Objective:

To assess the safety and operational effectiveness of a criterion-based screening model for adult ADHD within a NHS specialist secondary care setting, addressing the increasing demand for assessments.

Key Findings:

• 12.5% of participants received an ADHD diagnosis.
• The triage pathway achieved a sensitivity of 100.0% and an infinite Number Needed to Harm (NNH), indicating no false negatives but requiring careful interpretation.
• Specificity was 45.2% with a positive predictive value of 20.7%.
• 39.6% of referrals were triaged to alternative pathways, saving specialist clinician time.

Interpretation:

Criterion-based screening by trained non-specialist clinicians can enhance safety and efficiency in adult ADHD services, supporting task-shifting models and improving patient care.

Limitations:

• Findings require replication in larger, multi-site studies to confirm generalizability.
• Further research needed on inter-rater reliability and cost-effectiveness to validate the model's applicability.

Conclusion:

Preliminary findings indicate the potential for effective triage pathways in adult ADHD assessments, emphasizing the need for calibrated sensitivity in triage thresholds and the importance of further research.