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ADHD diagnosis and treatment in children and adolescents
- Author(s):
- Peterson, Bradley S, author
- United States Agency for Healthcare Research and Quality, sponsoring body
- Patient-Centered Outcomes Research Institute (US), sponsoring body
- Southern California Evidence-Based Practice Center/RAND, issuing body
- Title(s):
- ADHD diagnosis and treatment in children and adolescents / prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services and Patient-Centered Outcomes Research Institute ; prepared by Southern California Evidence-based Practice Center ; investigators, Bradley S. Peterson, Joey Trampush, Margaret Maglione, Maria Bolshakova, Morah Brown, Mary Rozelle, Aneesa Motala, Sachi Yagyu, Jeremy Miles, Sheila Pakdaman, Mario Gastelum, Bich Thuy (Becky) Nguyen, Erin Tokutomi, Esther Lee, Jerusalem Z. Belay, Coleman Schaefer, Benjamin Coughlin, Karin Celosse, Sreya Molakalapalli, Brittany Shaw, Tanzina Sazmin, Anne N. Onyekwuluje, Danica Tolentino, Susanne Hempel.
- Series:
- Comparative effectiveness review ; no. 267
AHRQ publication ; no. 24-EHC003
PCORI publication ; no. 2023-SR-03
- Country of Publication:
- United States
- Publisher:
- Rockville, MD : Agency for Healthcare Research and Quality, March 2024.
- Description:
- 1 online resource (1 PDF file (various paginations)) : illustrations.
-
Language:
- English
- Electronic Links:
- https://www.ncbi.nlm.nih.gov/books/NBK603001/
- Summary:
- OBJECTIVE: The systematic review assessed evidence on the diagnosis, treatment, and monitoring of attention deficit hyperactivity disorder (ADHD) in children and adolescents to inform a planned update of the American Academy of Pediatrics (AAP) guidelines. DATA SOURCES: We searched PubMed(r), Embase(r), PsycINFO(r), ERIC, clinicaltrials.gov, and prior reviews for primary studies published since 1980. The report includes studies published to June 15, 2023. REVIEW METHODS: The review followed a detailed protocol and was supported by a Technical Expert Panel. Citation screening was facilitated by machine learning; two independent reviewers screened full text citations for eligibility. We abstracted data using software designed for systematic reviews. Risk of bias assessments focused on key sources of bias for diagnostic and intervention studies. We conducted strength of evidence (SoE) and applicability assessments for key outcomes. The protocol for the review has been registered in PROSPERO (CRD42022312656). RESULTS: Searches identified 23,139 citations, and 7,534 were obtained as full text. We included 550 studies reported in 1,097 publications (231 studies addressed diagnosis, 312 studies addressed treatment, and 10 studies addressed monitoring). Diagnostic studies reported on the diagnostic performance of numerous parental ratings, teacher rating scales, teen/child self-reports, clinician tools, neuropsychological tests, EEG approaches, imaging, and biomarkers. Multiple approaches showed promising diagnostic performance (e.g., using parental rating scales), although estimates of performance varied considerably across studies and the SoE was generally low. Few studies reported estimates for children under the age of 7. Treatment studies evaluated combined pharmacological and behavior approaches, medication approved by the Food and Drug Administration, other pharmacologic treatment, psychological/behavioral approaches, cognitive training, neurofeedback, neurostimulation, physical exercise, nutrition and supplements, integrative medicine, parent support, school interventions, and provider or model-of-care interventions. Medication treatment was associated with improved broadband scale scores and ADHD symptoms (high SoE) as well as function (moderate SoE), but also appetite suppression and adverse events (high SoE). Psychosocial interventions also showed improvement in ADHD symptoms based on moderate SoE. Few studies have evaluated combinations of pharmacological and youth-directed psychosocial interventions, and we did not find combinations that were systematically superior to monotherapy (low SoE). Published monitoring approaches for ADHD were limited and the SoE is insufficient. CONCLUSION: Many diagnostic tools are available to aid the diagnosis of ADHD, but few monitoring strategies have been studied. Medication therapies remain important treatment options, although with a risk of side effects, as the evidence base for psychosocial therapies strengthens and other nondrug treatment approaches emerge.
- MeSH:
- Adolescent
Attention Deficit Disorder with Hyperactivity/diagnosis*
Attention Deficit Disorder with Hyperactivity/therapy*
Child
- Publication Type(s):
- Review
- Notes:
- Includes bibliographical references.
Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, 5600 Fishers Lane, Rockville, MD 20857; www.ahrq.gov and Patient-Centered Outcomes Research Institute, 1333 New Hampshire Avenue NW, Suite 1200, Washington, DC 20036; www.pcori.org Contract No. 75Q80120D00009 Prepared by: Southern California Evidence-based Practice Center, Los Angeles, CA.
- Other ID:
- (OCoLC)1433069953
- NLM ID:
- 9918819965406676 [Electronic Resource]