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Journal of Attention Disorders, Vol. 8, No. 3, 121-126 (2005)
DOI: 10.1177/1087054705277168
© 2005 SAGE Publications

Training Raters to Assess Adult ADHD: Reliability of Ratings

Lenard A. Adler

New York University School of Medicine, lenard.adler{at}med.nyu.edu

Thomas Spencer

Massachusetts General Hospital, Harvard Medical School

Stephen V. Faraone

SUNY Upstate Medical University

Fred W. Reimherr

University of Utah School of Medicine

Douglas Kelsey

Eli Lilly and Company

David Michelson

Eli Lilly and Company

Joseph Biederman

Massachusetts General Hospital, Harvard Medical School

The standardization of ADHD ratings in adults is important given their differing symptom presentation. The authors investigated the agreement and reliability of rater standardization in a large-scale trial of atomoxetine in adults with ADHD. Training of 91 raters for the investigator-administered ADHD Rating Scale (ADHDRS-IV-Inv) occurred prior to initiation of a large, 31-site atomoxetine trial. Agreement between raters on total scores was established in two ways: (a) by Kappa coefficient (rater agreement for each item with the percentage of raters that had identical item-by-item scores) and (b) intraclass correlation coefficients (reliability). For the ADHDRS-IV-Inv, rater agreement was moderate, and reliability, as measured by Cronbach’s alpha, was substantial. The data indicate that clinicians can be trained to reliably evaluate ADHD in adults using the ADHDRS-IV-Inv.

Key Words: adult ADHD • training • rater • agreement • symptoms


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[Abstract] [PDF]