Results Summary and Professional Abstract
Antipsychotic Treatment for Children with Hyperactivity or Conduct Disorders
Clinicians often prescribe antipsychotics for children and adolescents diagnosed with attention deficit hyperactivity disorder (ADHD) or disruptive, impulse-control, and conduct disorders (DICDs). New evidence on the benefits and harms of this treatment can help with decisions about these drugs.
Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.
The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments.
Peer reviewers commented and the researchers made changes or provided responses. Those comments and responses included the following:
- The reviewers expressed concern that the study described itself as a comparative effectiveness study of state interventions, but most of the analyses involved changes within individual states’ medication oversight programs. The reviewers asked the researchers to acknowledge the limited amount of comparisons they could make across states given the observational nature of this study. The researchers agreed that there were limitations in what comparative conclusions they could draw, and noted that a more experimental model, where children in foster care would be assigned randomly to different interventions, was not feasible. The researchers pointed out that the topic and need for better information would benefit from the type of large-scale data collection, quasi-experimental studies like this one. They expanded the report’s discussion to describe the types of inferences about between-state comparisons that could and could not be made in this type of study.
- The reviewers questioned the report’s description of patient and stakeholder engagement. They asked for clarification on the role of stakeholders in developing the project and interpreting results. They asked why stakeholders were not listed as authors of the report. The reviewers also questioned why current children in foster care were not included as study stakeholders. The researchers said they involved patients and families extensively in developing research aims, choosing and prioritizing outcomes, and interpreting results. The researchers said they did not engage stakeholders in writing the report because the writing took place after the budget period of the project. Further, the researchers noted that there were state policy issues with having minors in foster care participate in research studies related to guardianship. In addition, the researchers hesitated to involve minors in the study given the sensitive topics that would be raised in discussions. The researchers ultimately felt that choosing to work with foster care alumni was more appropriate as well as more feasible while still providing a high level of insight into the foster care experience.
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