Vrednotenje kakovosti raziskav razširjenosti motnje pozornosti s hiperaktivnostjo

Tivadar, Michelle (author), Locatelli, Igor (mentor), Štuhec, Matej (comentor)

Ozadje: Motnja pozornosti s hiperaktivnostjo (ADHD) je razvojna nevrološka motnja, za katero ocenjujejo, da prizadene približno 5–7 % otrok in mladostnikov ter 2–5 % odraslih. Ocene razširjenosti te motnje po svetu in med posameznimi raziskavami so zelo variabilne, najverjetneje zaradi metodoloških razlik pri raziskovanju. Za oblikovanje najboljših dokazov in s tem odločitev v zdravstvu je pomembno, da povzemamo samo najkakovostnejšo in nepristransko strokovno literaturo. Kritično vrednotenje raziskav o razširjenosti ADHD so do zdaj izvedli samo pri enem celovitem sistematičnem pregledu, ki zajema otroke, mladostnike in odrasle po vsem svetu. Namen: Kritično ovrednotiti raziskave, ki poročajo o razširjenosti ADHD, z uporabo veljavnega orodja in oceniti verjetnost za pristranosti pri njihovem načrtovanju, izvedbi in analizi. Metode: Iz nabora 266 raziskav, ki poročajo o razširjenosti ADHD, smo identificirali 94 takih, ki poročajo o trenutni razširjenosti klinično pridobljene diagnoze ADHD, jih razdelili v skupine po zasnovi in razvojnem obdobju preiskovancev ter jih s pomočjo izbranega orodja kritično ovrednotili po tveganju za pristranost. Pri tem smo upoštevali številne vire pristranosti in priredili ocenjevalno shemo orodja po zgledu Cochraneovega orodja RoB-2 za randomizirane kontrolirane raziskave. Rezultati: Trenutno najustreznejše orodje za kritično vrednotenje raziskav, ki poročajo o razširjenosti motenj in bolezni, je orodje Inštituta Joanne Briggs (JBI). Kar 57 raziskav (60,6 %), ki poročajo o razširjenosti klinično diagnosticiranega ADHD, je močno pristranskih in zgolj šest raziskav (6,4 %) ima nizko tveganje za pristranost. Najkakovostnejše so v zasnovi eno- in dvostopenjske klinične raziskave, hkrati pa je visoko tveganje za pristranost najpogosteje vpeljano ravno pri teh. Sklepi: Velikemu deležu dokazov na področju razširjenosti ADHD ne moremo popolnoma zaupati. Pomembno je, da izvajalci sistematičnih pregledov in metaanaliz izvedejo kritično vrednotenje raziskav, in za oblikovanje najboljših dokazov v zdravstvu povzemajo samo najkakovostnejšo literaturo. Pristop h kritičnemu vrednotenju raziskav mora biti strukturiran, premišljen in jasno predstavljen.

• Language: Slovenian
• Keywords: ADHD – motnja pozornosti s hiperaktivnostjo, razširjenost, kritično vrednotenje, orodje JBI
• Work type: Master's thesis/paper
• Organization: FFA - Faculty of Pharmacy
• Year: 2022
• PID: 20.500.12556/RUL-142484
• Publication date in RUL: 11.11.2022

Secondary language

• Language: English
• Title: Quality evaluation of studies on attention deficit hyperactivity disorder prevalence

Abstract

Background: Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder estimated to affect approximately 5-7% of children and adolescents and 2-5% of adults. Estimates of the prevalence of the disorder vary widely around the world and between studies, most likely due to methodological differences between studies. To generate the best evidence and therefore decisions in healthcare, it is important to summarise only the highest quality and unbiased literature. To date, only one comprehansive systematic review, covering children, adolescents and adults worldwide has critically appraised the included research on the prevalence of ADHD. Objectives: To critically appraise studies reporting the prevalence of ADHD using a valid tool, in order to assess the likelihood of bias in their design, conduct and analysis. Methods: From a pool of 266 studies reporting the prevalence of ADHD, we identified 94 studies reporting the point prevalence of a clinically acquired diagnosis of ADHD, grouped them accordnig to the study design and developmental period of the subjects, and critically evaluated them for risk of bias using the selected tool. We took into account multiple sources of bias and adapted the tool's rating scheme to the Cochrane RoB-2 tool for randomized trials. Results: Currently, the most appropriate tool for critically evaluating studies reporting the prevalence of disorders and diseases is The Joanna Briggs Institute Critical Appraisal Tool. As many as 57 studies (60,6%) reporting the prevalence of clinically diagnosed ADHD are highly biased and only six studies (6.4%) have a low risk of bias. The highest quality studies are the one- and two-stage clinical studies, but it is in these that the high risk of bias is most often introduced. Conclusions: Much of the evidence on the prevalence of ADHD cannot be fully trusted. It is important that systematic reviewes and meta-analysts critically appraise research, and summarise only the highest quality literature to generate the best evidence in healthcare. The approach to critical appraisal of research needs to be structured, carefully thought out and clearly presented.

• Keywords: ADHD – attention deficit hyperactivity disorder, prevalence, critical appraisal, JBI tool