All included treatments result ed in ADHD improvement .
On the basis of this literature review , a consistent pattern of improvement in pediatric ADHD patients ' core symptoms emerged across studies , study design s , and recommended treatment approaches .
OBJECTIVE The 2011 American Academy of Pediatrics attention-deficit/hyperactivity disorder ( ADHD ) guideline emphasizes monitoring and measuring outcomes of children diagnosed with ADHD ; however , recommendations for how to measure improvement are less clear .
A long-term goal was to develop an outcome measure that assesses the quality of care for children with ADHD .
As a first step in that process , we conducted a literature synthesis on the efficacy and effectiveness of guideline -recommended ADHD treatments on patient outcomes .
Clinical responses to atomoxetine in attention-deficit/hyperactivity disorder: the Integrated Data Exploratory Analysis (IDEA) study.
OBJECTIVE Clinical experience suggests that some ( but not all ) patients with attention-deficit/hyperactivity disorder ( ADHD ) are highly responsive to the nonstimulant atomoxetine . We conducted a retrospective analysis of r and omized controlled trials ( RCTs ) to identify potential baseline ( moderator ) and on-treatment ( mediator ) predictors of responses . METHOD Data from 6 U.S. RCTs among patients aged 6 to 18 years were pooled ( N = 1,069 ; subjects treated with atomoxetine , n = 618 ) . Subjects were categorized as much improved ( > or = 40 % decrease in ADHD Rating Scale-IV-Parent Version : Investigator Administered and Scored total score ) , minimally improved ( 25%- < 40 % decline ) , or nonresponders ( < 25 % decrease ) . Logistic regression , analyses of variance , and repeated- measures analyses were used to explore associations between baseline and on-treatment variables , achieving a much improved response at trial endpoint ( 6 - 9 weeks ) . RESULTS Forty-seven percent of patients showed a much improved clinical response , and 40 % did not respond . Only 13 % of the patients had a minimal response . No baseline characteristics predicted achieving a much improved clinical response ; the only predictor of achieving this response was being at least minimally improved by treatment week 4 ( sensitivity = 81 % , specificity = 72 % , positive predictive value = 75 % , and negative predictive value = 79 % ) . CONCLUSIONS Clinical response to atomoxetine was bimodal , with most subjects being either responders who were much improved or nonresponders . There were no demographic or clinical predictors of response . However , subjects who ultimately achieved a much improved response were likely to be at least minimal responders by week 4 . The recommendation to consider either augmenting or switching treatment in patients who do not achieve at least this level of response to atomoxetine by 4 weeks offers a method for limiting the extended duration of titration to subjects who are most likely to benefit further , while minimizing the duration of exposure in those less likely to achieve an excellent response
All included treatments result ed in ADHD improvement .
On the basis of this literature review , a consistent pattern of improvement in pediatric ADHD patients ' core symptoms emerged across studies , study design s , and recommended treatment approaches .
OBJECTIVE The 2011 American Academy of Pediatrics attention-deficit/hyperactivity disorder ( ADHD ) guideline emphasizes monitoring and measuring outcomes of children diagnosed with ADHD ; however , recommendations for how to measure improvement are less clear .
A long-term goal was to develop an outcome measure that assesses the quality of care for children with ADHD .
As a first step in that process , we conducted a literature synthesis on the efficacy and effectiveness of guideline -recommended ADHD treatments on patient outcomes .