Sistema de Salut de Catalunya
[Castells X] Grup de recerca TransLab, Departament de Ciències Mèdiques, Universitat de Girona, Girona, Spain. [Saez M] Grup de Recerca en Estadística, Econometria i Salut (GRECS), Universitat de Girona, Girona, Spain. Centro de Red de Investigación Biomédica en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. [Barcheni M] Departament de Farmacologia, Toxicologia i Terapèutica. Universitat Autònoma de Barcelona, Barcelona, Spain. [Cunill R] Parc Sanitari Sant Joan de Déu-Numància, Parc Sanitari Sant Joan de Déu, Barcelona, Spain. [Serrano D] Institut d'Assistència Sanitària, Salt, Spain. [López B] Grup de Recerca en Enginyeria de Sistemes Intel·ligents i de Control, Departament d'Enginyeria Elèctrica, Electrònica i Automàtica, Universitat de Girona, Girona, Spain. [Van Lissa C] Department of Methodology and Statistics, Universiteit Utrecht, The Netherlands
Institut d'Assistència Sanitària
2021-11-30T12:43:45Z
2021-11-30T12:43:45Z
2021-08-06
Transtorn per dèficit d'atenció i hiperactivitat; MetaForest; Aprenentatge automàtic
Desorden hiperactivo y deficit de atencion; MetaForest; Aprendizaje automático
Attention Deficit Hyperactivity Disorder; MetaForest; Machine learning
High placebo response in ADHD can reduce medication-placebo differences, jeopardizing the development of new medicines. This research aims to 1) determine placebo response in ADHD, 2) compare the accuracy of meta-regression and MetaForest in predicting placebo response, and 3) determine the covariates associated with placebo response. A systematic review with meta-analysis (SRMA) of RPCCTs investigating pharmacological interventions for ADHD was performed. Placebo response was defined as the change from baseline in ADHD symptom severity assessed according to the 18-item, clinician-rated, DSM-based rating scale. The effect of study design-, intervention- and patient-related covariates in predicting placebo response was studied by means of meta-regression and MetaForest. Ninety-four studies including 6,614 patients randomized to placebo were analysed. Overall, placebo response was -8.9 points, representing a 23.1% reduction in the severity of ADHD symptoms. Cross-validated accuracy metrics for meta-regression were R 2 = 0.0012 and RMSE = 3.3219 for meta-regression and 0.0382 and 3.2599 for MetaForest. Placebo response amongst ADHD patients increased by 63% between 2001 and 2020 and was larger in the US than in other regions of the world. Strong placebo response was found in ADHD patients. Both meta-regression and MetaForest showed poor performance in predicting placebo response. ADHD symptom improvement with placebo has markedly increased over the last two decades and is grater in the US than the rest of the world.
This study was funded in part by a grant from the Instituto de Salud Carlos III (PI19/00375). Caspar van Lissa is supported by a NWO Veni grant (NWO grant no. VI.Veni.191G.090).
Article
Accepted version
English
Trastorn per dèficit d'atenció amb hiperactivitat; Assaigs clínics - Mètodes estadístics; PSYCHIATRY AND PSYCHOLOGY::Mental Disorders::Neurodevelopmental Disorders::Attention Deficit and Disruptive Behavior Disorders::Attention Deficit Disorder with Hyperactivity; HEALTH CARE::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Statistics as Topic::Regression Analysis; PUBLICATION CHARACTERISTICS::Study Characteristics::Clinical Study::Clinical Trial::Controlled Clinical Trial::Randomized Controlled Trial; PSIQUIATRÍA Y PSICOLOGÍA::trastornos mentales::trastornos del desarrollo neurológico::trastornos conductuales disruptivos y déficit de atención::trastornos de déficit de atención con hiperactividad; ATENCIÓN DE SALUD::calidad, acceso y evaluación de la atención sanitaria::calidad de la atención sanitaria::mecanismos de evaluación de la atención sanitaria::estadística como asunto::análisis de regresión; CARACTERÍSTICAS DE PUBLICACIONES::características del estudio::estudio clínico::ensayo clínico::ensayo clínico controlado::ensayo clínico controlado aleatorizado
Oxford University Press
International Journal of Neuropsychopharmacology;
https://doi.org/10.1093/ijnp/pyab054
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
