Brown Ronald T, Amler Robert W, Freeman Wendy S, Perrin James M, Stein Martin T, Feldman Heidi M, Pierce Karen, Wolraich Mark L
Pediatrics. 2005 Jun;115(6):e749-57. doi: 10.1542/peds.2004-2560.
The American Academy of Pediatrics' Committee on Quality Improvement, Subcommittee on Attention-Deficit/Hyperactivity Disorder, reviewed and analyzed the current literature for the purpose of developing an evidence-based clinical practice guideline for the treatment of the school-aged child with attention-deficit/hyperactivity disorder (ADHD). This review included several key reports, including an evidence review from the McMaster Evidence-Based Practice Center (supported by the Agency for Healthcare Research and Quality), a report from the Canadian Coordinating Office for Health Technology Assessment, the Multimodal Treatment for ADHD comparative clinical trial (supported by the National Institute of Mental Health), and supplemental reviews conducted by the subcommittee. These reviews provided substantial information about different treatments for ADHD and their efficacy in improving certain characteristics or outcomes for children with ADHD as well as adverse effects and benefits of multiple modes of treatment compared with single modes (eg, medication or behavior therapies alone). The reviews also compared the effects of different medications. Other evidence documents the long-term nature of ADHD in children and its classification as a chronic condition, meriting the application of general concepts of chronic-condition management, including an individual treatment plan with a focus on ongoing parent and child education, management, and monitoring. The evidence strongly supports the use of stimulant medications for treating the core symptoms of children with ADHD and, to a lesser degree, for improving functioning. Behavior therapy alone has only limited effect on symptoms or functioning of children with ADHD, although combining behavior therapy with medication seems to improve functioning and may decrease the amount of (stimulant) medication needed. Comparison among stimulants (mainly methylphenidate and amphetamines) did not indicate that 1 class outperformed the other.
美国儿科学会质量改进委员会注意力缺陷/多动障碍小组委员会，对当前文献进行了审查和分析，目的是制定一项基于证据的临床实践指南，用于治疗学龄期注意力缺陷/多动障碍（ADHD）儿童。该审查包括几份关键报告，其中有麦克马斯特循证实践中心的证据综述（由医疗保健研究与质量局资助）、加拿大卫生技术评估协调办公室的一份报告、ADHD多模式治疗对比临床试验（由国家心理健康研究所资助）以及小组委员会进行的补充综述。这些综述提供了大量关于ADHD不同治疗方法的信息，以及它们在改善ADHD儿童某些特征或结果方面的疗效，还有与单一治疗模式（如单独使用药物或行为疗法）相比多模式治疗的不良反应和益处。这些综述还比较了不同药物的效果。其他证据证明了儿童ADHD的长期性及其作为一种慢性病的分类，这使得慢性病管理的一般概念得以应用，包括制定一个以持续的家长和儿童教育、管理及监测为重点的个体化治疗计划。证据有力地支持使用兴奋剂药物治疗ADHD儿童的核心症状，在一定程度上也支持其改善功能。单独的行为疗法对ADHD儿童的症状或功能仅有有限的效果，尽管将行为疗法与药物联合使用似乎能改善功能，并且可能减少所需（兴奋剂）药物的用量。兴奋剂（主要是哌甲酯和苯丙胺）之间的比较并未表明某一类药物比另一类更具优势。
