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December 1999

Development of Clinical Services for Attention-Deficit/Hyperactivity Disorder

Arch Gen Psychiatry. 1999;56(12):1097-1099. doi:10.1001/archpsyc.56.12.1097

THE RESULTS of the Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder (MTA) trial by the MTA Cooperative group1,2 have been eagerly awaited internationally. It is a landmark in the evolution of children's mental health into an evidence-based discipline. It is particularly impressive that so detailed and intensive a treatment regimen was delivered consistently across sites for so many cases. For once, the number of subjects in a trial is enough for robust conclusions. The outcome measures do justice to the complexity of the disorder and include most of the major domains in which adverse outcomes are to be expected in untreated groups. The strong lesson is that ambitious trials are also feasible. Where there are the will and resources to test treatment practices, it can be done with sufficient rigor to command authority from statisticians, trial experts, and clinicians.

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