Conners C K, Epstein J N, March J S, Angold A, Wells K C, Klaric J, Swanson J M, Arnold L E, Abikoff H B, Elliott G R, Greenhill L L, Hechtman L, Hinshaw S P, Hoza B, Jensen P S, Kraemer H C, Newcorn J H, Pelham W E, Severe J B, Vitiello B, Wigal T
Attention Deficit Disorder Program, DUMC, 2200 West Main Street, Suite 230B, Durham, NC 27715, USA.
J Am Acad Child Adolesc Psychiatry. 2001 Feb;40(2):159-67. doi: 10.1097/00004583-200102000-00010.
To conduct a post hoc investigation of the utility of a single composite measure of treatment outcome for the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder (MTA) at 14 months postbaseline.
Examination of multiple measures one at a time in the main MTA intent-to-treat outcome analyses failed to detect a statistically significant advantage of combined treatment (Comb) over medication management (MedMgt). A measure that increases power and precision using a single outcome score may be a useful alternative to multiple outcome measures.
Factor analysis of baseline scores yielded two "source factors" (parent and teacher) and one "instrument factor" (parent-child interactions). A composite score was created from the average of standardized parent and teacher measures.
The composite was internally consistent (alpha = .83), reliable (test-retest over 3 months = 0.86), and correlated 0.61 with clinician global judgments. In an intent-to-treat analysis, Comb was statistically significantly better than all other treatments, with effect sizes ranging from small (0.28) versus MedMgt, to moderately large (0.70) versus a community comparison group.
A composite of ADHD variables may be an important tool in future treatment trials with ADHD and may avoid some of the statistical limitations of multiple measures.
对美国国立精神卫生研究所（NIMH）注意力缺陷多动障碍儿童协作多中心多模式治疗研究（MTA）基线后14个月时治疗结果单一综合测量指标的效用进行事后调查。
在MTA主要意向性治疗结果分析中，一次检查多个测量指标未能发现联合治疗（Comb）相对于药物管理（MedMgt）具有统计学上的显著优势。使用单一结果分数提高检验效能和精度的测量指标可能是多个结果测量指标的有用替代方法。
对基线分数进行因子分析得出两个“源因子”（家长和教师）和一个“工具因子”（亲子互动）。根据标准化家长和教师测量指标的平均值创建综合分数。
该综合指标内部一致（α = 0.83）、可靠（3个月重测信度 = 0.86），与临床医生整体判断的相关性为0.61。在意向性治疗分析中，Comb在统计学上显著优于所有其他治疗，效应大小范围从小（相对于MedMgt为0.28）到中度大（相对于社区比较组为0.70）。
ADHD变量的综合指标可能是未来ADHD治疗试验中的重要工具，并且可能避免多个测量指标的一些统计学局限性。
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