QbTest in ADHD: Objective Measurement of Attention and Impulsivity
Diagnosing ADHD has traditionally relied on clinical history, questionnaires, and observational reports. These are valuable but subjective. Enter the QbTest—a computer-based assessment that provides objective, quantifiable measures of attention, impulsivity, and activity. It doesn’t replace the psychiatrist’s clinical judgment, but it adds a scientific layer of data that enriches diagnosis and monitoring.
What is the QbTest?
The QbTest (Quantified Behavior Test) is an FDA- and CE-cleared computerized test designed to support the assessment of ADHD in children, adolescents, and adults.
It combines a Continuous Performance Test (CPT) with a motion-tracking system:
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CPT component: Measures attention and impulse control by requiring the patient to respond to certain stimuli and inhibit responses to others.
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Motion tracking: An infrared camera tracks a reflective headband to quantify hyperactivity in real time.
This integration allows clinicians to see how inattention, impulsivity, and hyperactivity interact during a structured task.
What Does the QbTest Measure?
The test produces three key domains:
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Attention
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Number of correct vs. missed targets.
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Reaction time and variability.
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Ability to sustain focus over time.
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Impulsivity
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Number of incorrect responses (commission errors).
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Premature responses or difficulty inhibiting actions.
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Activity (Hyperactivity)
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Degree, frequency, and pattern of head movements.
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Quantitative measure of restlessness during the task.
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The results are compared against normative data from age- and sex-matched control groups.
Clinical Uses of the QbTest
1. Diagnosis Support
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Helps distinguish ADHD from conditions with overlapping symptoms (anxiety, depression, learning difficulties).
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Provides a visual report that parents, teachers, and patients can easily understand.
2. Treatment Monitoring
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Before and after medication initiation, QbTest can show objective changes in attention and activity.
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Particularly useful when families are uncertain if medication is “working.”
3. Motivational Tool
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Visual feedback helps children and adults see the difference treatment makes, improving adherence.
4. Research Utility
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Provides standardized outcome measures in clinical trials of ADHD treatments.
Advantages of QbTest
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Objective data reduces sole reliance on questionnaires.
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Time-efficient (takes about 15–20 minutes).
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Engaging for children due to its game-like format.
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Trackable across multiple sessions for long-term monitoring.
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Validated in multiple studies and approved by regulatory bodies.
Limitations of QbTest
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Not a standalone diagnostic tool: ADHD remains a clinical diagnosis based on history, collateral reports, and functional impairment.
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Influenced by context: Poor sleep, anxiety, or unfamiliarity with computers can affect performance.
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Cost and availability: Requires specific equipment and licensing, not universally available.
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Cultural/educational bias: Normative data may not perfectly fit all populations, especially outside Europe/North America.
Evidence Base
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Studies show QbTest has moderate to high sensitivity and specificity in differentiating ADHD from controls.
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NICE (2018) acknowledges QbTest as a supportive tool in ADHD diagnosis and monitoring, but not a substitute for comprehensive evaluation.
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In medication monitoring, QbTest often shows clear reductions in hyperactivity and impulsivity scores after stimulant treatment, aligning with clinical impressions.
A Typical Clinical Workflow
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Initial consultation: history, rating scales, clinical interview.
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QbTest administered in clinic (~20 minutes).
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Immediate generation of visual report (graphs, comparison with norms).
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Integration of QbTest results with clinical assessment.
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Repeat QbTest after starting or adjusting medication to measure treatment effects.
Conclusion
The QbTest represents the future of ADHD assessment—bringing objectivity into a field long dominated by subjective reports. While it cannot diagnose ADHD on its own, it offers clinicians and families tangible, data-driven insights into attention, impulsivity, and hyperactivity. When combined with thorough clinical evaluation, QbTest improves diagnostic confidence, supports shared decision-making, and enhances treatment monitoring.
✦ About the Author
I’m Dr. Srinivas Rajkumar T, MD (AIIMS, New Delhi), Consultant Psychiatrist in Chennai. At my Mind and Memory Clinic (Apollo Clinic, Velachery, Opp. Phoenix Mall), I integrate objective tools like QbTest with clinical expertise, alongside medications, psychotherapy, lifestyle strategies, and advanced neuromodulation (rTMS, tDCS, neurofeedback, ketamine therapy).
📍 Mind and Memory Clinic, Apollo Clinic, Velachery, Chennai (Opp. Phoenix Mall)
📞 +91 85951 55808