Volume 104, Issue 4 p. 638-643

Risk of Bias and Quality of Evidence for Treatment of ADHD With Stimulant Medication

James M. Swanson

Corresponding Author

James M. Swanson

University of California, Irvine, Irvine, California, USA

. Correspondence: James M. Swanson ([email protected])Search for more papers by this author
First published: 31 July 2018
Citations: 6


Storebø et al. provide a concise summary of two Cochrane reviews about benefits and harms of treatment of attention-deficit/hyperactivity disorder (ADHD) with methylphenidate: (1) a review of 185 randomized controlled trials that estimated benefits (e.g., moderate-to-large reduction in teacher-rated ADHD symptoms) and (2) a review of 260 nonrandomized trials that estimated harms (e.g., infrequent serious but frequent nonserious adverse events). They also mention (without providing much detail) additional information from the structured Cochrane method about the risk for bias in the trials reviewed (assessed as being high) and quality of evidence of the outcomes considered (rated as being very low). This led to the conclusion that “the jury is still out on benefits and harms.” A similar conclusion of the first review generated an extensive debate in the literature. Some details will be summarized and discussed herein to provide context in case the recent review and the summary by Storebø et al. revive the debate.

Conflict of Interest

J.M.S. acknowledges research support in the past for advisory board membership, speaker's bureau membership, and/or consulting for Alza, Richwood, Shire, Celgene, Novartis, Celltech, Gliatech, Cephalon, Watson, CIBA, UCB, Janssen, McNeil, and Lilly. In the past 2 years, J.M.S. acknowledges support for travel and advisory board membership for Medice and NLS.