32 TABLE 7 Clinical <strong>effectiveness</strong> MPH high dose (>30 mg/day) versus placebo Study Design Intervention – N Age Duration Core outcomes (years) (weeks) Administered two or more times daily Gittelman-Klein, 197657 P MPH (max. 60 mg/day, b.d.) – 166 6–12 12 Core: no core symptoms reported QoL: not reported AE: side effects st<strong>and</strong>ardised form: severity <strong>and</strong> consistency C (2×) MPH (25–40 mg/day, t.d.s.) – 19 12–19 6 Core: no hyp; Abbreviated Conners’ Questionnaire QoL: no CGI; Loney <strong>and</strong> Ordona Scale: response (patients <strong>and</strong> parents) AE: STESS (based on interview with parent <strong>and</strong> patient) Klorman, 1987 66 Brown, 198843 C (4×) MPH (42.56 mg/day, b.d.) –11 13–15 8 Core: CPRS: Hyperactivity Index; Conners’ Teacher Hyperactivity Index; ACTeRS: hyperactivity QoL: not reported AE: SERS (parents); weight Barkley, 199039 C (3×) MPH (1.0 mg/kg/day, b.d.) – 83 5–13 3 Core: not reported QoL: not reported AE: Stimulant Drug Side Effects Questionnaire: 17-item list Klorman, 199067 C (2×) MPH (35.21 mg/day, t.d.) – 48 12–18 6 Core: Abbreviated Conners’ Hyperactivity Questionnaire (parents, teachers); IOWA inattention/overactivity scale (parents, teachers); TOTS: hyperactivity <strong>and</strong> attention scales (parents, teachers) QoL: no CGI; ratings <strong>of</strong> global outcome (parents/patients) AE: STESS (patients, parents); Nowlis Mood Scale: fatigue (patients); weight Pelham, 199379 C (3×) MPH (32 mg/day, b.d.) – 31 5.4–9.9 6 Core: no hyp; IOWA CTRS: inattention/overactivity QoL: not reported AE: not reported Ahmann, 199335 C (3×) MPH (1.5 mg/kg/day, t.d.) – 234 5–15 4 Core: not reported QoL: not reported AE: BSEQ C (4×) MPH (1.2 mg/kg/day, b.d.) – 22 7–13 6 Core: no hyp; IOWA CTRS: inattention/overactivity QoL: not reported Kolko, 1999 69 AE: SSERS P MPH (15, 30 or 45 mg/day, t.d.) – 312 6–12 4 Core: SNAP-IV Hyperactivity/Impulsivity (teacher rated) (parent rated) QoL: CGI (investigator rated) AE: solicited <strong>and</strong> spontaneous reports: focus on sleep quality, tics <strong>and</strong> appetite (parent) Wolraich, 2001 97 Quinn, 2003 84 [Confidential information removed] ACTeRS, ADD-H Comprehensive Teachers’ Rating Scale; b.d., twice daily; BSEQ, Barkley Side Effects Questionnaire; C, crossover trial (number <strong>of</strong> crossovers); CGI, Clinical Global Impression; CPRS, Conners’ Parent Rating Scale; CTRS, Conners’ Teacher Rating Scale; P, parallel trial; SNAP, Swanson, Nolan <strong>and</strong> Pelham (scale); SSERS, Stimulant Drug Side Effects Rating Scale; t.d.s., three times daily.
TABLE 8 Results for hyperactivity [MPH High dose (>30 mg/day) versus placebo] Study Scale MPH high dose: Placebo: mean (SD) p-Value (if reported) or mean (SD) mean differencea 6–12 years Wolraich, 2001 97 MD (95%CI) SNAP-IV Hyperactivity/Impulsivity (teacher) 0.93 (0.79) 1.57 (0.89) –1.26 (–1.44 to –1.08) SNAP-IV Hyperactive/Impulsivity (parent) 1.10 (0.69) 1.83 (0.89) –0.58 (–0.73 to –0.43) 13–15 years Brown, 1988 43 CPRS (Hyperactivity Index) 9.33 (2.06) 12.66 (4.13) NS Conners’ Teacher Hyperactivity Index 17.33 (3.72) 24.50 (2.81)
- Page 1 and 2: A systematic review and economic mo
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- 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
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- Page 15 and 16: Background Attention deficit hypera
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- Page 73 and 74: TABLE 33 Results for hyperactivity
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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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