Evidence, interpretation, and qualification from multiple reports of long-term outcomes in the Multimodal Treatment Study of children with ADHD (MTA): Part II: supporting details.
OBJECTIVE
To review and provide details about the primary and secondary findings from the Multimodal Treatment study of ADHD (MTA) published during the past decade as three sets of articles.


METHODS
In the second of a two part article, we provide additional background and detail required by the complexity of the MTA to address confusion and controversy about the findings outlined in part I (the Executive Summary).


RESULTS
We present details about the gold standard used to produce scientific evidence, the randomized clinical trial (RCT), which we applied to evaluate the long-term effects of two well-established unimodal treatments, Medication Management (MedMGT) and behavior therapy (Beh), the multimodal combination (Comb), and treatment "as usual" in the community (CC). For each of the first three assessment points defined by RCT methods and included in intent-to-treat analyses, we discuss our definition of evidence from the MTA, interpretation of the serial presentations of findings at each assessment point with a different definition of long-term varying from weeks to years, and qualification of the interim conclusions about long-term effects of treatments for ADHD based on many exploratory analyses described in additional published articles.


CONCLUSIONS
Using a question and answer format, 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 / Q000188:drug therapy / Q000628:therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D003131:Combined Modality Therapy; D006801:Humans; D011613:Psychotherapy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
D000697:Central Nervous System Stimulants