Table 1_Parent-teacher agreement on ADHD symptom ratings: a systematic review and meta-analysis.docx

The overall parent-teacher agreement was low (Kappa = 0.25, 95% CI: 0.18-0.31), with substantial heterogeneity (I² = 75.8%). Subgroup analyses revealed that gender had a minimal impact on agreement levels (boys: Kappa=0.25; girls: Kappa=0.32). However, sample settings significantly moderated agreement: school-based samples showed the highest concordance (Kappa=0.31), followed by community samples (Kappa=0.27), while clinical samples demonstrated the lowest and non-significant agreement (Kappa=0.07).</p>Conclusions<p>This meta-analysis confirmed low parent-teacher agreement in ADHD assessments, with the lowest agreement observed in clinical samples.

Existing studies also suggest moderate agreement between parents themselves, although the limited data precluded a meta-analysis on this specific comparison. Nevertheless, these findings highlight that high levels of discrepancy across informants should be a focus of clinical attention. When integrating multi-informant data, such discrepancies must be explicitly interpreted, and standardized methods are needed to reconcile them in diagnostic decision-making.</p>Systematic review registration<p>crd.york.ac.uk/prospero/display_record.php?RecordID=4556281, identifier CRD4202455628.</p>