In-depth review reveals the latest evidence on ADHD diagnosis, treatment, and monitoring

Hundreds of studies on attention-deficit/hyperactivity disorder (ADHD) are published each year, but more research is needed to ensure that their findings improve lives.

Researchers at the Southern California Center for Evidence Review, part of the Keck School of Medicine at the University of Southern California, will compile the latest insights with input from expert stakeholders in the field to ultimately provide information. Did. clinical practice. Broadly speaking, we found that both pharmacotherapy and psychosocial treatments are effective in treating ADHD, and that children with ADHD can and do improve.

“There is more research than ever on ADHD, but we need to summarize it in a reliable and valid way,” said Dr. Suzanne Hempel, professor and director of clinical population and public health sciences at the Keck School of Medicine. Ta. of the Southern California Evidence Review Center, which supervised this work.

The team includes researchers from the Southern California Center for Evidence-Based Practice, the Division of Child Psychiatry at the Keck School of Medicine, and the Behavioral Health Institute at Children's Hospital Los Angeles, and has published more than 23,000 studies on ADHD. I considered things. Their research was commissioned by the Agency for Healthcare Research and Quality.

Results will be published in two parts fellow paper in a diary Pediatrics, answers big questions about what works to effectively diagnose and treat ADHD and points out ongoing gaps in research, including how best to monitor the progression of the condition over time. Clinicians selected by the American Academy of Pediatrics (AAP) will now use their review of the evidence to develop updated clinical guidelines to inform best practices for ADHD care across the United States.

“Parents, teachers, and health care providers need evidence-based information about ADHD,” Hempel said. “We included only the most robust studies in our review, which allows us to state the strongest evidence.”

New findings regarding diagnosis and treatment

Before starting the literature review, the research team made the following observations. Questions and protocols We collaborate with ADHD experts in the field to ensure we ask and answer questions that can directly benefit patients, families, and healthcare providers. Along the way, the researchers also posted their preliminary findings and welcomed feedback during a 45-day public comment period.

The team conducted extensive research that was not limited to diagnostic tools and treatment approaches that were already known to be effective. From over 23,000 publications, the researchers selected 550 studies for final analysis. Studies were selected if they met the team's rigorous selection criteria, which prioritized rigorous study designs such as randomized controlled trials.

Many tools are available for diagnosing ADHD, including parent and teacher rating scales, patient self-report, neuropsychological testing, EEG approaches, imaging, biomarkers, and activity monitoring and observation. Researchers found wide variation in results for several approaches, with some studies showing that a particular method was highly effective and others showing it to be less effective. .

“Diagnosis of ADHD is improving, but research is still characterized by a lot of variation,” Hempel said.

Many treatments for ADHD have been rigorously tested, building a strong evidence base for pharmacotherapy (including both stimulant and non-stimulant drugs) and psychosocial approaches, including: behavior modification. Other non-drug treatments analyzed by the team included cognitive training, neurofeedback, gymnasticsnutrition and supplements, parent support, and school interventions.

“Medication has the strongest evidence to improve not only ADHD symptoms, but also other problems associated with ADHD, such as oppositional and destructive behavior,” said Dr. said Dr. Bradley Peterson. CHLA) and lead author of the review.

Long-term monitoring of ADHD

In addition to reviewing the evidence regarding diagnosis and treatment, researchers investigated what is known about ongoing monitoring of ADHD. How can health care providers assess whether a child or adolescent needs to continue treatment for this condition? Experts in the field agree that this is a serious issue. However, few studies have investigated this issue.of Consideration of the evidence The research team concluded that further research is needed to monitor ADHD over time.

These publications will be used to support AAP updates. Clinical practice guidelines for ADHDprovides up-to-date advice on how best to diagnose, evaluate, and treat conditions.

“The key point is that ADHD is treatable. There's a lot of research showing that kids absolutely can get better,” Hempel said.