title: The pharmacological and non-pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: protocol for a systematic review and network meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders of children and adolescents, with a significant impact on health services and the community in terms of economic and social burdens. The objective of this systematic review will be to evaluate the comparative efficacy and safety of pharmacological and non-pharmacological treatments in children and adolescents with ADHD.
  
  
  METHODS
  Searches involving PubMed/MEDLINE and the Cochrane Database of Systematic Reviews will be used to identify related systematic reviews and relevant randomized trials. Search results will be supplemented by reports from the regulatory and health technology agencies, clinical trials registers and by data requested from trialists and/or pharmaceutical companies. We will consider studies evaluating pharmacological interventions (e.g. stimulants, non-stimulants, antidepressants), psychological interventions (e.g. behavioural interventions, cognitive training and neurofeedback) and complementary and alternative medicine interventions (e.g. dietary interventions, supplement with fatty acids, vitamins, minerals, aminoacids, herbal treatment, homeopathy, and mind-body interventions including massage, chiropractic, acupuncture, yoga, meditation, Tai chi). Eligible control conditions will be placebo, waitlist, no treatment and usual care. Randomized controlled trials of a minimum of 3 weeks duration will be included. The primary outcomes of interest will be the proportion of patients who responded to treatment and who dropped out of the allocated treatment, respectively. Secondary outcomes will include treatment discontinuation due to adverse events, as well as the occurrences of serious adverse events and specific adverse events (decreased weight, anorexia, insomnia and sleep disturbances, anxiety, syncope and cardiovascular events). Two reviewers will independently screen references identified by the literature search, as well as potentially relevant full-text articles in duplicate. Data will be abstracted and risk of bias will be appraised by two team members independently. Conflicts at all levels of screening and abstraction will be resolved through discussion. Random-effects pairwise meta-analyses and Bayesian network meta-analyses will be conducted where appropriate.
  
  
  CONCLUSIONS
  This systematic review and network meta-analysis will compare the efficacy and safety of treatments used for ADHD in children and adolescents. The findings will assist patients, clinicians and healthcare providers to make evidence-based decisions regarding treatment selection.
  
  
  BACKGROUND
  PROSPERO CRD42014015008 .
authors: Fundación Instituto de Investigación en Servicios de Salud, Valencia, Spain. ferran_catala@hotmail.com.
authors: Ferrán
authors: F
authors: Catalá-López
authors: Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), Ottawa, ON, Canada. bhutton@ohri.ca.|Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada. bhutton@ohri.ca.
authors: Brian
authors: B
authors: Hutton
authors: Centro de Atención Integral a Drogodependientes (CAID) Norte, Regional Health Council, Madrid, Spain. anunezbeltran@hotmail.com.
authors: Amparo
authors: A
authors: Núñez-Beltrán
authors: Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), Ottawa, ON, Canada. almayhew@ohri.ca.
authors: Alain D
authors: AD
authors: Mayhew
authors: Australasian Cochrane Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. matthew.page@monash.edu.
authors: Matthew J
authors: MJ
authors: Page
authors: Instituto Aragonés de Ciencias de la Salud (IACS), Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Zaragoza, Spain. ridao_man@gva.es.|FISABIO-Salud Pública, Valencia, Spain. ridao_man@gva.es.
authors: Manuel
authors: M
authors: Ridao
authors: Spanish Council for Scientific Research (CSIC), Barcelona, Spain. aurelio.tobias@idaea.csic.es.
authors: Aurelio
authors: A
authors: Tobías
authors: University of Valencia, Valencia, Spain. miguel.a.catala@uv.es.
authors: Miguel A
authors: MA
authors: Catalá
authors: University of Valencia/CIBERSAM, and Instituto de Investigación Sanitaria de Valencia (INCLIVA), Valencia, Spain. rafael.tabares@uv.es.
authors: Rafael
authors: R
authors: Tabarés-Seisdedos
authors: Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), Ottawa, ON, Canada. dmoher@ohri.ca.|Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada. dmoher@ohri.ca.
authors: David
authors: D
authors: Moher
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy / Q000628:therapy*; D001521:Behavior Therapy; D002491:Central Nervous System Agents / Q000627:therapeutic use*; D002648:Child; D002985:Clinical Protocols; D000529:Complementary Therapies; D006801:Humans; D017063:Outcome Assessment, Health Care; D012107:Research Design; D000078202:Systematic Reviews as Topic; D015201:Meta-Analysis as Topic
chemical_list: D002491:Central Nervous System Agents