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The Multimodal Treatment Study of Children With Attention-Deficit/Hyperactivity Disorder (MTA)¹ was seriously flawed.

First, the study was not placebo controlled or double blind. The MTA not only lacked a placebo control group, but in drawing their conclusions, the investigators relied on evaluations made by teachers and parents who were not blinded to the treatment. The MTA was "open label," with all the scientific flaws associated with such studies. As Nies and Spielberg² observed, "Placebo effects, which occur in a large percentage of patients, can confound many studies—particularly those that involve subject responses; controls must take this into account."²(p45)

There were no ethical or scientific reasons not to use placebo control groups. There are numerous recent double-blind placebo-controlled studies of stimulants for attention-deficit/hyperactivity disorder, including 8 that I reviewed from 1990 to 1998.^{3, 4} One lasted longer than 15 months.⁵ Many children in the MTA study went without medication in the . . . [Full Text of this Article]

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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Evidence, Interpretation, and Qualification From Multiple Reports of Long-Term Outcomes in the Multimodal Treatment Study of Children With ADHD (MTA): Part II: Supporting Details
Swanson et al.
J Atten Disord 2008;12:15-43.
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