Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: protocol for a systematic review and meta-analysis
Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: protocol for a systematic review and meta-analysis
INTRODUCTION:
Attention-deficit hyperactivity disorder (ADHD) has been related to increased rates of unintentional injuries. However, the magnitude of the effect and to which extent variables such as sex, age or comorbidity can influence this relationship is unknown. Additionally, and importantly, it is unclear if, and to which degree, ADHD medications can decrease the number of unintentional injuries. Due to the amount of economic and social resources invested in the treatment of injuries, filling these gaps in the literature is highly relevant from a public health standpoint. Here, we present a protocol for a systematic review and meta-analysis to estimate the relationship between ADHD and unintentional injuries and assess the impact of pharmacological treatment for ADHD METHODS AND ANALYSIS: We will combine results from 114 bibliographic databases for studies relating ADHD and risk of injuries. Bibliographic searches and data extraction will be carried out independently by two researchers. The studies' risk of bias will be assessed using the Newcastle-Ottawa Scale. Articles reporting ORs or HRs of suffering an injury in ADHD compared with controls (or enough data to calculate them) will be combined using Robust Variance Estimation, a method that permits to include multiple non-independent outcomes in the analysis. All analyses will be carried out in Stata. Age, sex and comorbid conduct disorders will be considered as potential causes of variance and their effect analysed through meta-regression and subgroup analysis. Sensitivity analyses will exclude articles with longer follow-ups, non-stringent definitions of ADHD or controls and statistically uncontrolled/controlled outcomes. Studies implementing a self-controlled case series methodology to investigate if ADHD drugs reduce the risk of injuries will be combined with a generalised linear mixed model using the Poisson distribution and a log link function.
Ruiz-Goikoetxea, Maite
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Cortese, Samuele
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Aznarez-Sanado, Maite
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Magallon, Sara
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Luis, Elkin
411cca65-0937-4462-8ed7-4bce12973ef5
Zallo, Noelia Alvarez
786f1f19-dc8f-4c62-befa-5b6322dcda86
de Castro-Manglano, Pilar
57a9786b-9cd9-4126-b38c-0c0c31e655d2
Soutullo, Cesar
af2ad4a9-e6d1-4bd3-8970-9fd794cd1c8d
Arrondo, Gonzalo
04d06971-cf7c-4753-9f46-d6fa37468022
September 2017
Ruiz-Goikoetxea, Maite
4f5ed354-2626-4099-8e46-246005445178
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Aznarez-Sanado, Maite
87ef48e3-4843-491c-a3bc-3ea015b2e635
Magallon, Sara
9b075c36-f41b-4987-9952-a124c6ba800d
Luis, Elkin
411cca65-0937-4462-8ed7-4bce12973ef5
Zallo, Noelia Alvarez
786f1f19-dc8f-4c62-befa-5b6322dcda86
de Castro-Manglano, Pilar
57a9786b-9cd9-4126-b38c-0c0c31e655d2
Soutullo, Cesar
af2ad4a9-e6d1-4bd3-8970-9fd794cd1c8d
Arrondo, Gonzalo
04d06971-cf7c-4753-9f46-d6fa37468022
Ruiz-Goikoetxea, Maite, Cortese, Samuele, Aznarez-Sanado, Maite, Magallon, Sara, Luis, Elkin, Zallo, Noelia Alvarez, de Castro-Manglano, Pilar, Soutullo, Cesar and Arrondo, Gonzalo
(2017)
Risk of unintentional injuries in children and adolescents with ADHD and the impact of ADHD medications: protocol for a systematic review and meta-analysis.
BMJ Open, 7, [e018027].
(doi:10.1136/bmjopen-2017-018027).
Abstract
INTRODUCTION:
Attention-deficit hyperactivity disorder (ADHD) has been related to increased rates of unintentional injuries. However, the magnitude of the effect and to which extent variables such as sex, age or comorbidity can influence this relationship is unknown. Additionally, and importantly, it is unclear if, and to which degree, ADHD medications can decrease the number of unintentional injuries. Due to the amount of economic and social resources invested in the treatment of injuries, filling these gaps in the literature is highly relevant from a public health standpoint. Here, we present a protocol for a systematic review and meta-analysis to estimate the relationship between ADHD and unintentional injuries and assess the impact of pharmacological treatment for ADHD METHODS AND ANALYSIS: We will combine results from 114 bibliographic databases for studies relating ADHD and risk of injuries. Bibliographic searches and data extraction will be carried out independently by two researchers. The studies' risk of bias will be assessed using the Newcastle-Ottawa Scale. Articles reporting ORs or HRs of suffering an injury in ADHD compared with controls (or enough data to calculate them) will be combined using Robust Variance Estimation, a method that permits to include multiple non-independent outcomes in the analysis. All analyses will be carried out in Stata. Age, sex and comorbid conduct disorders will be considered as potential causes of variance and their effect analysed through meta-regression and subgroup analysis. Sensitivity analyses will exclude articles with longer follow-ups, non-stringent definitions of ADHD or controls and statistically uncontrolled/controlled outcomes. Studies implementing a self-controlled case series methodology to investigate if ADHD drugs reduce the risk of injuries will be combined with a generalised linear mixed model using the Poisson distribution and a log link function.
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bmjopen-2017-018027
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Accepted/In Press date: 25 August 2017
e-pub ahead of print date: 25 September 2017
Published date: September 2017
Identifiers
Local EPrints ID: 415081
URI: http://eprints.soton.ac.uk/id/eprint/415081
ISSN: 2044-6055
PURE UUID: c68e45a5-3d87-40d3-b3e3-70081fbd86a3
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Date deposited: 25 Oct 2017 16:30
Last modified: 16 Mar 2024 04:21
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Contributors
Author:
Maite Ruiz-Goikoetxea
Author:
Maite Aznarez-Sanado
Author:
Sara Magallon
Author:
Elkin Luis
Author:
Noelia Alvarez Zallo
Author:
Pilar de Castro-Manglano
Author:
Cesar Soutullo
Author:
Gonzalo Arrondo
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