Computerized continuous performance tests (CPTs) are commonly used to characterize attention in attention deficit-hyperactivity disorder (ADHD). Virtual classroom CPTs, designed to enhance ecological validity, are increasingly being utilized. Lacking is a quantitative meta-analysis of clinical comparisons of attention performance in children with ADHD using virtual classroom CPTs. The objective of the present systematic PRISMA review was to address this empirical void and compare three-dimensional (3D) virtual classroom CPTs to traditional two-dimensional (2D) CPTs. The peer-reviewed literature on comparisons of virtual classroom performance between children with ADHD and typically developing children was explored in six databases (e.g., Medline). Published studies using a virtual classroom to compare attentional performance between children with ADHD and typically developing children were included. Given the high heterogeneity with modality comparisons (i.e., computerized CPTs vs. virtual classroom CPTs for ADHD), both main comparisons included only population comparisons (i.e., control vs. ADHD) using each CPT modality. Meta-analytic findings were generally consistent with previous meta-analyses of computerized CPTs regarding the commonly used omission, commission, and hit reaction time variables. Results suggest that the virtual classroom CPTs reliably differentiate attention performance in persons with ADHD. Ecological validity implications are discussed pertaining to subtle meta-analytic outcome differences compared to computerized 2D CPTs. Further, due to an inability to conduct moderator analyses, it remains unclear if modality differences are due to other factors. Suggestions for future research using the virtual classroom CPTs are provided.

中文翻译：

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在描述ADHD时，虚拟现实教室连续性能测试与传统连续性能测试的比较：荟萃分析。

计算机连续性能测试（CPT）通常用于表征注意力缺陷多动障碍（ADHD）的注意力。旨在提高生态有效性的虚拟教室CPT越来越多地被利用。缺乏是使用虚拟教室CPT对患有ADHD的儿童的注意力表现进行临床比较的定量荟萃分析。本系统PRISMA综述的目的是解决这一经验空白，并将三维（3D）虚拟教室CPT与传统的二维（2D）CPT进行比较。在六个数据库（例如，Medline）中探索了经过同行评审的有关多动症儿童与典型发育儿童之间虚拟教室表现比较的文献。包括已发表的研究，该研究使用虚拟教室比较患有多动症的儿童和通常发育中的儿童之间的注意力表现。鉴于模式比较（即，ADHD的计算机化CPT与虚拟教室CPT）的高度异质性，两个主要比较仅包括使用每种CPT方式的人群比较（即，对照组与ADHD）。荟萃分析的结果通常与以前对计算机化的CPT进行的荟萃分析一致，涉及到常用的遗漏，委托和命中反应时间变量。结果表明，虚拟教室CPT能够可靠地区分ADHD患者的注意力表现。与计算机二维CPT相比，讨论了与微妙的荟萃分析结果差异有关的生态有效性。进一步，由于无法进行主持人分析，因此尚不清楚模式差异是否是由其他因素引起的。提供了使用虚拟教室CPT进行未来研究的建议。