title: Management strategies for attention-deficit/hyperactivity disorder: a regional deliberation on the evidence.
abstract: Parents, clinicians, and policymakers require the latest evidence to help inform treatment decisions. The New England Comparative Effectiveness Public Advisory Council (CEPAC) leverages existing federally produced comparative effectiveness research supplemented with additional clinical and economic analyses to deliberate on the latest evidence. At its June 2012 meeting, the CEPAC voted on the evidence for the treatment of attention-deficit/hyperactivity disorder (ADHD) in preschoolers and school-aged children. The CEPAC voted unanimously that parent behavior training was better than usual care (eg, wait-list control) for the preschool population. They also judged it to be of "reasonable value" compared with usual care. The CEPAC also stipulated unanimously that medications are better than usual care (eg, services provided at individual practitioner discretion) for school-aged children in regards to long-term effectiveness and safety. The CEPAC members and clinical experts recommended the increased use of parent behavior training as first-line therapy for preschoolers and emphasized the importance of proper monitoring of and dosing for all children who receive medication for their ADHD symptoms. The ADHD CEPAC meeting demonstrated the important role that a public, transparent deliberation on the latest medical evidence can have in supporting informed decision making and efficient use of health care resources.
authors.affiliation: Institute for Clinical and Economic Review, MGH Institute for Technology Assessment, Boston, MA 02114, USA. semond@icer-review.org
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Emond
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Ollendorf
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Colby
authors.forename: Sarah Jane
authors.initials: SJ
authors.lastname: Reed
authors.forename: Steven D
authors.initials: SD
authors.lastname: Pearson
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D000697:Central Nervous System Stimulants / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D057186:Comparative Effectiveness Research; D019317:Evidence-Based Medicine; D006801:Humans; D008774:Methylphenidate / Q000008:administration & dosage*; D009511:New England / Q000453:epidemiology; D016487:Parenting; D017410:Practice Guidelines as Topic; D015995:Prevalence
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate