Attention Deficit Hyperactivity Disorder Diagnosis and

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Comparative Effectiveness Review,Number 203, Attention Deficit Hyperactivity Disorder Diagnosis. and Treatment in Children and Adolescents,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,Contract No 290 2015 00004 I. Prepared by,Duke Evidence based Practice Center,Investigators.
Alex R Kemper M D M P H M S,Gary R Maslow M D M P H. Sherika Hill M H A Ph D,Behrouz Namdari M D,Nancy M Allen LaPointe Pharm D M H S. Adam P Goode D P T Ph D,Remy R Coeytaux M D Ph D,Deanna Befus B A B S N. Andrzej S Kosinski Ph D,Samantha E Bowen Ph D,Amanda J McBroom Ph D. Kathryn R Lallinger M S L S,Gillian D Sanders Ph D.
AHRQ Publication No 18 EHC005 EF,January 2018,Key Messages. Purpose of Review, To update a previous review by comparing strategies to diagnose treat and monitor children and. adolescents with attention deficit hyperactivity disorder ADHD. Key Messages, Evidence was insufficient on imaging or electroencephalogram to diagnose ADHD in. children 7 17 years of age, Little evidence adds to the 2011 report that found that methylphenidate is effective for. children under age 6 with ADHD and that psychostimulants can be effective for children. 6 12 years of age, Atomoxetine had slightly higher gastrointestinal effects than methylphenidate.
Cognitive behavioral therapy may improve ADHD symptoms among children 7 17 years. Child or parent training improved ADHD symptoms among children 7 17 years of age. but did not change academic performance, Omega 3 6 supplementation made no difference in ADHD symptoms. Future studies are needed to evaluate diagnosis monitoring and long term outcomes for. children and adolescents with ADHD managed in usual care settings. This report is based on research conducted by the Duke Evidence based Practice Center EPC. under contract to the Agency for Healthcare Research and Quality AHRQ Rockville MD. Contract No 290 2015 00004 I The findings and conclusions in this document are those of the. authors who are responsible for its contents the findings and conclusions do not necessarily. represent the views of AHRQ Therefore no statement in this report should be construed as an. official position of AHRQ or of the U S Department of Health and Human Services. None of the investigators have any affiliations or financial involvement that conflicts with. the material presented in this report, The information in this report is intended to help health care decisionmakers patients and. clinicians health system leaders and policymakers among others make well informed. decisions and thereby improve the quality of health care services This report is not intended to. be a substitute for the application of clinical judgment Anyone who makes decisions concerning. the provision of clinical care should consider this report in the same way as any medical. reference and in conjunction with all other pertinent information i e in the context of available. resources and circumstances presented by individual patients. This report is made available to the public under the terms of a licensing agreement between the. author and the Agency for Healthcare Research and Quality This report may be used and. reprinted without permission except those copyrighted materials that are clearly noted in the. report Further reproduction of those copyrighted materials is prohibited without the express. permission of copyright holders, AHRQ or U S Department of Health and Human Services endorsement of any derivative. products that may be developed from this report such as clinical practice guidelines other. quality enhancement tools or reimbursement or coverage policies may not be stated or implied. This report may periodically be assessed for the currency of conclusions If an assessment is. done the resulting surveillance report describing the methodology and findings will be found on. the Effective Health Care Program Web site at www effectivehealthcare ahrq gov Search on the. title of the report, Persons using assistive technology may not be able to fully access information in this report For. assistance contact epc ahrq hhs gov, Suggested citation Kemper AR Maslow GR Hill S Namdari B Allen LaPointe NM Goode.
AP Coeytaux RR Befus D Kosinski AS Bowen SE McBroom AJ Lallinger KR Sanders GD. Attention Deficit Hyperactivity Disorder Diagnosis and Treatment in Children and Adolescents. Comparative Effectiveness Review No 203 Prepared by the Duke University Evidence based. Practice Center under Contract No 290 2015 00004 I AHRQ Publication No 18 EHC005 EF. Rockville MD Agency for Healthcare Research and Quality January 2018 Posted final reports. are located on the Effective Health Care Program search page. DOI https doi org 10 23970 AHRQEPCCER203, The Agency for Healthcare Research and Quality AHRQ through its Evidence based. Practice Centers EPCs sponsors the development of systematic reviews to assist public and. private sector organizations in their efforts to improve the quality of health care in the United. States These reviews provide comprehensive science based information on common costly. medical conditions and new health care technologies and strategies. Systematic reviews are the building blocks underlying evidence based practice they focus. attention on the strength and limits of evidence from research studies about the effectiveness and. safety of a clinical intervention In the context of developing recommendations for practice. systematic reviews can help clarify whether assertions about the value of the intervention are. based on strong evidence from clinical studies For more information about AHRQ EPC. systematic reviews see www effectivehealthcare ahrq gov reference purpose cfm. AHRQ expects that these systematic reviews will be helpful to health plans providers. purchasers government programs and the health care system as a whole Transparency and. stakeholder input are essential to the Effective Health Care Program Please visit the Web site. www effectivehealthcare ahrq gov to see draft research questions and reports or to join an. email list to learn about new program products and opportunities for input. If you have comments on this systematic review they may be sent by mail to the Task Order. Officer named below at Agency for Healthcare Research and Quality 5600 Fishers Lane. Rockville MD 20857 or by email to epc ahrq hhs gov. Gopal Khanna M B A Arlene S Bierman M D M S,Director Director. Agency for Healthcare Research and Quality Center for Evidence and Practice. Improvement,Agency for Healthcare Research and Quality. Stephanie Chang M D M P H Suchitra Iyer Ph D,Director Task Order Officer. Evidence based Practice Center Program Center for Evidence and Practice. Center for Evidence and Practice Improvement Improvement. Agency for Healthcare Research and Quality Agency for Healthcare Research and Quality. Acknowledgments, The authors thank Naomi Davis Ph D for providing clinical expertise Megan von Isenburg.
M S L S for help with the literature search and retrieval Robyn E Schmidt B A for assistance. with project coordination and Rebecca N Gray D Phil and Liz Wing M A for editorial. assistance,Key Informants, In designing the study questions the EPC consulted several Key Informants who represent the. end users of research The EPC sought the Key Informant input on the priority areas for research. and synthesis Key Informants are not involved in the analysis of the evidence or the writing of. the report Therefore in the end study questions design methodological approaches and or. conclusions do not necessarily represent the views of individual Key Informants. Key Informants must disclose any financial conflicts of interest greater than 10 000 and any. other relevant business or professional conflicts of interest Because of their role as end users. individuals with potential conflicts may be retained The TOO and the EPC work to balance. manage or mitigate any conflicts of interest, The list of Key Informants who provided input to this report follows. Barry Anton Ph D A B P P Laurence Greenhill M D, Rainier Behavioral Health Columbia University Medical Center. Tacoma WA New York NY,William Barbaresi M D FAAP Aaron Lopata M D M P P. Boston Children s Hospital Health Resources and Services Administration. Boston MA Maternal and Child Health Bureau,Rockville MD.
Coleen Boyle Ph D M S Hyg, Centers for Disease Control and Prevention Doris Lotz M D M P H. Atlanta GA Chief Medical Officer,New Hampshire Department of Health and. Teka Dempson Human Services, National Federation of Families for Children s Concord NH. Mental Health,Durham NC Mark Wolraich M D,University of Oklahoma Health Sciences. Theodore Ganiats M D Center,University of Miami Oklahoma City OK.
Technical Expert Panel, In designing the study questions and methodology at the outset of this report the EPC consulted. several technical and content experts Broad expertise and perspectives were sought Divergent. and conflicting opinions are common and perceived as healthy scientific discourse that results in. a thoughtful relevant systematic review Therefore in the end study questions design. methodologic approaches and or conclusions do not necessarily represent the views of. individual technical and content experts, Technical Experts must disclose any financial conflicts of interest greater than 10 000 and any. other relevant business or professional conflicts of interest Because of their unique clinical or. content expertise individuals with potential conflicts may be retained The TOO and the EPC. work to balance manage or mitigate any potential conflicts of interest identified. The list of Technical Experts who provided input to this report follows. Coleen Boyle Ph D M S Hyg, Centers for Disease Control and Prevention Susanna Visser M S Dr Ph. Atlanta GA Centers for Disease Control and Prevention. Atlanta GA,Theodore Ganiats M D,University of Miami Mark Wolraich M D. Miami FL University of Oklahoma Health Sciences,Laurence Greenhill M D Oklahoma City OK.
Columbia University Medical Center,New York NY Julie Zito Ph D. University of Maryland,William E Pelham Jr Ph D Baltimore MD. Florida International University,Erin Schoenfelder Gonzalez Ph D. Seattle Children s Hospital,Seattle WA,Provided input on Draft Report. Peer Reviewers, Prior to publication of the final evidence report EPCs sought input from independent Peer.
Reviewers without financial conflicts of interest However the conclusions and synthesis of the. scientific literature presented in this report do not necessarily represent the views of individual. Peer Reviewers must disclose any financial conflicts of interest greater than 10 000 and any. other relevant business or professional conflicts of interest Because of their unique clinical or. content expertise individuals with potential nonfinancial conflicts may be retained The TOO. and the EPC work to balance manage or mitigate any potential nonfinancial conflicts of interest. identified,The list of Peer Reviewers follows,Charles J Homer M D M P H. Harvard TH Chan School of Public Health,Peter Jensen M D. Mayo Clinic,Rochester MN, Attention Deficit Hyperactivity Disorder Diagnosis. and Treatment in Children and Adolescents,Structured Abstract. Objectives Attention deficit hyperactivity disorder ADHD is a common pediatric. neurobehavioral disorder often treated in the primary care setting This systematic review. updates and extends two previous Agency for Healthcare Research and Quality AHRQ. systematic evidence reviews and focuses on the comparative effectiveness of methods to. establish the diagnosis of ADHD updates the comparative effectiveness of pharmacologic and. nonpharmacologic treatments and evaluates different monitoring strategies in the primary care. setting for individuals from birth through 17 years of age. Data sources We searched PubMed Embase PsycINFO and the Cochrane Database of. Systematic Reviews for relevant English language studies published from January 1 2011. through November 7 2016, Review methods Two investigators screened each abstract and full text article for inclusion.
abstracted the data and performed quality ratings and evidence grading Random effects models. were used to compute summary estimates of effects when sufficient data were available for. meta analysis, Results Evidence was contributed from 103 articles describing 90 unique studies Twenty one. studies related to diagnosis 69 studies related to treatment and no studies were identified on. monitoring The Attention and Executive Function Rating Inventory and Childhood Executive. Functioning Inventory performed better than the Cambridge Neuropsychological Test. Automated Battery for the diagnosis of ADHD for ages 7 17 years strength of evidence. SOE low Evidence was insufficient on the use of electroencephalography EEG or. neuroimaging to establish the diagnosis of ADHD for ages 7 17 years No studies directly. assessed the harms to children labeled as having ADHD Limited additional evidence published. since the original 2011 report was available on ADHD medications approved by the Food and. Drug Administration FDA compared with placebo or compared to different FDA approved. ADHD medications SOE insufficient For atomoxetine and methylphenidate the most. Attention Deficit Hyperactivity Disorder Diagnosis and Treatment in Children and Adolescents Structured Abstract Objectives Attention deficit hyperactivity disorder ADHD is a common pediatric neurobehavioral disorder often treated in the primary care setting This systematic review

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