Pediatrics. 2001 Oct;108(4):1033-44. doi: 10.1542/peds.108.4.1033.
This clinical practice guideline provides evidence-based recommendations for the treatment of children diagnosed with attention-deficit/hyperactivity disorder (ADHD). This guideline, the second in a set of policies on this condition, is intended for use by clinicians working in primary care settings. The initiation of treatment requires the accurate establishment of a diagnosis of ADHD; the American Academy of Pediatrics (AAP) clinical practice guideline on diagnosis of children with ADHD(1) provides direction in appropriately diagnosing this disorder. The AAP Committee on Quality Improvement selected a subcommittee composed of primary care and developmental-behavioral pediatricians and other experts in the fields of neurology, psychology, child psychiatry, education, family practice, and epidemiology. The subcommittee partnered with the Agency for Healthcare Research and Quality and the Evidence-based Practice Center at McMaster University, Ontario, Canada, to develop the evidence base of literature on this topic.(2) The resulting systematic review, along with other major studies in this area, was used to formulate recommendations for treatment of children with ADHD. The subcommittee also reviewed the multimodal treatment study of children with ADHD(3) and the Canadian Coordinating Office for Health Technology Assessment report (CCOHTA).(4) Subcommittee decisions were made by consensus where definitive evidence was not available. The subcommittee report underwent extensive review by sections and committees of the AAP as well as by numerous external organizations before approval from the AAP Board of Directors. The guideline contains the following recommendations for the treatment of a child diagnosed with ADHD:
本临床实践指南为诊断为注意力缺陷多动障碍(ADHD)的儿童治疗提供了循证建议。本指南是关于该病症的一系列政策中的第二个,供在基层医疗环境中工作的临床医生使用。治疗的启动需要准确确立ADHD的诊断;美国儿科学会(AAP)关于ADHD儿童诊断的临床实践指南(1)为恰当诊断该疾病提供了指导。AAP质量改进委员会挑选了一个小组委员会,其成员包括基层医疗和发育行为儿科医生以及神经学、心理学、儿童精神病学、教育、家庭医疗和流行病学领域的其他专家。该小组委员会与医疗保健研究与质量局以及加拿大安大略省麦克马斯特大学循证实践中心合作,以建立关于该主题的文献证据基础。(2)由此产生的系统评价以及该领域的其他主要研究被用于制定ADHD儿童的治疗建议。该小组委员会还审查了ADHD儿童的多模式治疗研究(3)和加拿大卫生技术评估协调办公室报告(CCOHTA)。(4)在缺乏确凿证据的情况下,小组委员会通过共识做出决定。在获得AAP董事会批准之前,小组委员会的报告经过了AAP各部门和委员会以及众多外部组织的广泛审查。该指南包含以下针对诊断为ADHD的儿童的治疗建议: