Clinical Practice Guidelines for the Evaluation and Diagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents
Key points
- The review identified 18 relevant clinical practice guidelines (CPGs) on the evaluation and/or diagnosis of attention-deficit/hyperactivity disorder (ADHD) in children and adolescents and included five of them.
- The included CPGs came from the American Academy of Pediatrics (AAP), the British Association of Psychopharmacology (BAP), the National Institute for Health and Care Excellence (NICE), the Scottish Intercollegiate Guidelines Network (SIGN) and the Canadian ADHD Resource Alliance (CADDRA).
- Five reviewers independently appraised guideline quality with the AGREE II instrument.
- NICE achieved the highest total score (91.4%), followed by SIGN, CADDRA, BAP and AAP.
- The applicability of the guidelines needs to improve to enhance their clinical use and relevance.
Overview
This systematic review summarizes and appraises CPGs for the evaluation and diagnosis of ADHD in children and adolescents. It helps clinicians identify the relevant guidelines and judge which of them are of high quality and trustworthy enough to follow in practice.
Background
The authors describe ADHD as a frequently diagnosed, pervasive and controversial neurobehavioural disorder of childhood that makes everyday requests and routines challenging, with problems in focus, organisation, impulsivity and practical planning. Consistent guidelines support better quality care, evidence-based practice, cost-efficient services, clinical outcomes, care planning, multidisciplinary communication and resource allocation, although guidelines also have limitations. Several international societies have published ADHD guidelines aimed at different groups of health professionals.
Methods
Of 18 relevant guidelines extracted from the literature, five were selected. Their quality was assessed independently by five reviewers with the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool, using the AGREE II training manual as a guide, and the recommendations reported in the guidelines were summarized.
Results and implications
The NICE guideline had the highest total score (91.4%), followed in order by the SIGN, CADDRA, BAP and AAP guidelines. The authors conclude that guideline applicability should be improved in future and recommend using the AGREE II instrument in the education and training of healthcare professionals.
Frequently asked questions
Which ADHD guideline scored highest?
The NICE guideline, with a total AGREE II score of 91.4%.
What is AGREE II?
A tool for appraising the quality of clinical practice guidelines, applied here independently by five reviewers.
Does this review make new diagnostic recommendations?
No. It summarizes and appraises existing guidelines so that clinicians can choose high-quality ones.
Source
Razzak et al. Clinical Practice Guidelines for the Evaluation and Diagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents: A systematic review of the literature. Sultan Qaboos University Medical Journal 2021;21(1):e12-21. doi:10.18295/squmj.2021.21.01.003. This summary was prepared by Medpresso from the original publication and is not a substitute for the full text or medical advice.