Table 1, Eligibility criteria - ADHD Diagnosis and Treatment in Children and Adolescents

PICOTSO Element	KQ1 (Diagnosis)	KQ2 (Treatments)	KQ3 (Monitoring)
Population	Individuals birth through 17 years of age without the diagnosis of ADHD Exclusion: Individuals 18 years of age or older unless findings are reported separately for younger participants	Individuals birth through 17 years of age with a diagnosis of ADHD Exclusion: Individuals 18 years of age or older unless findings are reported separately for younger participants	Individuals birth through 17 years of age who have previously begun treatment for ADHD Exclusion: For long-term studies, the age of the individuals were greater than 17, but these studies were only considered for inclusion if the age at enrollment in the study was 18 years or younger, and administrative claims data used for diagnosis of ADHD
Interventions	Any ADHD diagnostic strategy for the diagnosis of ADHD in children through 17 years Exclusion: Validation studies or not reporting on diagnostic performance; non-English language questionnaires and interview guides	Any treatment of ADHD, alone or in combination. Exclusion: Studies with less than 4 weeks of treatment	Follow-up visit methods and frequencies for monitoring, independent of treatment, including remote monitoring or telehealth strategies
Comparators	Confirmation of diagnosis by a specialist (gold standard), such as a psychologist, psychiatrist or other care provider using a well-validated and reliable process of confirming a clinical diagnosis of ADHD Exclusion: Comparison to diagnosis with a non-validated instrument	Specific treatments compared with other treatments as described above or to no treatment Exclusion: Comparisons to other patient groups rather than treatments	Follow-up compared with differing frequencies of follow-up or different settings of follow-up for monitoring strategies; no restrictions for long-term outcomes
Outcomes	Diagnostic accuracy (e.g., sensitivity, specificity, accuracy, area under the curve, positive predictive value, negative predictive value, likelihood ratios, false positives, false negatives, false negatives, false positives, misdiagnosis, stigma, and costs following diagnosis comparing those with and without ADHD	Patient health outcomes, global clinical impression, social and family functioning, functional impairment, executive functioning, academic performance outcomes, acceptability of treatment, adverse events of treatment, loss of spontaneity, progress toward patient-identified goals, quality of peer relationships, motor vehicle collisions or other accidents, risk-taking behaviors and interactions with the legal system	Monitoring strategy success (e.g., feasibility, uptake), changes in treatment or dose, adverse effects of treatment, changes in intermediate and final outcomes
Timing	For assessment of diagnostic accuracy: diagnostic follow-up must be within 4 months of the initial evaluation and must be completed before treatment is initiated For labeling: any time after the ADHD diagnosis	Any	Any
Setting	Primary or specialty care settings	Any (including remote monitoring and telehealth)	Any (including remote monitoring and telehealth)
Study Design	RCTs For diagnostic accuracy, observational studies, are eligible if they include patients with diagnostic uncertainty and direct comparison of diagnosis in primary care to diagnosis by a mental health specialist Controlled clinical trials and prospective and retrospective observational studies with comparator for non-drug treatments Exclusion: Editorials, nonsystematic reviews, letters, case series, case reports, pre-post studies. Systematic reviews are not eligible for inclusion but will be retained.	RCTs Controlled clinical trials and prospective and retrospective observational studies with comparator for non-drug treatments Exclusion: Editorials, nonsystematic reviews, letters, case series, case reports, pre-post studies. Studies with fewer than 100 participants had to report a power calculation to determine that studies had sufficient power to detect effects. Systematic reviews are not eligible for inclusion but will be retained	RCTs No study size restriction Exclusion: Editorials, nonsystematic reviews, letters, case series, case reports, pre-post studies. Systematic reviews were not eligible for inclusion but will be retained
Other limiters	English-language publications Published after 1980 Exclusion: Non-English language and abbreviated publications (abstracts, letters)	English-language publications Published after 1980 Exclusion: Non-English language and abbreviated publications (abstracts, letters)	English-language publications Monitoring strategies and long-term effects have no publication year restriction Journal manuscripts and trial record data with results Exclusion: Non-English language and abbreviated publications (abstracts, letters)

PICOTSO Element

KQ1 (Diagnosis)

KQ2 (Treatments)

KQ3 (Monitoring)

Population

Individuals birth through 17 years of age without the diagnosis of ADHD

Exclusion: Individuals 18 years of age or older unless findings are reported separately for younger participants

Individuals birth through 17 years of age with a diagnosis of ADHD

Exclusion: Individuals 18 years of age or older unless findings are reported separately for younger participants

Individuals birth through 17 years of age who have previously begun treatment for ADHD

Exclusion: For long-term studies, the age of the individuals were greater than 17, but these studies were only considered for inclusion if the age at enrollment in the study was 18 years or younger, and administrative claims data used for diagnosis of ADHD

Interventions

Any ADHD diagnostic strategy for the diagnosis of ADHD in children through 17 years

Exclusion: Validation studies or not reporting on diagnostic performance; non-English language questionnaires and interview guides

Any treatment of ADHD, alone or in combination.

Exclusion: Studies with less than 4 weeks of treatment

Follow-up visit methods and frequencies for monitoring, independent of treatment, including remote monitoring or telehealth strategies

Comparators

Confirmation of diagnosis by a specialist (gold standard), such as a psychologist, psychiatrist or other care provider using a well-validated and reliable process of confirming a clinical diagnosis of ADHD

Exclusion: Comparison to diagnosis with a non-validated instrument

Specific treatments compared with other treatments as described above or to no treatment

Exclusion: Comparisons to other patient groups rather than treatments

Follow-up compared with differing frequencies of follow-up or different settings of follow-up for monitoring strategies; no restrictions for long-term outcomes

Outcomes

Diagnostic accuracy (e.g., sensitivity, specificity, accuracy, area under the curve, positive predictive value, negative predictive value, likelihood ratios, false positives, false negatives, false negatives, false positives, misdiagnosis, stigma, and costs following diagnosis comparing those with and without ADHD

Patient health outcomes, global clinical impression, social and family functioning, functional impairment, executive functioning, academic performance outcomes, acceptability of treatment, adverse events of treatment, loss of spontaneity, progress toward patient-identified goals, quality of peer relationships, motor vehicle collisions or other accidents, risk-taking behaviors and interactions with the legal system

Monitoring strategy success (e.g., feasibility, uptake), changes in treatment or dose, adverse effects of treatment, changes in intermediate and final outcomes

Timing

For assessment of diagnostic accuracy: diagnostic follow-up must be within 4 months of the initial evaluation and must be completed before treatment is initiated
For labeling: any time after the ADHD diagnosis

Any

Setting

Primary or specialty care settings

Any (including remote monitoring and telehealth)

Study Design

RCTs
For diagnostic accuracy, observational studies, are eligible if they include patients with diagnostic uncertainty and direct comparison of diagnosis in primary care to diagnosis by a mental health specialist
Controlled clinical trials and prospective and retrospective observational studies with comparator for non-drug treatments

Exclusion: Editorials, nonsystematic reviews, letters, case series, case reports, pre-post studies. Systematic reviews are not eligible for inclusion but will be retained.

RCTs
Controlled clinical trials and prospective and retrospective observational studies with comparator for non-drug treatments

Exclusion: Editorials, nonsystematic reviews, letters, case series, case reports, pre-post studies. Studies with fewer than 100 participants had to report a power calculation to determine that studies had sufficient power to detect effects. Systematic reviews are not eligible for inclusion but will be retained

RCTs
No study size restriction

Exclusion: Editorials, nonsystematic reviews, letters, case series, case reports, pre-post studies. Systematic reviews were not eligible for inclusion but will be retained

Other limiters

English-language publications
Published after 1980

Exclusion: Non-English language and abbreviated publications (abstracts, letters)

English-language publications
Published after 1980

Exclusion: Non-English language and abbreviated publications (abstracts, letters)

English-language publications
Monitoring strategies and long-term effects have no publication year restriction
Journal manuscripts and trial record data with results

Exclusion: Non-English language and abbreviated publications (abstracts, letters)

From: 2, Methods

Cover of ADHD Diagnosis and Treatment in Children and Adolescents

ADHD Diagnosis and Treatment in Children and Adolescents [Internet].

Comparative Effectiveness Review, No. 267.

Peterson BS, Trampush J, Maglione M, et al.

Rockville (MD): Agency for Healthcare Research and Quality (US); 2024 Mar.

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

Table 1Eligibility criteria