Halloween, ADHD, and Subjectivity in Medical Diagnosis

Christopher Worsham, Charles Bray and Anupam Jena

No 33232, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: The practice of medicine relies on accurate diagnosis. However, the diagnosis of many medical conditions involves assessments that invite varying degrees of subjectivity. External and arbitrary factors can influence physicians’ diagnostic assessments in conditions ranging from heart attacks to neurodevelopmental conditions like attention deficit hyperactivity disorder (ADHD). Quantifying this subjectivity is challenging, however, particularly for neurodevelopmental and psychiatric conditions where subjective assessments of behavior are common and important. Halloween, a holiday characterized by excitement among children, could present a natural experiment to study subjectivity in diagnosis, if any ensuing behavioral changes influence diagnosis rates of ADHD. Using data on over 100 million physician office visits, we compared ADHD diagnosis rates, by day, among children seen by physicians in the 10 weekdays surrounding seven Halloween holidays. The rate of new ADHD diagnosis was 62.7 per 10,000 child-visits on Halloween, compared with 55.1 during surrounding weekdays, a 14% increase. There were no increases in diagnoses of several neuropsychiatric disorders with diagnostic criteria that are less focused on hyperactive behavior. Our findings highlight subjectivity in ADHD diagnosis and support the need to consider external factors that may influence diagnosis.

JEL-codes: I1 I10 I12 (search for similar items in EconPapers)
Date: 2024-12
New Economics Papers: this item is included in nep-hea
Note: EH
References: Add references at CitEc
Citations:

Downloads: (external link)
http://www.nber.org/papers/w33232.pdf (application/pdf)
Access to the full text is generally limited to series subscribers, however if the top level domain of the client browser is in a developing country or transition economy free access is provided. More information about subscriptions and free access is available at http://www.nber.org/wwphelp.html. Free access is also available to older working papers.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:nbr:nberwo:33232

Ordering information: This working paper can be ordered from
http://www.nber.org/papers/w33232
The price is Paper copy available by mail.

Access Statistics for this paper

More papers in NBER Working Papers from National Bureau of Economic Research, Inc National Bureau of Economic Research, 1050 Massachusetts Avenue Cambridge, MA 02138, U.S.A.. Contact information at EDIRC.
Bibliographic data for series maintained by ().