Does Quotient take the place of rating scales?
No, Quotient is complementary to symptom rating scales providing the “signs” to go along with the “symptoms.”The current standards of care for diagnosis and management of ADHD recommend symptom rating scales, which are subjective in nature and are often affected by bias on the part of the parent/teacher informant. Experts in the field agree that an accurate, quantitative, objective test to measure the neurobehavioral functions relevant to ADHD is a needed addition to the physician’s tool kit.
Did Pearson invent the Quotient ADHD System?
Pearson develops, manufactures and markets proprietary diagnostic systems for the objective assessment of neurobiological disorders like ADHD. The Quotient® ADHD System Pearson is based on a patented research design developed in the Developmental Biopsychiatry Program at McLean Hospital, a Harvard Medical School Affiliate, and is exclusively licensed to Pearson.
How does Quotient work?
Quotient® (formerly known as MMAT, the McLean Motion and Attention Test) is a non- invasive FDA-cleared device providing objective measures of a subject’s ability to inhibit motor activity, sustain attention and suppress impulsive responses. Deficits in response inhibition in these neurological control functions are directly related to the core symptom domains of ADHD: hyperactivity, inattention, and impulsivity. With this technology, clinicians obtain objective, accurate and reliable information within minutes about brain function with a strong correlation to the presence or absence of a level of symptom burden sufficient for the diagnosis of ADHD.
The Quotient technology has consistently demonstrated accurate quantification of the degree to which a person is able to control involuntary movement while maintaining voluntary movement efficiency, focus attention to stimuli, sustain attention during a lengthy attention task and inhibit impulsive reactions. By design, the developmental abilities measured by Quotient® coincide with the areas of deficit manifest in the triad of symptoms characteristic of ADHD (hyperactivity, inattention and impulsivity). Deficits in the capacity to control motor activity, attend to a task, and respond without impulsivity appear to be the result of inefficient and ineffective neurological processing particularly in the domain of response inhibition.
Isn’t ADHD just a response to our modern U.S. society?
ADHD was recognized as a valid psychiatric disorder over 100 years ago. Only in the last several decades has research clearly demonstrated that ADHD is a neurobiological disorder with specific behavioral symptoms, which demonstrates specific symptomatic improvement with treatments including medications that regulate the efficiency and synchronicity of catecholamine neurotransmission. World-wide epidemiologic data indicates that the prevalence of ADHD is similar in all countries and cultures, although the recognition of that disorder may vary from region to region.
Why do I need Quotient when I already use the Vanderbilt Symptom Rating Scale?
Clinical disorders are defined by signs and symptoms and Quotient provides the signs complementary to the Vanderbilt’s symptoms. The Vanderbilt and similar symptom rating scales count the symptoms described by the patient to determine if the patient meets the syndrome definition of ADHD disorder in DSM-5. Like most CNS disorders, ADHD is a recognized by certain signature symptoms (what the patient or others report) but there are few reliable signs (what we can directly measure) to inform the differential diagnosis. Quotient uniquely measures the objective signs of ADHD that complement the traditional assessment of symptoms of the disorder. The easily administered computerized test objectively quantifies neurobehavioral indicators of the same neurological control processes that have demonstrated correlation to the symptoms of ADHD. The results of Quotient® assessment also correlate strongly with areas of the brain known to be implicated in the control of motion, attention and inhibition of impulsivity manifest in the symptoms of the disorder.
Can I give the Quotient test to the same patient more than once?
Yes, there are many benefits to serial Quotient testing in the management of ADHD. There is no “learning effect” from taking the test multiple times and the test demonstrated high test-retest reliability. The Quotient technology was developed as the McLean Motion and Attention Test by Dr. Martin Teicher and cleared by the FDA for marketing to clinicians for the objective assessment of the core symptoms of ADHD: hyperactivity, impulsivity and inattention. In effect, it serves as a ‘bioassay’ for assessing the state of neurological control on specific components of attention, activity and impulsivity. Teicher and other researchers have demonstrated that changes in Quotient scores observed on sequential tests pre- and post-treatment correlate well with other assessments of change in response to treatment.
Since insurers don’t usually pay for screening tests, is Quotient reimbursed?
Quotient is not designed as a screening test, but rather it is a very specific assessment of neurobehavioral domains salient to the diagnosis and ongoing management of ADHD. Most medical insurance companies recognize the importance of a comprehensive assessment for ADHD and reimburse clinicians for appropriate use of the Quotient® ADHD Test. Clearly, current standards and practices for ADHD require accurate disorder-specific information for optimal clinical care. Absence of that information in many cases impedes prompt accurate diagnosis and reduces the likelihood of effective and efficient therapy with sustained positive health outcomes for the vast majority of patients. Reimbursement for medical services of all types, including Quotient, vary from region to region and insurer to insurer.
Is Quotient cost effective in a Community Mental Health Center?
There are lots of factors that affect cost-effectiveness but we can make several general observations. In all medical services, better management of chronic conditions reduces overall costs. ADHD is a chronic health issue so it stands to reason that early identification and proper management holds the promise of reducing overall costs through improved effectiveness of care (i.e., treat patients better and reduce burden of illness) and improved efficiency of care (i.e., avoid duplication and inadequacies in care that increase cost of current care). ADHD is most costly in systems of care when it isn’t recognized or is inadequately treated.
Has Quotient been approved by the FDA?
Yes. Quotient was the first diagnostic device to receive clearance for marketing from the FDA for the intended use of “providing clinicians with objective measurements of hyperactivity, impulsivity and inattention to aid in the clinical assessment of ADHD”.
Is patient information secure on Quotient?
In strict compliance with HIPAA guidance, all subject data is filed in a secure encrypted folder accessible only by the clinician’s unique system credentials. The clinician with the necessary security credentials may access the reports of his or her patients at any time from any internet-connected computer.
What information gets sent back to me on the Quotient report?
The Quotient report provides detailed analysis of patterns of motion, accuracy of attention to stimuli, and fluctuations in attention states over the course of the task. Proprietary algorithms on the Quotient server analyze the raw tests results in comparison to age and gender matched cohorts on multiple dimensions for both motion and attention. The test reports include graphical displays of the subject’s behaviors during the test, tabular comparisons to age and gender norms and a percentile rank of the test performance relative to norms. In addition the computerized analysis integrates composite scores for attention and motion from a compilation of individual metrics to quantify subject’s overall performance profile relative to developmentally expectable “normal” behavior.