The benefits and harms of methylphenidate treatment for attention deficit hyperactivity disorder (ADHD) in children and adolescents: preliminary results

Article type
Authors
Storebø OJ1, Krogh HB1, Ramstad E1, Danvad Nilausen T1, Rosendal S1, Skoog M2, Groth C3, Holmskov M1, Løgstrup Magnusson F1, Forsbøl B4, Buch Rasmussen K1, Kirubakaran R5, Zwi M6, Gillies D7, Gauci D8, Riegl M9, Maia CR10, Simonsen E1, Gluud C2
1Psychiatric Research Unit, Region Zealand Psychiatry, Denmark
2Copenhagen Trial Unit, Centre for Clinical Intervention Research, Copenhagen University Hospital, Denmark
3Paediatric Department, Herlev University Hospital, Denmark
4Child Psychiatric Clinic, Child and Adolescent Psychiatric Department, Region Zealand, Denmark
5South Asian Cochrane Network & Centre, Prof. BV Moses & ICMR Advanced Centre for Research & Training in Evidence Informed Health Care Christian Medical College, India
6Richmond Royal Hospital, South West London & St George's NHS Mental Health Trust, United Kingdom
7Western Sydney Local Health District - Mental Health Cumberland Hospital, Australia
8Department Health Information and Research, Ministry of Health, Malta
9Medicines and Healthcare Products Regulatory Agency, Special Populations Unit (Paediatrics), United Kingdom
10ADHD Outpatient Program (ProDAH), Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil
Abstract
Introduction:
In this large Cochrane systematic review we will include about 150 randomised clinical trials (RCTs) and 220 non-randomised studies (NRS) for assessment of benefits and harms. The organizational and logistical challenges in conducting this review and synthesizing data were tremendous.

Aim:
To assess the benefits and harms of methylphenidate treatment for attention deficit hyperactivity disorder (ADHD) in children and adolescents.

Methods:
The work is being conducted by an international research group of 19 people, and the organisation of references, data extractions, and author correspondences to obtain additional data from about 250 studies, are organised using the online reference software Mendeley and Google Drive. The benefits are measured by parallel and cross-over RCT studies and these are combined in large meta-analyses as well as case control studies. The harms are assessed by both RCTs and NRS studies. The cohort studies are synthesised by the use of weighted means and case reports reported qualitatively. We are using a hierarchy structure for the different study designs in relation to each adverse outcome and thereby showing all the possible evidence from RCTs to case studies. Different subgroup analyses are conducted including risk of bias, types of rating scales, duration of treatment, parallel compared to 1st period cross over trials, sex, dose, and age.

Results:
Approximately 370 included studies are being processed systematically and the review is scheduled to be completed mid-2014. The logistical challenges, the organisation of the large amount of data and preliminary results are presented.