title: Antipsychotic treatment for children and adolescents with schizophrenia spectrum disorders: protocol for a network meta-analysis of randomised trials.
abstract: BACKGROUND
  Antipsychotic treatment in early-onset schizophrenia (EOS) lacks a rich evidence base, and efforts to rank different drugs concerning their efficacy have not proven any particular drug superior. In contrast to the literature regarding adult-onset schizophrenia (AOS), comparative effectiveness studies in children and adolescents are limited in number and size, and only a few meta-analyses based on conventional methodologies have been conducted.
  
  
  METHODS
  We will conduct a network meta-analysis of all randomised controlled trials (RCTs) that evaluate antipsychotic therapies for EOS to determine which compounds are efficacious, and to determine the relative efficacy and safety of these treatments when compared in a network meta-analysis. Unlike a contrast-based (standard) meta-analysis approach, an arm-based network meta-analysis enables statistical inference from combining both direct and indirect comparisons within an empirical Bayes framework. We will acquire eligible studies through a systematic search of MEDLINE, the Cochrane Central Registry of Controlled Trials, Clinicaltrials.gov and Centre for Reviews and Dissemination databases. Eligible studies should randomly allocate children and adolescents presenting with schizophrenia or a related non-affective psychotic condition to an intervention group or to a control group. Two reviewers will-independently and in duplicate-screen titles and abstracts, complete full text reviews to determine eligibility, and subsequently perform data abstraction and assess risk of bias of eligible trials. We will conduct meta-analyses to establish the effect of all reported therapies on patient-relevant efficacy and safety outcomes when possible.
  
  
  BACKGROUND
  No formal ethical procedures regarding informed consent are required as no primary data collection is undertaken. The review will help facilitate evidence-based management, identify key areas for future research, and provide a framework for conducting large systematic reviews combining direct and indirect comparisons. The study will be disseminated by peer-reviewed publication and conference presentation.
  
  
  BACKGROUND
  PROSPERO CRD42013006676.
authors.affiliation: Mental Health Services-Capital Region of Denmark and Faculty of Health Science, Child and Adolescent Mental Health Center, University of Copenhagen Denmark, Denmark.
authors.forename: A K
authors.initials: AK
authors.lastname: Pagsberg
authors.affiliation: Musculoskeletal Statistics Unit, The Parker Institute, Dept. Rheum., Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark.
authors.forename: S
authors.initials: S
authors.lastname: Tarp
authors.affiliation: The Danish Council for the Use of Expensive Hospital Medicines Secretariat, Copenhagen, Denmark.
authors.forename: D
authors.initials: D
authors.lastname: Glintborg
authors.affiliation: Department of Child and Adolescent Psychiatry, University of Southern Denmark, Odense, Denmark.
authors.forename: A D
authors.initials: AD
authors.lastname: Stenstrøm
authors.affiliation: Department of Neuroscience and Pharmacology, Psychiatric Centre Copenhagen, University Hospital Copenhagen and Laboratory of Neuropsychiatry, University of Copenhagen, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Fink-Jensen
authors.affiliation: Hofstra North Shore Long Island, Jewish School of Medicine and The Zucker Hillside Hospital, New York, New York, USA.
authors.forename: C U
authors.initials: CU
authors.lastname: Correll
authors.affiliation: Musculoskeletal Statistics Unit, The Parker Institute, Dept. Rheum., Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark.
authors.forename: R
authors.initials: R
authors.lastname: Christensen
mesh_terms: D000293:Adolescent; D002648:Child; D006801:Humans; D014150:Antipsychotic Agents / Q000627:therapeutic use; D011618:Psychotic Disorders / Q000188:drug therapy; D016032:Randomized Controlled Trials as Topic; D012559:Schizophrenia / Q000188:drug therapy; D016896:Treatment Outcome; D000071076:Network Meta-Analysis as Topic
chemical_list: D014150:Antipsychotic Agents
keywords: EPIDEMIOLOGY; PAEDIATRICS