The Treatment of Attention-Deficit Hyperactivity Disorder: An Annotated Bibliography and Critical Appraisal of Published Systematic Reviews and Metaanalyses

Author:

Jadad Alejandro R1,Booker Lynda2,Gauld Mary2,Kakuma Ritsuko3,Boyle Michael4,Cunningham Charles E5,Kim Marie6,Schachar Russell7

Affiliation:

1. Director, McMaster Evidence-based Practice Center, Health Information Research Unit; Professor, Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario

2. Research Associate, McMaster Evidence-based Practice Center, Health Information Research Unit; Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario

3. Project Assistant, McMaster Evidence-based Practice Center, Health Information Research Unit; Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario

4. Professor, Department of Psychiatry and Behavioural Neurosciences, Hamilton Health Sciences Corporation; Department of Clinical Epidemiology & Biostatistics, McMaster University; Department of Psychiatry, McMaster University, Hamilton, Ontario

5. Professor, Department of Psychology, Hamilton Health Sciences Corporation; Department of Psychiatry, McMaster University; Department of Psychology, McMaster University, Hamilton, Ontario

6. Assistant Professor, Department of Pediatrics, McMaster University, Hamilton Health Sciences Corporation, Hamilton, Ontario

7. Professor, Department of Psychiatry, University of Toronto; Director, Division of Child & Adolescent Psychiatry, University of Toronto; Division of Child Psychiatry, Research Institute, the Hospital for Sick Children, Toronto, Ontario

Abstract

Context: The Agency for Health Care Policy and Research charged the McMaster Evidence-based Practice Center with conducting a comprehensive systematic review of the literature on the treatment of attention-deficit hyperactivity disorder (ADHD), with input from various groups of stakeholders. One strategy used to avoid duplication of work included a critical appraisal of existing systematic reviews and metaanalyses. Objective: To identify and appraise published metaanalyses and systematic reviews on the treatment of ADHD and to produce an annotated bibliography. Data Sources: Medline, Cumulative Index in Nursing and Allied Health (CINAHL), Healthstar, Psycinfo, and Embase were searched to September 1998; the Cochrane Database (1998 issue 3), selected Internet sites, and the files of investigators were also reviewed. Study Selection: Review articles described as systematic reviews or metaanalyses or including a Methods section were identified independently by 3 reviewers. Data Extraction: Two reviewers extracted, by consensus, relevant information on the name, methodological quality, ADHD-related aspects (comorbid disorders, family characteristics) of those reviews; data on the population, study setting, interventions, and outcomes evaluated by the reviews were also retrieved. Results: Thirteen reviews, published from 1982 to 1998, were included. Eight included metaanalysis and 5 a qualitative review. Non-pharmacological treatments were mentioned in 6 reviews and combination therapies in 3. One review focused on the treatment of adults. Forty-seven drugs and 20 adverse effects were mentioned. Most reviews had major methodological flaws. Conclusions: Most published systematic reviews and metaanalyses on the treatment of ADHD have limited value for guiding clinical, policy, and research decisions. A rigorous, systematic review following established methodological criteria is warranted.

Publisher

SAGE Publications

Subject

Psychiatry and Mental health

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