Clinical Practice Guidelines on Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

 LIUMao-bai ¹ , ZHENGBin ¹ , LINa ¹ , ZHANGLing-li ^2,3 , LIYou-ping ⁴

1. Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou 350001, China;
2. Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu 610041, China;
3. Evidence-based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu 610041, China;
4. Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

Keywords：

Children; Adolescent; Attention-deficit/hyperactivity disorder (ADHD); Guideline; Systematic review

DOI：

10.7507/1672-2531.20150068

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Objective To systematically review the methodological quality of guidelines concerning attention-deficit/hyperactivity disorder (ADHD) in children and adolescents, and to compare differences and similarities of the drugs recommended, in order to provide guidance for clinical practice. Methods Guidelines concerning ADHD were electronically retrieved in PubMed, EMbase, VIP, WanFang Data, CNKI, NGC (National Guideline Clearinghouse), GIN (Guidelines International Network), NICE (National Institute for Health and Clinical Excellence) from inception to December 2013. The methodological quality of included guidelines were evaluated according to the AGREE Ⅱ instrument, and the differences between recommendations were compared. Results A total of 9 guidelines concerning ADHD in children and adolescents were included, with development time ranging from 2004 to 2012. Among 9 guidelines, 4 were made by the USA, 3 in Europe and 2 by UK. The levels of recommendations were Level A for 2 guidelines, and Level B for 7 guidelines. The scores of guidelines according to the domains of AGREE Ⅱ decreased from "clarity of presentations", "scope and purpose", "participants", "applicability", "rigour of development" and "editorial independence". Three evidence-based guidelines scored the top three in the domain of "rigour of development". There were slightly differences in the recommendations of different guidelines. Conclusion The overall methodological quality of ADHD guidelines is suboptimal in different countries or regions. The 6 domains involving 23 items in AGREE Ⅱ vary with scores, while the scores of evidence-base guidelines are higher than those of non-evidence-based guidelines. The guidelines on ADHD in children and adolescents should be improved in "rigour of development" and "applicability" in future. Conflicts of interest should be addressed. And the guidelines are recommended to be developed on the basis of methods of evidence-based medicine, and best evidence is recommended.

Citation： LIUMao-bai, ZHENGBin, LINa, ZHANGLing-li, LIYou-ping. Clinical Practice Guidelines on Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2015, 15(4): 403-408. doi: 10.7507/1672-2531.20150068 Copy

1.	候雪关, 明杰. 儿童注意缺陷多动障碍的遗传学研究进展. 包头医学院学报, 2013, 29(3):133-135.
2.	徐通. 儿童注意缺陷多动障碍的诊断与功能评估. 中国儿童保健杂志, 2013, 21(9):897-898.
3.	石统昆, 武丽杰, 王凤华, 等. 不同亚型注意缺陷多动障碍儿童视觉工作记忆研究. 中国妇幼保健, 2008, 23(15):2082-2084.
4.	Graham ID, Beardall S, Carter AO, et al. What is the quality of drug therapy clinical practice guidelines in Canada. CMAJ, 2001, 165(2):157-163.
5.	陈尹, 胡世莲, 李幼平, 等. 全球药物干预治疗单纯性高血压指南的系统评价. 中国循证医学杂志, 2012, 12(10):1180-1194.
6.	李春波, 何燕玲, 张明园. 一致性检验方法的合理应用. 上海精神医学, 2000, 12(4):228-230.
7.	Mahajan R, Bernal MP, Panzer R, et al. Clinical practice pathways for evaluation and medication choice for attention-deficit/hyperactivity disorder symptoms in autism spectrum disorders. Pediatrics, 2012, 130(2):125-138.
8.	Subcommittee on Attention-Deficit/Hyperactivity Disorder; Steering Committee on Quality Improvement and Management. ADHD:clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 2011, 128(5):1007-1022.
9.	List BA, Barzman DH. Evidence-based recommendations for the treatmentof aggression in pediatric patients with attention deficit hyperactivity disorder. Psychiatr Q, 2011, 82(1):33-42.
10.	Pliszka S, AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry, 2007, 46(7):894-921.
11.	Graham J, Banaschewski T, Buitelaar J, et al. European guidelines on managing adverse effects of medication for ADHD. Eur Child Adolesc Psychiatry, 2011, 20(1):17-37.
12.	Banaschewski T, Coghill D, Santosh P, et al. Long-acting medications for the hyperkinetic disorders. A systematic review and European treatment guideline. Eur Child Adolesc Psychiatry, 2006, 15(8):476-495.
13.	Taylor E, Döpfner M, Sergeant J, et al. European clinical guidelines for hyperkinetic disorder-first upgrade. Eur Child Adolesc Psychiatry, 2004, 13(1):17-30.
14.	Nutt DJ, Fone K, Asherson P, et al. Evidence-based guidelines for management of attention-deficit/hyperactivity disorder in adolescents in transition to adult services and in adults:recommendations from the British Association for Psychopharmacology. J Psychopharmacol, 2007, 21(1):10-41.
15.	Atkinson M, Hollis C. NICE guideline:attention deficit hyperactivity disorder. Arch Dis Child Educ Pract Ed, 2010, 95(1):24-27.
16.	Graf C, Wager E, Bowman A, et al. Best Practice Guidelines on Publication Ethics:a Publisher, s Perspectives. Int J Clin Pract, 2007, 61(152):1-26.
17.	Jackson G. Conflict of interest:full disclosure is essential. Int J Clin Pract, 2006, 60(10):1147-1148.
18.	Burgers IS, Cluzeau FA, Hanna SE, et al. Towards evidence-based clinical practice:an international survey of 18 clinical guideline programs. Int Qual Health Care, 2003, 15(1):31-45.
19.	杜亚松, 查彩琴, 李雪荣. 哌醋甲酯治疗注意缺陷多动障碍的疗效研究. 上海精神医学, 1997, 9(1):21-23.
20.	潘学霞, 麻宏伟, 万彬, 等. 盐酸哌甲酯控释片治疗注意缺陷多动障碍疗效观察. 中国当代儿科杂志, 2008, 10(4):471-474.
21.	Polus S, Lerberg P, Vogel J, et al. Appraisal of WHO Guidelines in Maternal Health Using the AGREE Ⅱ Assessment Tool. PloS One, 2012, 7(8):e38891.

1. 候雪关, 明杰. 儿童注意缺陷多动障碍的遗传学研究进展. 包头医学院学报, 2013, 29(3):133-135.
2. 徐通. 儿童注意缺陷多动障碍的诊断与功能评估. 中国儿童保健杂志, 2013, 21(9):897-898.
3. 石统昆, 武丽杰, 王凤华, 等. 不同亚型注意缺陷多动障碍儿童视觉工作记忆研究. 中国妇幼保健, 2008, 23(15):2082-2084.
4. Graham ID, Beardall S, Carter AO, et al. What is the quality of drug therapy clinical practice guidelines in Canada. CMAJ, 2001, 165(2):157-163.
5. 陈尹, 胡世莲, 李幼平, 等. 全球药物干预治疗单纯性高血压指南的系统评价. 中国循证医学杂志, 2012, 12(10):1180-1194.
6. 李春波, 何燕玲, 张明园. 一致性检验方法的合理应用. 上海精神医学, 2000, 12(4):228-230.
7. Mahajan R, Bernal MP, Panzer R, et al. Clinical practice pathways for evaluation and medication choice for attention-deficit/hyperactivity disorder symptoms in autism spectrum disorders. Pediatrics, 2012, 130(2):125-138.
8. Subcommittee on Attention-Deficit/Hyperactivity Disorder; Steering Committee on Quality Improvement and Management. ADHD:clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 2011, 128(5):1007-1022.
9. List BA, Barzman DH. Evidence-based recommendations for the treatmentof aggression in pediatric patients with attention deficit hyperactivity disorder. Psychiatr Q, 2011, 82(1):33-42.
10. Pliszka S, AACAP Work Group on Quality Issues. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry, 2007, 46(7):894-921.
11. Graham J, Banaschewski T, Buitelaar J, et al. European guidelines on managing adverse effects of medication for ADHD. Eur Child Adolesc Psychiatry, 2011, 20(1):17-37.
12. Banaschewski T, Coghill D, Santosh P, et al. Long-acting medications for the hyperkinetic disorders. A systematic review and European treatment guideline. Eur Child Adolesc Psychiatry, 2006, 15(8):476-495.
13. Taylor E, Döpfner M, Sergeant J, et al. European clinical guidelines for hyperkinetic disorder-first upgrade. Eur Child Adolesc Psychiatry, 2004, 13(1):17-30.
14. Nutt DJ, Fone K, Asherson P, et al. Evidence-based guidelines for management of attention-deficit/hyperactivity disorder in adolescents in transition to adult services and in adults:recommendations from the British Association for Psychopharmacology. J Psychopharmacol, 2007, 21(1):10-41.
15. Atkinson M, Hollis C. NICE guideline:attention deficit hyperactivity disorder. Arch Dis Child Educ Pract Ed, 2010, 95(1):24-27.
16. Graf C, Wager E, Bowman A, et al. Best Practice Guidelines on Publication Ethics:a Publisher, s Perspectives. Int J Clin Pract, 2007, 61(152):1-26.
17. Jackson G. Conflict of interest:full disclosure is essential. Int J Clin Pract, 2006, 60(10):1147-1148.
18. Burgers IS, Cluzeau FA, Hanna SE, et al. Towards evidence-based clinical practice:an international survey of 18 clinical guideline programs. Int Qual Health Care, 2003, 15(1):31-45.
19. 杜亚松, 查彩琴, 李雪荣. 哌醋甲酯治疗注意缺陷多动障碍的疗效研究. 上海精神医学, 1997, 9(1):21-23.
20. 潘学霞, 麻宏伟, 万彬, 等. 盐酸哌甲酯控释片治疗注意缺陷多动障碍疗效观察. 中国当代儿科杂志, 2008, 10(4):471-474.
21. Polus S, Lerberg P, Vogel J, et al. Appraisal of WHO Guidelines in Maternal Health Using the AGREE Ⅱ Assessment Tool. PloS One, 2012, 7(8):e38891.

Chinese Journal of Evidence-Based Medicine

Clinical Practice Guidelines on Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: A Systematic Review

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