Clinical relevance of the primary findings of the MTA: success rates based on severity of ADHD and ODD symptoms at the end of treatment.
J Am Acad Child Adolesc Psychiatry
; 40(2): 168-79, 2001 Feb.
Article
en En
| MEDLINE
| ID: mdl-11211365
ABSTRACT
OBJECTIVES:
To develop a categorical outcome measure related to clinical decisions and to perform secondary analyses to supplement the primary analyses of the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder (MTA).METHOD:
End-of-treatment status was summarized by averaging the parent and teacher ratings of attention-deficit/hyperactivity disorder and oppositional defiant disorder symptoms on the Swanson, Nolan, and Pelham, version IV (SNAP-IV) scale, and low symptom-severity ("Just a Little") on this continuous measure was set as a clinical cutoff to form a categorical outcome measure reflecting successful treatment. Three orthogonal comparisons of the treatment groups (combined treatment [Comb], medication management [MedMgt], behavioral treatment [Beh], and community comparison [CC]) evaluated hypotheses about the MTA medication algorithm ("Comb + MedMgt versus Beh + CC"), multimodality superiority ("Comb versus MedMgt"), and psychosocial substitution ("Beh versus CC").RESULTS:
The summary of SNAP-IV ratings across sources and domains increased the precision of measurement by 30%. The secondary analyses of group differences in success rates (Comb = 68%; MedMgt = 56%; Beh = 34%; CC = 25%) confirmed the large effect of the MTA medication algorithm and a smaller effect of multimodality superiority, which was now statistically significant (p < .05). The psychosocial substitution effect remained negligible and nonsignificant.CONCLUSION:
These secondary analyses confirm the primary findings and clarify clinical decisions about the choice between multimodal and unimodal treatment with medication.
Buscar en Google
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Psicometría
/
Trastorno por Déficit de Atención con Hiperactividad
/
Índice de Severidad de la Enfermedad
/
Ensayos Clínicos Controlados Aleatorios como Asunto
/
Déficit de la Atención y Trastornos de Conducta Disruptiva
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Child
/
Humans
Idioma:
En
Revista:
J Am Acad Child Adolesc Psychiatry
Asunto de la revista:
PEDIATRIA
/
PSIQUIATRIA
Año:
2001
Tipo del documento:
Article
País de afiliación:
Estados Unidos