Clinical relevance of the primary findings of the MTA: Success rates based on severity of ADHD and ODD symptoms at the end of treatment
Clinical relevance of the primary findings of the MTA: Success rates based on severity of ADHD and ODD symptoms at the end of treatment
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DOI：
10.1097/00004583-200102000-00011
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发表时间：
2001-02-01
影响因子：
13.3
通讯作者：
Wu, M
中科院分区：
文献类型：
--
作者：
Swanson, JM;Kraemer, HC;Wu, M
目的：开发与临床决策相关的分类结果测量，并进行二次分析，以补充NIMH儿童注意力缺陷/多动障碍（MTA）多站点多模式合作治疗研究的主要分析。方法：通过在Swanson， Nolan和Pelham，版本IV（SNAP-IV）量表上平均父母和老师对注意缺陷/多动障碍和对立违抗性障碍症状的评分来总结治疗结束状态，并将此连续测量中的低症状严重程度（“只有一点”）设置为临床截止点，以形成反映治疗成功的分类结果测量。三个治疗组的正交比较（联合治疗[Comb]、药物管理[MedMgt]、行为治疗[Beh]和社区比较[CGI]）评估了MTA用药算法（“Comb + MedMgt vs Beh + CC”）、多模式优势（“Comb vs MedMgt”）和社会心理替代（“Beh vs CC”）的假设。结果：SNAP-IV评分跨来源和域的汇总使测量精度提高了30%。分组成功率差异的二次分析（Comb = 68%; MedMgt = 56%; Beh = 34%; CC = 25%）证实了MTA用药算法的主要作用和多模式优势的较小作用，现在具有统计学意义(p
Objectives: To develop a categorical outcome measure related to clinical decisions and to perform secondary analyses to supplement the primary analyses of the NIMH Collaborative Multisite Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder (MTA). Method: End-of-treatment status was summarized by averaging the parent and teacher ratings of attention-deficit/hyperactivity disorder and oppositional defiant disorder symptoms on the Swanson, Nolan, and Pelham, version IV(SNAP-IV) scale, and low symptom-Severity ("Just a Little") on this continuous measure was set as a clinical cutoff to form a categorical outcome measure reflecting successful treatment. Three orthogonal comparisons of the treatment groups (combined treatment [Comb], medication management [MedMgt], behavioral treatment [Beh], and community comparison [CGI) evaluated hypotheses about the MTA medication algorithm ("Comb + MedMgt Versus Beh + CC"), multimodality superiority ("Comb versus MedMgt"), and psychosocial substitution ("Beh versus CC"). Results: The summary of SNAP-IV ratings across sources and domains increased the precision of measurement by 30%. The secondary analyses of group differences in success rates (Comb = 68%; MedMgt = 56%; Beh = 34%; CC = 25%) confirmed the targe effect of the MTA medication algorithm and a smaller effect of multimodality superiority, which was now statistically significant (p