sample. Epidemiology and psychiatric sciences. 2019 May;29:e37.
Journal cover image

Published In

Epidemiology and psychiatric sciences

DOI

EISSN

2045-7979

ISSN

2045-7960

Publication Date

May 2019

Volume

29

Start / End Page

e37

Related Subject Headings

  • Young Adult
  • United Kingdom
  • Social Class
  • Single-Parent Family
  • Sex Factors
  • Risk Assessment
  • Reproducibility of Results
  • Prospective Studies
  • Mothers
  • Male