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Members Chair, Professor Tom Walley, Director, NHS HTA Programme, Department of Pharmacology & Therapeutics, University of Liverpool Members Programme Director, Professor Tom Walley, Director, NHS HTA Programme, Department of Pharmacology & Therapeutics, University of Liverpool Chair, Professor Jon Nicholl, Director, Medical Care Research Unit, University of Sheffield, School of Health and Related Research Deputy Chair, Professor Jenny Hewison, Professor of Health Care Psychology, Academic Unit of Psychiatry and Behavioural Sciences, University of Leeds School of Medicine Dr Jeffrey Aronson Reader in Clinical Pharmacology, Department of Clinical Pharmacology, Radcliffe Infirmary, Oxford Professor Deborah Ashby, Professor of Medical Statistics, Department of Environmental and Preventative Medicine, Queen Mary University of London Health Technology Assessment 2006; Vol. 10: No. 23 Health Technology Assessment Programme Director, Professor Tom Walley, Director, NHS HTA Programme, Department of Pharmacology & Therapeutics, University of Liverpool Prioritisation Strategy Group Professor Bruce Campbell, Consultant Vascular & General Surgeon, Royal Devon & Exeter Hospital Dr Edmund Jessop, Medical Advisor, National Specialist, Commissioning Advisory Group (NSCAG), Department of Health, London Deputy Director, Professor Jon Nicholl, Director, Medical Care Research Unit, University of Sheffield, School of Health and Related Research Professor Jon Nicholl, Director, Medical Care Research Unit, University of Sheffield, School of Health and Related Research Dr John Reynolds, Clinical Director, Acute General Medicine SDU, Radcliffe Hospital, Oxford HTA Commissioning Board Professor Ann Bowling, Professor of Health Services Research, Primary Care and Population Studies, University College London Dr Andrew Briggs, Public Health Career Scientist, Health Economics Research Centre, University of Oxford Professor John Cairns, Professor of Health Economics, Public Health Policy, London School of Hygiene and Tropical Medicine, London Professor Nicky Cullum, Director of Centre for Evidence Based Nursing, Department of Health Sciences, University of York Mr Jonathan Deeks, Senior Medical Statistician, Centre for Statistics in Medicine, University of Oxford Dr Andrew Farmer, Senior Lecturer in General Practice, Department of Primary Health Care, University of Oxford Professor Fiona J Gilbert, Professor of Radiology, Department of Radiology, University of Aberdeen Professor Adrian Grant, Director, Health Services Research Unit, University of Aberdeen Professor F D Richard Hobbs, Professor of Primary Care & General Practice, Department of Primary Care & General Practice, University of Birmingham Professor Peter Jones, Head of Department, University Department of Psychiatry, University of Cambridge Professor Sallie Lamb, Professor of Rehabilitation, Centre for Primary Health Care, University of Warwick Professor Stuart Logan, Director of Health & Social Care Research, The Peninsula Medical School, Universities of Exeter & Plymouth Current and past membership details of all HTA ‘committees’ are available from the HTA website (www.hta.ac.uk) © Queen’s Printer and Controller of HMSO 2006. All rights reserved. Dr Ron Zimmern, Director, Public Health Genetics Unit, Strangeways Research Laboratories, Cambridge Dr Linda Patterson, Consultant Physician, Department of Medicine, Burnley General Hospital Professor Ian Roberts, Professor of Epidemiology & Public Health, Intervention Research Unit, London School of Hygiene and Tropical Medicine Professor Mark Sculpher, Professor of Health Economics, Centre for Health Economics, Institute for Research in the Social Services, University of York Dr Jonathan Shapiro, Senior Fellow, Health Services Management Centre, Birmingham Ms Kate Thomas, Deputy Director, Medical Care Research Unit, University of Sheffield Ms Sue Ziebland, Research Director, DIPEx, Department of Primary Health Care, University of Oxford, Institute of Health Sciences 379
380 Health Technology Assessment Programme Members Chair, Dr Ron Zimmern, Director of the Public Health Genetics Unit, Strangeways Research Laboratories, Cambridge Ms Norma Armston, Lay Member, Bolton Professor Max Bachmann Professor of Health Care Interfaces, Department of Health Policy and Practice, University of East Anglia Professor Rudy Bilous Professor of Clinical Medicine & Consultant Physician, The Academic Centre, South Tees Hospitals NHS Trust Dr Paul Cockcroft, Consultant Medical Microbiologist and Clinical Director of Pathology, Department of Clinical Microbiology, St Mary's Hospital, Portsmouth Members Chair, Dr John Reynolds, Chair Division A, The John Radcliffe Hospital, Oxford Radcliffe Hospitals NHS Trust Professor Tony Avery, Head of Division of Primary Care, School of Community Health Services, Division of General Practice, University of Nottingham Ms Anne Baileff, Consultant Nurse in First Contact Care, Southampton City Primary Care Trust, University of Southampton Professor Stirling Bryan, Professor of Health Economics, Health Services Management Centre, University of Birmingham Diagnostic Technologies & Screening Panel Professor Adrian K Dixon, Professor of Radiology, University Department of Radiology, University of Cambridge Clinical School Dr David Elliman, Consultant Paediatrician/ Hon. Senior Lecturer, Population Health Unit, Great Ormond St. Hospital, London Professor Glyn Elwyn, Primary Medical Care Research Group, Swansea Clinical School, University of Wales Swansea Mr Tam Fry, Honorary Chairman, Child Growth Foundation, London Dr Jennifer J Kurinczuk, Consultant Clinical Epidemiologist, National Perinatal Epidemiology Unit, Oxford Dr Susanne M Ludgate, Medical Director, Medicines & Healthcare Products Regulatory Agency, London Professor William Rosenberg, Professor of Hepatology, Liver Research Group, University of Southampton Dr Susan Schonfield, Consultant in Public Health, Specialised Services Commissioning North West London, Hillingdon Primary Care Trust Dr Phil Shackley, Senior Lecturer in Health Economics, School of Population and Health Sciences, University of Newcastle upon Tyne Dr Margaret Somerville, PMS Public Health Lead, Peninsula Medical School, University of Plymouth Dr Graham Taylor, Scientific Director & Senior Lecturer, Regional DNA Laboratory, The Leeds Teaching Hospitals Pharmaceuticals Panel Mr Peter Cardy, Chief Executive, Macmillan Cancer Relief, London Professor Imti Choonara, Professor in Child Health, Academic Division of Child Health, University of Nottingham Dr Robin Ferner, Consultant Physician and Director, West Midlands Centre for Adverse Drug Reactions, City Hospital NHS Trust, Birmingham Dr Karen A Fitzgerald, Consultant in Pharmaceutical Public Health, National Public Health Service for Wales, Cardiff Mrs Sharon Hart, Head of DTB Publications, Drug & Therapeutics Bulletin, London Dr Christine Hine, Consultant in Public Health Medicine, South Gloucestershire Primary Care Trust Professor Stan Kaye, Cancer Research UK Professor of Medical Oncology, Section of Medicine, The Royal Marsden Hospital, Sutton Ms Barbara Meredith, Lay Member, Epsom Dr Andrew Prentice, Senior Lecturer and Consultant Obstetrician & Gynaecologist, Department of Obstetrics & Gynaecology, University of Cambridge Dr Frances Rotblat, CPMP Delegate, Medicines & Healthcare Products Regulatory Agency, London Current and past membership details of all HTA ‘committees’ are available from the HTA website (www.hta.ac.uk) Professor Lindsay Wilson Turnbull, Scientific Director, Centre for MR Investigations & YCR Professor of Radiology, University of Hull Professor Martin J Whittle, Associate Dean for Education, Head of Department of Obstetrics and Gynaecology, University of Birmingham Dr Dennis Wright, Consultant Biochemist & Clinical Director, Pathology & The Kennedy Galton Centre, Northwick Park & St Mark’s Hospitals, Harrow Professor Jan Scott, Professor of Psychological Treatments, Institute of Psychiatry, University of London Mrs Katrina Simister, Assistant Director New Medicines, National Prescribing Centre, Liverpool Dr Richard Tiner, Medical Director, Medical Department, Association of the British Pharmaceutical Industry, London Dr Helen Williams, Consultant Microbiologist, Norfolk & Norwich University Hospital NHS Trust
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A systematic review and economic mo
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A systematic review and economic mo
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Objectives: To assess the clinical
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Glossary and list of abbreviations
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Glossary Adverse effect An abnormal
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Glossary continued effects. Sometim
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Glossary continued point between tw
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Background Attention deficit hypera
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mean differences with 95% confidenc
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This review examines the clinical a
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4 Background E. Symptoms should not
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6 Background Concerta XL Concerta X
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8 Methods for reviewing effectivene
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10 Methods for reviewing effectiven
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Quantity and quality of research av
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TABLE 1 The quality of included stu
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TABLE 2 An overview of trials inclu
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TABLE 2 An overview of trials inclu
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TABLE 3 MPH low dose (≤15 mg/day)
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Quality of life Only one of the 12
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TABLE 5 MPH medium dose (15-30 mg/d
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Hyperactivity All nine studies that
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TABLE 6 Results for hyperactivity [
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Study Parallel trials Buitelaar 199
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TABLE 8 Results for hyperactivity [
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Study Parallel trials Gittelman-Kle
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TABLE 11 MPH high dose (>30 mg/day)
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TABLE 14 ER-MPH medium dose (20-40
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Study Crossover trials Stein 2003 S
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TABLE 19 Results for hyperactivity
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TABLE 22 MPH low dose (≤ 15 mg/da
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TABLE 24 MPH medium dose (15-30 mg/
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assessed by parents and teachers. I
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TABLE 30 DEX medium dose (10-20 mg/
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TABLE 38 DEX medium dose (10-20 mg/
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TABLE 41 DEX-SR plus non-drug inter
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Study Michelson 2001 [0.5] Michelso
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Hyperactivity Five trials (publishe
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TABLE 47 IR-MPH low-dose (≤ 15 mg
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STP. 77,78 Neither examined hyperac
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Adverse events No significant diffe
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did report that there were no signi
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Summary The one study in this categ
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showed persisting significant super
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easily rectified with dosage adjust
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Aim The aim of this chapter is to r
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only level of social disability tha
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did not include a ‘global’ HRQo
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might decrease but costs would be e
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1st line pharmacotherapy Response,
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TABLE 70 Data for weighted average
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The probabilistic results were used
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The review also uncovered a mis-ref
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TABLE 77 Results of sensitivity ana
Page 115 and 116: TABLE 80 Response a rates (%) estim
Page 117 and 118: TABLE 82 Drug costs used in the cos
Page 119 and 120: The review of the economic evidence
Page 121 and 122: Extrapolation A secondary analysis
Page 123 and 124: economic model rests on the assumpt
Page 125 and 126: TABLE 87 Data used in calculating w
Page 127 and 128: not fully probabilistic. The averag
Page 129 and 130: Probability cost-effective 1.0 0.9
Page 131 and 132: TABLE 93 Results of sensitivity ana
Page 133 and 134: Base case model Responder to MPH Re
Page 135 and 136: TABLE 96 Results of the sensitivity
Page 137 and 138: The same method for synthesising th
Page 139 and 140: TABLE 103 Results of the economic m
Page 141: of the 64 identified in the clinica
Page 144 and 145: 126 Discussion impact of active dru
Page 147: MPH, DEX and ATX improve hyperactiv
Page 151 and 152: 1. National Institute for Clinical
Page 153 and 154: tutoring on the behavior and achiev
Page 155 and 156: 91. Stein MA, Blondis TA, Schnitzle
Page 157 and 158: 140. Hill P, Taylor E. An auditable
Page 159 and 160: 189. Francis S, Fine J, Tannock R.
Page 161 and 162: 235. Rhodes SM, Coghill DR, Matthew
Page 163 and 164: hyperactive boys: comparative and c
Page 165: This version of HTA monograph volum
Page 169: 382 Health Technology Assessment Pr
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