What the Green Dots Mean on QbCheck for ADHD
The green dots on the QbCheck represent moments when the patient correctly responds to target stimuli during the continuous performance test - they indicate accurate responses (correct hits) when the patient is supposed to click or respond to the designated target pattern.
Understanding QbCheck Visual Feedback
The QbCheck is an online version of the QbTest that uses your computer's webcam to track movement while you perform a continuous performance task 1. During the test:
- Green dots = Correct responses to target stimuli (when you're supposed to click and you do)
- Red dots typically indicate commission errors (clicking when you shouldn't)
- Missing responses indicate omission errors (not clicking when you should)
The test measures three core domains:
- Activity (movement tracked via webcam)
- Inattention (omission errors - missed targets)
- Impulsivity (commission errors - responding to non-targets)
Important Clinical Context and Limitations
QbCheck and similar continuous performance tests should NOT be used as standalone diagnostic tools for ADHD 2, 3. The evidence is clear on this:
Diagnostic Accuracy Limitations
The QbTest shows only moderate discriminative ability with:
- Sensitivity: 78% (meaning 22% of people with ADHD test negative)
- Specificity: 70% (meaning 30% of people without ADHD test positive)
- Overall accuracy (AUC): 0.72 for total scores 2
These numbers indicate acceptable but not good performance - insufficient for standalone screening or diagnosis 2.
Proper Clinical Use
The QbCheck should only be used as an adjunct to comprehensive clinical assessment, not as a replacement for it 4, 2. The AAP guidelines emphasize that neuropsychological testing (including CPTs like QbCheck) has not been found to improve diagnostic accuracy in most cases 5.
The gold standard remains:
- Clinical interview with parents/caregivers
- DSM-5 diagnostic criteria
- Information from multiple settings (home, school)
- DSM-based ADHD rating scales with normative data 5
Where QbCheck May Add Value
When used appropriately as part of comprehensive assessment, QbCheck may:
- Reduce time to diagnosis
- Improve clinician confidence in diagnostic decisions
- Facilitate communication with caregivers about objective findings 4
However, the test results alone cannot confirm or rule out ADHD - the green dots showing correct responses are just one data point among many needed for proper diagnosis 2, 3.