Clinical Relevance of the Primary Findings of the MTA: Success Rates Based on Severity of ADHD and ODD Symptoms at the End of Treatment

Swanson, James M.; Kraemer, Helena C.; Hinshaw, Stephen P.; Arnold, L. Eugene; Conners, C. Keith; Abikoff, Howard; Clevenger, Walter; Davies, Mark; Elliott, Glen R.; Greenhill, Laurence L.; Hechtman, Lily; Hoza, Betsy; Jensen, Peter S.; March, John S.; Newcorn, Jeffrey H.; Owens, Elizabeth B.; Pelham, William E.; Schiller, Ellen; Severe, Joanne B.; Simpson, Steve; Vitiello, Benedetto; Wells, Karen C.; Wigal, Timothy; Wu, Min

doi:10.1097/00004583-200102000-00011

Cited by 942 publications

(768 citation statements)

References 13 publications

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“…Secondary analysis looked at rates of success defined by a cutoff on the SNAP-IV score at the end of the treatment. 71 Results from the secondary analysis found increased success rates for combined treatment and medication management and confirmed the initial results. 71 An 8-year follow-up of MTA children, however, did not find differences between the four treatment groups, and children with ADHD combined subtype showed poorer functioning than non-ADHD children, despite the improved outcomes compared with baseline.…”

Section: Long-term Efficacy and Effectivenesssupporting

confidence: 63%

“…71 Results from the secondary analysis found increased success rates for combined treatment and medication management and confirmed the initial results. 71 An 8-year follow-up of MTA children, however, did not find differences between the four treatment groups, and children with ADHD combined subtype showed poorer functioning than non-ADHD children, despite the improved outcomes compared with baseline. 72 These results suggest that an initial period of randomly assigned treatment does not change the disorder trajectory.…”

Section: Long-term Efficacy and Effectivenesssupporting

confidence: 63%

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Developments and challenges in the diagnosis and treatment of ADHD

Dias

Kieling

Graeff-Martins

et al. 2013

Rev. Bras. Psiquiatr.

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Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder, often associated with other psychiatric comorbidities, functional impairments, and poor long-term outcomes. The objective of this selected review is to describe current advances and challenges in the diagnosis and treatment of ADHD. The disorder is associated with neurobiological underpinnings and is highly heterogeneous in various aspects, such as symptom profiles, cognitive impairments, and neurobiological and genetic features. The efficacy and safety of short-term pharmacological treatments across the life cycle is well studied, but further research investigating long-term treatment, impact of treatment in preschoolers, and non-pharmacological interventions is needed. Future research is also needed to better characterize the neurodevelopmental pathways of the disorder, linking clinical and neurobiological information, less investigated populations, and new interventions.

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Section: Long-term Efficacy and Effectivenesssupporting

confidence: 63%

Section: Long-term Efficacy and Effectivenesssupporting

confidence: 63%

Developments and challenges in the diagnosis and treatment of ADHD

Dias

Kieling

Graeff-Martins

et al. 2013

Rev. Bras. Psiquiatr.

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“…Though behavioural therapy may be less effective, it is still helpful for many children and multimodal behavioural interventions with parent training, interventions in school and cognitive behaviour therapy of the child have been shown to be effective in a substantial proportion of patients [162,36]. The costs of a short course of parent training are comparable to those of medication; the outcome may be somewhat less favourable in terms of symptom reduction, but has the advantage of carrying very little physical hazard.…”

Section: ■ Integration Of Approachesmentioning

confidence: 99%

European clinical guidelines for hyperkinetic disorder ? first upgrade

Taylor

Döpfner

Sergeant

et al. 2004

European Child & Adolescent Psychiatry

502

452

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■ Abstract Background The validity of clinical guidelines changes over time, because new evidencebased knowledge and experience develop. Objective Hence, the European clinical guidelines on hyperkinetic disorder from 1998 had to be evaluated and modified. Method Discussions at the European Network for Hyperkinetic Disorders (EUNETHYDIS) and iterative critique of each clinical analysis. Guided by evidence-based information and based on evaluation (rather than metaanalysis) of the scientific evidence a group of child psychiatrists and psychologists from several European countries updated the guidelines of 1998. When reliable information is lacking the group gives a clinical consensus when it could be found among themselves. Results The group presents here a set of recommendations for the conceptualisation and management of hyperkinetic disorder and attention deficit/hyperactivity disorder (ADHD). Conclusion A general scheme for practice in Europe could be provided, on behalf of the European Society for Child and Adolescent Psychiatry (ESCAP).

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“…29 At baseline and on the 24th week of the study protocol, all parents/caregivers were asked to complete the Health Utility Index (HUI ® ) questionnaire (proxy assessment) 30 (more details below).…”

Section: -Week Naturalistic Studymentioning

confidence: 99%

“…Treatment effect was defined as a symptom reduction X 30% in the SNAP-IV rating scale 29 (inattention and hyperactivity/impulsivity) between baseline and week 4, and from week 4 to week 24 of follow-up. Similarly, adverse events were evaluated by means of the Barkley SERS.…”

Section: -Week Naturalistic Studymentioning

confidence: 99%

Cost-utility analysis of methylphenidate treatment for children and adolescents with ADHD in Brazil

Maia

Stella²,

Wagner

et al. 2015

Rev. Bras. Psiquiatr.

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Objective: To perform a cost-utility analysis on the treatment of attention deficit hyperactivity disorder (ADHD) with methylphenidate immediate-release (MPH-IR) in children and adolescents from Brazil. Method: A Markov model was constructed to compare MPH-IR vs. no treatment. A 24-week naturalistic study was conducted to collect transition probabilities and utility data. Effectiveness was expressed as quality-adjusted life-years (QALY), and costs reported in 2014 international dollars (I$). The perspective was the Brazilian Unified Health System as payer, and the time horizon was 6 years. Results: Of 171 patients, 73 provided information at baseline, and 56 at week 24. Considering the MPH-IR monthly cost of I$ 38, the incremental cost-effectiveness ratio (ICER) of treatment was I$ 9,103/QALY for children and I$ 11,883/QALY for adolescents. In two-way sensitivity analysis, considering one Gross National Product per capita (I$ 11,530) as willingness-to-pay, a cost of no-treatment lower than I$ 45/month would render MPH-IR a cost-saving strategy. Discussion: MPH-IR treatment of children and adolescents is cost-effective for ADHD patients from the Brazilian public health system perspective. Both patients and the healthcare system might benefit from such a strategy. Trial registration number: NCT01705613.

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Clinical Relevance of the Primary Findings of the MTA: Success Rates Based on Severity of ADHD and ODD Symptoms at the End of Treatment

Cited by 942 publications

References 13 publications

Developments and challenges in the diagnosis and treatment of ADHD

Developments and challenges in the diagnosis and treatment of ADHD

European clinical guidelines for hyperkinetic disorder ? first upgrade

Cost-utility analysis of methylphenidate treatment for children and adolescents with ADHD in Brazil

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