Pelham 2002.

Study characteristics
Methods	Cross‐over trial with 2 interventions: MPH placebo
Participants	Number of participants screened: not stated Number of participants included: 136 (all boys) Number of participants followed up: 136 Number of withdrawals: 0 Diagnosis of ADHD: DSM‐III‐R (therefore no subtype) Age: mean 9.7 years (range 7.6‐12.7) IQ: mean 104.5 MPH‐naive: not stated Ethnicity: white (81%), African American (15%) Country: USA Setting: Summer Treatment Program Comorbidity: ODD (53%), CD (24%) Comedication: not stated Other sociodemographics: median family income: USD 25,000, (range USD 10,000 to > USD 100,000) Inclusion criteria Boys attending a psychiatric institute and clinic intensive Summer Treatment Program over 8 weeks Exclusion criteria Not stated
Interventions	Participants were randomly assigned to 1 of 2 possible drug condition orders of 0.3 mg/kg MPH and placebo Mean MPH dosage: 10 mg (SD 2.7) Administration schedule: twice daily at 7:45 am and 11:45 am Duration of each medication condition programme: 12 days (order randomly assigned daily over 6 weeks, doses administered over week days, except on Fridays); follow‐up: 30 days Washout before trial initiation: 2 weeks medication‐free baseline in programme, unclear for follow‐up Titration period: none Treatment compliance: not reported
Outcomes	ADHD symptoms Daily ratings of inattention/hyperactivity using IOWA CRS completed by counsellor Daily ratings of inattention/hyperactivity using IOWA CRS completed by teacher General behaviour Daily ratings of oppositional defiant behaviour using IOWA CRS completed by counsellor Daily ratings of oppositional defiant behaviour using IOWA CRS, completed by teacher
Notes	Sample calculation: no Ethics approval: yes Comment from trial authors Boys were told 50% of the time whether they were receiving placebo or medication and incorrectly 50% of the time; all boys received behavioural interventions over the course of the programme Key conclusion of trial authors Expectancy (of treatment effectiveness) did not improve behaviour; only active medication improved behaviour Exclusion of MPH non‐responders/children who have previously experienced AEs while taking MPH before randomisation: no Any withdrawals due to AEs: no Funding source: NIMH (Grant MH48157) Email correspondence with trial authors: June 2014. Emailed trial authors to ask for additional information but have not received a reply
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Not described
Allocation concealment (selection bias)	Unclear risk	Not described
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Capsules were identical
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Raters were blinded to medication condition
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	All of the outcomes used for this review are reported for 133 of the 136 boys. The reason for the missing data is not stated. Selection bias (e.g. titration after randomisation → exclusion): Unclear
Selective reporting (reporting bias)	Unclear risk	Although measures were rated daily, how data were aggregated/reported as a single result per phase is not clear.