Accuracy of Electronic Health Record-Derived Data for the Identification of Incident ADHD

J Atten Disord. 2017 Mar;21(5):416-425. doi: 10.1177/1087054713520616. Epub 2014 Jan 1.


Objective: To assess the accuracy of electronic health record (EHR)-derived diagnoses in identifying children with incident (i.e., newly diagnosed) ADHD.

Method: In 10 large health care organizations, electronic diagnoses data were used to identify all potential cases of incident ADHD among 3- through 9-year-old children. A random sample of records was manually reviewed to determine whether a diagnosis of ADHD was documented in clinician notes.

Results: From electronic diagnoses data, a total of 7,362 children with incident ADHD were identified. Upon manual review of 500 records, the diagnosis of incident ADHD was confirmed in clinician notes for 71.5% (95% confidence interval [CI] = [56.5, 86.4]) of records for 3- through 5-year-old children and 73.6% (95% CI = [65.6, 81.6]) of records for 6- through 9-year-old children.

Conclusion: Studies predicated on the identification of incident ADHD cases will need to carefully consider study designs that minimize the likelihood of case misclassification.

Keywords: ADHD; accuracy; child; electronic health records.

Publication types

  • Comparative Study
  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Ambulatory Care
  • Attention Deficit Disorder with Hyperactivity / diagnosis*
  • Child
  • Child, Preschool
  • Electronic Health Records / standards*
  • Female
  • Humans
  • Retrospective Studies