Evidence, interpretation, and qualification from multiple reports of long-term outcomes in the Multimodal Treatment study of Children With ADHD (MTA): part I: executive summary.
OBJECTIVE
To review the primary and secondary findings from the Multimodal Treatment study of ADHD (MTA) published over the past decade as three sets of articles.


METHODS
In a two-part article-Part I: Executive Summary (without distracting details) and Part II: Supporting Details (with additional background and detail required by the complexity of the MTA)-we address confusion and controversy about the findings.


RESULTS
We discuss the basic features of the gold standard used to produce scientific evidence, the randomized clinical trial, for which was used to contrast four treatment conditions: medication management alone (MedMgt), behavior therapy alone (Beh), the combination of these two (Comb), and a community comparison of treatment "as usual" (CC). For each of the three assessment points we review three areas that we believe are important for appreciation of the findings: definition of evidence from the MTA, interpretation of the serial presentations of findings at each assessment point with a different definition of long-term, and qualification of the interim conclusions about long-term effects of treatments for ADHD.


CONCLUSIONS
We discuss the possible clinical relevance of the MTA and present some practical suggestions based on current knowledge and uncertainties facing families, clinicians, and investigators regarding the long-term use of stimulant medication and behavioral therapy in the treatment of children with ADHD.
UCI Child Development Center, University of California, Irvine, Irvine, CA 92612, USA. jmswanso@uci.edu
James
J
Swanson
L Eugene
LE
Arnold
Helena
H
Kraemer
Lily
L
Hechtman
Brooke
B
Molina
Stephen
S
Hinshaw
Benedetto
B
Vitiello
Peter
P
Jensen
Ken
K
Steinhoff
Marc
M
Lerner
Laurence
L
Greenhill
Howard
H
Abikoff
Karen
K
Wells
Jeffery
J
Epstein
Glen
G
Elliott
Jeffrey
J
Newcorn
Betsy
B
Hoza
Timothy
T
Wigal
D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D032921:Consensus; D006801:Humans; D011613:Psychotherapy; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D000697:Central Nervous System Stimulants