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18 TABLE 2 Clinical effectiveness An overview of trials included in the review – and comparators (cont’d) Study Placebo/st. comm. care/attent. contr. Non-drug (+ placebo) MPH low dose MPH medium dose MPH high dose MPH low dose + non-drug MPH medium dose + non-drug MPH high dose + non-drug MPH-SR low dose MPH-SR medium dose MPH-SR high dose MPH-SR low dose + non-drug MPH-SR medium dose + non-drug MPH-SR high dose + non-drug MPH low dose + MPH-SR 20 mg MPH + thioridazine hydrochloride DEX low dose DEX medium dose DEX high dose DEX medium dose + non-drug DEX high dose + non-drug DEX-TR/ER DEX-SR + non-drug ATX L+M ATX H Caffeine Pemoline Pemoline + non-drug Imipramine Adderall Adderall + non-drug MAOI + diet GLA 500 mg + vitamin E Chlorpromazine Hydroxyzine Levoamphetamine Thioridazine hydrochloride Pindolol Age (years) IQ 4.0–5.1 60 × × × 6.1–18.2 NR × × × 6.9–12.2 100 × × × × 6.0–12 NR × × [Confidential information removed] 6.0–12 NR × × × 12.0–19 101 × × 12.0–18 109 × × 5.6–11.9 109 × × 7.0–13 NR × × × × × × 7.0–15 NR × × 7.0–13 94 × 2 × 5.0–17 NR × × 2 8.0–18 NR × 2 × 6.0–16 NR × × 6.0–15 NR × × 7–9.9 101 × × × × 6.5–11 95 × × × 8.1–13.2 106 × × × × × 5.4–9.9 111 × × × × × × 5.8–12.7 NR × × × 2 6.0–12 110 × × 2 3 6.0–12 105 × × × 6.0–11 NR × × × Handen, 199960 Hoeppner, 1997 61 James, 2001 62 Kelsey, 2004 63 Kemner, 2004 99 Klein, 1997 65 Klorman, 1987 66 Klorman, 1990 67 Klorman, 1994 68 Kolko, 1999 69 Kratochvil, 2002 70 Kupietz, 1988 71 Manos, 1999 72 Michelson, 2001 73 Michelson, 2002 74 Michelson, 2004 75 MTA, 1999 76 Pelham, 1987 77 Pelham, 1990 78 Pelham, 1993 79 Pelham, 1999 80 Pelham, 1999 81 Pelham, 2001 82 Pliszka, 2000 100 continued
TABLE 2 An overview of trials included in the review – and comparators (cont’d) Study Placebo/st. comm. care/attent. contr. Non-drug (+ placebo) MPH low dose MPH medium dose MPH high dose MPH low dose + non-drug MPH medium dose + non-drug MPH high dose + non-drug MPH-SR low dose MPH-SR medium dose MPH-SR high dose MPH-SR low dose + non-drug MPH-SR medium dose + non-drug MPH-SR high dose + non-drug MPH low dose + MPH-SR 20 mg MPH + thioridazine hydrochloride DEX low dose DEX medium dose DEX high dose DEX medium dose + non-drug DEX high dose + non-drug DEX-TR/ER DEX-SR + non-drug ATX L+M ATX H Caffeine Pemoline Pemoline + non-drug Imipramine Adderall Adderall + non-drug MAOI + diet GLA 500 mg + vitamin E Chlorpromazine Hydroxyzine Levoamphetamine Thioridazine hydrochloride Pindolol Age (years) IQ © Queen’s Printer and Controller of HMSO 2006. All rights reserved. Health Technology Assessment 2006; Vol. 10: No. 23 Quinn, 200384 [Confidential information removed] Rapport, 1989 85 5.0–15 100 × 3 × Schachar, 1997 86 6.0–12 108 × × Smith, 1998 88 12.0–17 101 × × 2 Spencer, 2002 89 7.0–13 105 × × Steele, 2004 90 [Confidential information removed] Stein, 1996 91 6.0–12 NR × 3 Stein, 2003 92 5.9–16 107 × × × × Swanson, 2004 32 6.0–12 NR × 2 2 2 Tervo, 2002 93 9.9 (2.9) NR × × × Weiss, 2004 94 [Confidential information removed] Wernicke, 2004 95 7.0–12 NR × × Werry, 1980 96 5.5–12.5 NR × × × Wolraich, 2001 97 6.0–12 NR × × × Zeiner, 199998 7.0–12 102 × × NR, not reported; SR, single release, ER, extended release. 19
Page 1 and 2: A systematic review and economic mo
Page 3 and 4: A systematic review and economic mo
Page 5 and 6: Objectives: To assess the clinical
Page 7 and 8: Glossary and list of abbreviations
Page 9 and 10: Glossary Adverse effect An abnormal
Page 11 and 12: Glossary continued effects. Sometim
Page 13 and 14: Glossary continued point between tw
Page 15 and 16: Background Attention deficit hypera
Page 17 and 18: mean differences with 95% confidenc
Page 19: This review examines the clinical a
Page 22 and 23: 4 Background E. Symptoms should not
Page 24 and 25: 6 Background Concerta XL Concerta X
Page 26 and 27: 8 Methods for reviewing effectivene
Page 28 and 29: 10 Methods for reviewing effectiven
Page 31 and 32: Quantity and quality of research av
Page 33 and 34: TABLE 1 The quality of included stu
Page 35: TABLE 2 An overview of trials inclu
Page 39 and 40: TABLE 3 MPH low dose (≤15 mg/day)
Page 41 and 42: Quality of life Only one of the 12
Page 43 and 44: TABLE 5 MPH medium dose (15-30 mg/d
Page 45 and 46: Hyperactivity All nine studies that
Page 47 and 48: TABLE 6 Results for hyperactivity [
Page 49 and 50: Study Parallel trials Buitelaar 199
Page 51 and 52: TABLE 8 Results for hyperactivity [
Page 53 and 54: Study Parallel trials Gittelman-Kle
Page 55 and 56: TABLE 11 MPH high dose (>30 mg/day)
Page 57 and 58: TABLE 14 ER-MPH medium dose (20-40
Page 59 and 60: Study Crossover trials Stein 2003 S
Page 61 and 62: TABLE 19 Results for hyperactivity
Page 63 and 64: TABLE 22 MPH low dose (≤ 15 mg/da
Page 65 and 66: TABLE 24 MPH medium dose (15-30 mg/
Page 67 and 68: assessed by parents and teachers. I
Page 71 and 72: TABLE 30 DEX medium dose (10-20 mg/
Page 75 and 76: TABLE 38 DEX medium dose (10-20 mg/
Page 77 and 78: TABLE 41 DEX-SR plus non-drug inter
Page 79 and 80: Study Michelson 2001 [0.5] Michelso
Page 81 and 82: Hyperactivity Five trials (publishe
Page 83 and 84: TABLE 47 IR-MPH low-dose (≤ 15 mg
Page 85 and 86: 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
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TABLE 80 Response a rates (%) estim
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TABLE 82 Drug costs used in the cos
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The review of the economic evidence
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Extrapolation A secondary analysis
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economic model rests on the assumpt
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TABLE 87 Data used in calculating w
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not fully probabilistic. The averag
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Probability cost-effective 1.0 0.9
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TABLE 93 Results of sensitivity ana
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Base case model Responder to MPH Re
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TABLE 96 Results of the sensitivity
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The same method for synthesising th
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TABLE 103 Results of the economic m
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of the 64 identified in the clinica
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126 Discussion impact of active dru
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MPH, DEX and ATX improve hyperactiv
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1. National Institute for Clinical
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tutoring on the behavior and achiev
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91. Stein MA, Blondis TA, Schnitzle
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140. Hill P, Taylor E. An auditable
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189. Francis S, Fine J, Tannock R.
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235. Rhodes SM, Coghill DR, Matthew
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hyperactive boys: comparative and c
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This version of HTA monograph volum
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380 Health Technology Assessment Pr
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382 Health Technology Assessment Pr
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