title: Attention-deficit/hyperactivity disorder: identifying high priority future research needs.
abstract: With onset often occurring before 6 years of age, attention-deficit/hyperactivity disorder (ADHD) involves attention problems, impulsivity, overactivity, and sometimes disruptive behavior. Impairment usually persists into adulthood, with an estimated worldwide prevalence in adults of 2.5%. Existing gaps in evidence concerning ADHD hinder decision-making about treatment. This article describes and prioritizes future research needs for ADHD in three areas: treatment effectiveness for at-risk preschoolers; long-term treatment effectiveness; and variability in prevalence, diagnosis, and treatment.Using a recent systematic review concerning ADHD completed by a different evidence-based practice center as a foundation, we worked with a diverse group of 12 stakeholders, who represented researchers, funders, healthcare providers, patients, and families, to identify and prioritize research needs. From an initial list of 29 evidence gaps, we enumerated 8 high-priority research needs: a) accurate, brief standardized diagnosis and assessment; b) comparative effectiveness and safety of pharmacologic treatments for children under 6 years of age; c) comparative effectiveness of different combinations of psychosocial and pharmacologic treatments for children under 6 years of age; d) case identification and measurement of prevalence and outcomes; e) comparative effectiveness of psychosocial treatment alone versus pharmacologic and combination treatments for children under 6 years of age; f) comparative long-term treatment effectiveness for people 6 years of age and older; g) relative efficacy of specific psychosocial program components for children under 6 years of age; and h) identification of person-level effect modifiers for people 6 years of age and older. In this article, we describe these future research needs in detail and discuss study designs that could be used to address them.
authors.affiliation: GAYNES, WINES, JONAS, ELLIS, and CAREY: University of North Carolina at Chapel Hill and the Cecil G. Sheps Center for Health Services Research, RTI-UNC Evidence-based Practice Center, Chapel Hill, NC; CHRISTIAN: University of North Carolina at Chapel Hill and the Carolina Institute for Developmental Disabilities, Chapel Hill, NC; SAAVEDRA, VISWANATHAN, and WOODELL: Research Triangle Institute International, RTI-UNC Evidence-based Practice Center, Research Triangle Park, NC.
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Gaynes
authors.forename: Robert
authors.initials: R
authors.lastname: Christian
authors.forename: Lissette M
authors.initials: LM
authors.lastname: Saavedra
authors.forename: Roberta
authors.initials: R
authors.lastname: Wines
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Jonas
authors.forename: Meera
authors.initials: M
authors.lastname: Viswanathan
authors.forename: Alan R
authors.initials: AR
authors.lastname: Ellis
authors.forename: Carol
authors.initials: C
authors.lastname: Woodell
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Carey
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D035843:Biomedical Research / Q000592:standards*; D006302:Health Services Research / Q000592:standards*; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000592:standards*; D012107:Research Design / Q000592:standards*; D012196:Review Literature as Topic; D014481:United States; D016270:United States Agency for Healthcare Research and Quality