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Use of an Internet portal to improve community-based pediatric ADHD care : a cluster randomized trial . OBJECTIVE To determine the effectiveness of a quality improvement program to improve pediatricians ' adherence to existing , evidence-based , attention-deficit/hyperactivity disorder ( ADHD ) practice guidelines . METHODS Forty-nine community-based pediatricians at 8 practices participated in a cluster-randomized trial . Practices were matched according to the numbers of pediatricians and the proportions of patients receiving Medicaid . The medical charts for a random sample of patients with ADHD for each of the participating pediatricians were examined at baseline and 6 months . All practices participated in 4 sessions of training , including didactic lectures and office flow modification workshops . Practices were then given access to an ADHD Internet portal that allowed parents , teachers , and pediatricians to input information ( eg , rating scales ) about patients , after which information was scored , interpreted , and formatted in a report style that was helpful for assessment and treatment of patients with ADHD . Physicians evaluated their practice behaviors quarterly and addressed underperforming areas . RESULTS Pediatricians in the intervention group , compared with those in the control group , demonstrated significantly higher rates of many American Academy of Pediatrics-recommended ADHD care practices , including collection of parent ( Cohen 's d = 0.69 ) and teacher ( d = 0.68 ) rating scales for assessment of children with ADHD , use of Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition , criteria ( d = 0.85 ) , and use of teacher rating scales to monitor treatment responses ( d = 1.01 ) . CONCLUSION A quality improvement intervention that can be widely disseminated by using Internet-based information technology significantly improved the quality of ADHD care in community-based pediatric settings .
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Intervention_Educational
Use of an Internet portal
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Intervention_Educational
quality improvement program
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Intervention_Educational
training , including didactic lectures and office flow modification workshops .
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Intervention_Educational
ADHD Internet portal
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Intervention_Control
control
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Intervention_Educational
A quality improvement intervention
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Intervention_Educational
Internet-based information technology
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Outcome_Mental
practice behaviors
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Outcome_Mental
underperforming areas .
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Outcome_Mental
collection of parent
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Outcome_Mental
teacher
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Outcome_Mental
rating scales
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Outcome_Mental
Statistical Manual of Mental Disorders
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Outcome_Mental
teacher rating scales
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Participant_Age
pediatric
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Participant_Condition
ADHD
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Participant_Sample-size
Forty-nine