qEEG Testing for ADHD?

[edieb]

In my area of the country, I am seeing tons and tons of testing evaluations for the diagnosis for ADHD done using qEEG. The providers who are doing these evaluations are either school neuropsychologists or psychiatrists. Is this a legitimate diagnostic evaluation? I notice on the testing reports that the providers do not rule out diagnoses that may resemble ADHD such as childhood/early onset bipolar, anxiety spectrum disorders, etc. At the bottom of the reports, it says "note generated by eClinicalworks EMR/PM..."

I searched online for one of the sources for his report, and here is the psychiatrist's website:

http://www.dbmclinic.com/index.php

Apparently, they conduct all kinds of neuropsych-ish evaluations but only have master's level therapists, MDs, and NPs on staff

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[WisNeuro]

qEEG should not be used for diagnostic purposes. That indicator is far away from being used in primetime. Providers who use these results as diagnostic clearly have not read the research or current guidelines. They are also not admissible as evidence in court preceedings, due to the lack of empirical evidence supporting its use.

 

[AcronymAllergy]

qEEG should not be used for diagnostic purposes. That indicator is far away from being used in primetime. Providers who use these results as diagnostic clearly have not read the research or current guidelines. They are also not admissible as evidence in court preceedings, due to the lack of empirical evidence supporting its use.

This. Last I checked, the research supporting qEEG use in ADHD was still very unrefined, and was nowhere near being ready for "prime time" diagnostically. I wonder if these folks are basically doing a "traditional" ADHD eval, throwing on qEEG because it's new and shiny, and then just charging more for what could essentially be done with some elbow grease and a few rating forms.

And as an added bonus, the treatment of choice (i.e., stimulant meds) is going to provide benefits (at least short-term) regardless, which (joy!) then serves as confirmation-biased evidence that the diagnosis was "correct."

 

[PsyDr]

qEEG is going to measure approximately 6,000 variables per event. Sensitivity at best is 98%, with those sudies having a specificity in the 80% range, if I recall accurately. When specificity is raised to 97%, sensitivity is around 87%.

Imagine if an MMPI had 6000 questions. Would those numbers be acceptable?

Neurology's whitepaper maintains that it is not acceptable practice.

 

[edieb]

qEEG should not be used for diagnostic purposes. That indicator is far away from being used in primetime. Providers who use these results as diagnostic clearly have not read the research or current guidelines. They are also not admissible as evidence in court preceedings, due to the lack of empirical evidence supporting its use.

No the only measure given for diagnosis is the qEEG. There is no psych. testing used

 

[WisNeuro]

No the only measure given for diagnosis is the qEEG. There is no psych. testing used

I would disregard any clinical formulations by these people if this is their sole diagnostic tool. It is clear that they know little to nothing about evidence based medicine and are doing their patients a great disservice.

 

[erg923]

Generally speaking, medicine seems to be much more on the evidence-based practice (what does the lit tell us?) bandwagon than psychologists still are. Nevertheless, its always amazing to see such massive variability in adhereing to empirically-based practice standards and conclusions.

I noted that throughout our most recent pregnancy, conversations with myself and my wife our OB/GYN CONSTANTLY cited the current OB lit when explaining her reasoning, rationale for procedure or a specific treatment, etc. On the other side of the aisle, you have... this type of nonsense.

 

[psychRA]

Looks like that clinic also offers Working Memory Training for ADHD, so they're clearly pretty comfortable with the idea of charging money for things that aren't backed by reliable science.

 

[edieb]

Looks like that clinic also offers Working Memory Training for ADHD, so they're clearly pretty comfortable with the idea of charging money for things that aren't backed by reliable science.

Can MDs and NPs bill for all this???? They have no formal testing in testing

 

[WisNeuro]

Can MDs and NPs bill for all this???? They have no formal testing in testing

Ah, the power of the AMA as a lobbying body...

I'm not sure if they can bill insurance for this, but there are some things that astound me in relation to what I know they can bill for.

 

[edieb]

Ah, the power of the AMA as a lobbying body...

I'm not sure if they can bill insurance for this, but there are some things that astound me in relation to what I know they can bill for.

It is a Nurse Practitioner and she does bill Blue Cross/Blue Shield for this.

 

[WisNeuro]

It is a Nurse Practitioner and she does bill Blue Cross/Blue Shield for this.

Ugh, some aspects of the healthcare system absolutely disgust me. They'll pay for this, but a former patient of mine in an AMC who had a cerebellar artery dissection can't get insurance to cover rehab services. Ridiculous.

 

[psychRA]

It is a Nurse Practitioner and she does bill Blue Cross/Blue Shield for this.

There are plenty of "learning centers" near my grad program that have sprung up to offer testing and (unsupported) treatments for kids with learning disabilities, all administered by people without any type of degree that would have provided sufficient training. We generally got the sense that they were catering to families who could afford to pay for services out of pocket, because insurance certainly wasn't going to cover them.

I would cringe internally when a parent reported that they'd been paying $100 an hour for their child to practice reading with colored overlays to treat their dyslexia, but I'd think "well, it's a free market, and if parents are willing to pay for a useless therapy, I guess I can't stop them." It's distressing that insurance dollars are actually funding this sort of nonsense.

 

[psychRA]

Speaking of scientifically unsupported products for learning disorders, I just noticed the SDN page that I'm currently viewing is brought to me by Synaptol, the natural medicine that "Safely and quickly relieves ADD / ADHD symptoms including hyperactivity, inattentiveness, poor concentration, and difficulty reading and writing." Eyeroll.

 

[WisNeuro]

Speaking of scientifically unsupported products for learning disorders, I just noticed the SDN page that I'm currently viewing is brought to me by Synaptol, the natural medicine that "Safely and quickly relieves ADD / ADHD symptoms including hyperactivity, inattentiveness, poor concentration, and difficulty reading and writing." Eyeroll.

apparently that supplement is just a bunch of poisons thrown together in homeopathic concentrations

http://neurologicalketchup.blogspot.com/2011/09/i-have-seen-new-supplement-advertised.html