ADHD干预措施的好处和危害:总体审查和共同决策的平台
Corentin J Gosling1,2,3, Miguel Garcia-Argibay3,4,5,6, Michele De Prisco7
1Laboratoire DysCo, Université Paris Nanterre, 92000 Nanterre, France Corentin.gosling@parisnanterre.fr.
这一综合性审查证实,几种药物和疗法有效地减少儿童和成人注意力缺陷/多动症 (ADHD) 症状,尽管长期证据有限. 一个在线平台为共享决策提供最新的证据.
科学领域:
- 神经科学是一个神经科学.
- 精神病学是一个精神病学.
- 证据综合 证据综合
背景情况:
- 注意缺陷/多动障碍 (ADHD) 管理需要有关干预有效性和确定性的最新证据.
- 现有的审查可能不涵盖寿命,也可能不包括用于共享决策的活体证据综合.
研究的目的:
- 进行跨生命周期的ADHD干预措施的总体审查.
- 评估ADHD干预措施的效果和证据确定性.
- 开发一个不断更新的网络平台,向有过ADHD经验的人传播活证据合成.
主要方法:
- 对ADHD干预措施的随机对照试验 (RCT) 的元分析的系统性审查的总体综述.
- 标准化对元分析的重新估计和方法质量的评估 (AMSTAR-2) 和证据确定性 (GRADE框架).
- 开发一个在线平台 (https://ebiadhd-database.org/),以展示发现.
主要成果:
- 在短期内,甲基胺,安非他胺和阿托莫克赛丁等药物对儿童和青少年的多动症症状减轻的效果大小为中等至大 (中等至高确定性).
- 在成年人中,阿托莫克西丁,认知行为疗法和甲基酸显示出中等效果大小 (至少中等确定性).
- 非药物干预表明有希望,但证据的确定性较低;对于任何干预措施都没有发现高确定性长期证据.
结论:
- 本综述提供了当前的证据,以指导患者,从业者和指导方针开发者的ADHD管理.
- 开发的在线平台旨在通过提供有关ADHD干预措施的可访问证据,加强临床实践中的共享决策.
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