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Original Article

Systematic evidence synthesis of treatments for ADHD in children and adolescents: indirect treatment comparisons of lisdexamfetamine with methylphenidate and atomoxetine

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Pages 1673-1685 | Accepted 10 Mar 2014, Published online: 15 Apr 2014

Figures & data

Figure 1. PRISMA diagram for study inclusion and exclusion. PRISMA = Preferred Reporting Items for Systematic Reviews and Meta-Analyses; RCT = randomized controlled clinical trial.

Figure 1. PRISMA diagram for study inclusion and exclusion. PRISMA = Preferred Reporting Items for Systematic Reviews and Meta-Analyses; RCT = randomized controlled clinical trial.

Figure 2. Network diagram of all trials included in the meta-analyses. ATX = atomoxetine; LDX = lisdexamfetamine; MPH-LA = methylphenidate long acting; MPH-intR = methylphenidate intermediate release; MPH-SA = methylphenidate short acting. SourcesCitation17–19,Citation27,Citation29–55.

Figure 2. Network diagram of all trials included in the meta-analyses. ATX = atomoxetine; LDX = lisdexamfetamine; MPH-LA = methylphenidate long acting; MPH-intR = methylphenidate intermediate release; MPH-SA = methylphenidate short acting. SourcesCitation17–19,Citation27,Citation29–55.

Table 1. Summary of trial and baseline patient characteristics, by treatment.

Figure 3. Forest plot of network meta-analysis relative risks for treatment response based on ADHD-RS and CGI-I. ADHD-RS = ADHD Rating Scale; ATX = atomoxetine; CGI-ADHD-S = Clinical Global Impressions–ADHD–Severity; CGI-I = Clinical Global Impression–Improvement scale; LDX = lisdexamfetamine; MPH-LA = methylphenidate long acting; MPH-intR = methylphenidate intermediate release; MPH-SA = methylphenidate short acting.

Figure 3. Forest plot of network meta-analysis relative risks for treatment response based on ADHD-RS and CGI-I. ADHD-RS = ADHD Rating Scale; ATX = atomoxetine; CGI-ADHD-S = Clinical Global Impressions–ADHD–Severity; CGI-I = Clinical Global Impression–Improvement scale; LDX = lisdexamfetamine; MPH-LA = methylphenidate long acting; MPH-intR = methylphenidate intermediate release; MPH-SA = methylphenidate short acting.

Figure 4. Forest plot of network meta-analysis relative risks for all-cause and adverse-event-related withdrawals. ATX = atomoxetine; LDX = lisdexamfetamine; MPH-LA = methylphenidate long acting; MPH-intR = methylphenidate intermediate release; MPH-SA = methylphenidate short acting.

Figure 4. Forest plot of network meta-analysis relative risks for all-cause and adverse-event-related withdrawals. ATX = atomoxetine; LDX = lisdexamfetamine; MPH-LA = methylphenidate long acting; MPH-intR = methylphenidate intermediate release; MPH-SA = methylphenidate short acting.

Table 2. Effects of trial and patient characteristics used as covariates in network meta-analysis models.

Table 3. Reduced chi-squared statistics, by NMA model and inclusion or exclusion of covariates.

Table 4. Comparison of indirect evidence of NMA results with head-to-head estimates.

Table 5. Heterogeneity test results for direct meta-analyses of placebo-controlled trials.

Supplemental material

Supplementary Material

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