Methodological concerns with network meta-analysis on drugs for attention deficit hyperactivity disorder
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We thank Padilha and colleagues for their network meta-analysis on efficacy and safety of drugs for attention deficit hyperactivity disorder in children and adolescents . The network meta-analysis looks comprehensive and the results are interesting. We invite readers to consider the following potential limitations of the study.
The authors included head-to-head randomised clinical trials, with only 12 trials in the benefit analyses and 33 trials in the harm analyses . By excluding placebo-controlled trials, they focus on a small and select sample out of the many available trials on drugs for attention deficit hyperactivity disorder in children and adolescents. The authors also stress the limited amount of comparisons themselves in their discussion section . When we systematically reviewed methylphenidate alone, we found 185 randomised clinical trials on methylphenidate versus placebo or no intervention . Head-to-head comparisons can be informative, but it would have been...
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Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
The manuscript does not contain clinical studies or patient data.
- 3.Cipriani A, Furukawa TA, Salanti G, Chaimani A, Atkinson LZ, Ogawa Y et al (2018) Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet Psychiatry 391(10128):1357–1366. https://doi.org/10.1016/S0140-6736(17)32802-7 CrossRefGoogle Scholar
- 5.Higgins JPT, Altman DG, Sterne JAC (eds) (2017) Chapter 8: assessing risk of bias in included studies. In: Higgins JPT, Churchill R, Chandler J, Cumpston MS (eds) Cochrane handbook for systematic reviews of interventions version 5.2.0 [updated June 2017]. Cochrane. http://www.training.cochrane.org/handbook
- 6.Rodrigues-Tartari R, Swardfager W, Salum GA, Rohde LA, Cogo-Moreira H (2018) Assessing risk of bias in randomized controlled trials of methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD). Int J Methods Psychiatr Res 27:e1586. https://doi.org/10.1002/mpr.1586 CrossRefGoogle Scholar
- 10.Catalá-López F, Hutton B, Núñez-Beltrán A, Page MJ, Ridao M, Macías Saint-Gerons D et al (2017) The pharmacological and non-pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: a systematic review with network meta-analyses of randomised trials. PLoS One 12:e0180355. https://doi.org/10.1186/s13643-015-0005-7 CrossRefGoogle Scholar
- 11.Cipriani A, Higgins JPT, Geddes JR, Salanti G (2013) Conceptual and technical challenges in network meta-analysis. Ann Intern Med 159:130–137. https://doi.org/10.7326/0003-4819-159-2-201307160-00008 CrossRefGoogle Scholar