Kazda Luise, Bell Katy, Thomas Rae, McGeechan Kevin, Barratt Alexandra
Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
BMJ Open. 2019 Nov 7;9(11):e032327. doi: 10.1136/bmjopen-2019-032327.
Worldwide, attention deficit hyperactivity disorder (ADHD) diagnosis rates in children and adolescents have been increasing consistently over the past decades, fuelling a debate about the underlying reasons for this trend. While many hypothesise that a substantial number of these additional cases are overdiagnosed, to date there has been no comprehensive evaluation of evidence for or against this hypothesis. Thus, with this scoping review we aim to synthesise published evidence on the topic in order to investigate whether existing literature is consistent with the occurrence of overdiagnosis and/or overtreatment of ADHD in children and adolescents.
The proposed scoping review will be conducted in the context of a framework of five questions, developed specifically to identify areas in medicine with the potential for overdiagnosis and overtreatment. The review will adhere to the Joanna Briggs Methodology for Scoping Reviews. We will search Medline, Embase, PsycINFO and the Cochrane Library electronic databases for primary studies published in English from 1979 onwards. We will also conduct forward and backward citation searches of included articles. Data from studies that meet our predefined exclusion and inclusion criteria will be charted into a standardised extraction template with results mapped to our predetermined five-question framework in the form of a table and summarised in narrative form.
The proposed study is a scoping review of the existing literature and as such does not require ethics approval. We intend to disseminate the results from the scoping review through publication in a peer-reviewed journal and through conference presentations. Further, we will use the findings from our scoping review to inform future research to fill key evidence gaps identified by this review.
在全球范围内，儿童和青少年注意力缺陷多动障碍（ADHD）的诊断率在过去几十年中持续上升，引发了关于这一趋势潜在原因的争论。虽然许多人推测这些新增病例中有相当一部分是过度诊断，但迄今为止，尚未对支持或反对这一假设的证据进行全面评估。因此，通过本范围综述，我们旨在综合该主题已发表的证据，以调查现有文献是否与儿童和青少年ADHD的过度诊断和/或过度治疗情况相符。
拟进行的范围综述将在一个由五个问题构成的框架内开展，该框架是专门为识别医学中存在过度诊断和过度治疗可能性的领域而制定的。综述将遵循乔安娜·布里格斯范围综述方法。我们将在Medline、Embase、PsycINFO和Cochrane图书馆电子数据库中检索1979年起以英文发表的原始研究。我们还将对纳入文章进行向前和向后的引文检索。符合我们预先定义的排除和纳入标准的研究数据将被录入标准化的提取模板，结果以表格形式映射到我们预先确定的五个问题框架中，并以叙述形式进行总结。
拟开展的研究是对现有文献的范围综述，因此无需伦理批准。我们打算通过在同行评审期刊上发表以及在会议上进行报告来传播范围综述的结果。此外，我们将利用范围综述的结果为未来研究提供信息，以填补本综述所确定的关键证据空白。
