Date of Award

January 2015

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Michael H. Bloch

Second Advisor

Andrés Martin

Subject Area(s)

Mental health, Medicine

Abstract

Baseline clinical characteristics can be used to predict treatment response in children with Attention Deficit and Hyperactivity Disorder (ADHD). This analysis aimed to identify empirically derived subgroups of children with ADHD based on likelihood of response to treatment within the 4 randomly assigned treatment groups of the Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder (MTA).

To identify clinical characteristics of predictive value selected data points were utilized for regression and receiver operating curve (ROC) analysis. Response to treatment at 14 months (defined as a 25-30% reduction in standardized score of symptoms obtained from the SNAP scale) for each treatment group was utilized as the binary outcome for ROC testing. The response rate in the 4 MTA-delivered treatment arms ranged from 77% (medication management and combination treatment groups) to 60% in the behavioral treatment group. By comparison, the response rate with community treatment was 57%.

ROC analysis identified subgroups of children with very different likelihoods of treatment response (ranging from 18-93%) using baseline clinical characteristic. These differential response rates are useful to identify patient subgroups that would most benefit from specific treatment strategies, and provide useful prognostic data in the treatment of childhood ADHD.

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