Tirosh 1993a.

Study characteristics
Methods	16‐day, double‐blind, cross‐over, counterbalanced trial with 2 interventions: MPH placebo
Participants	Number of participants screened: not stated Number of participants included: 20 (16 boys, 4 girls) Number of participants followed up: 20 Number of withdrawals: 0 Diagnosis of ADHD: DSM‐III (ADD 30%, ADHD 70%) Age: mean 9.3 years (range 7‐12) IQ: mean 102 (SD 11) MPH‐naive: 100% Ethnicity: not stated Country: Israel Setting: outpatient clinic Comorbidity: no Comedication: no Other sociodemographics: middle (12), upper‐middle (5) and low (3) socioeconomic status of parents Inclusion criteria DSM‐III diagnosis of ADHD 7‐12 years old Exclusion criteria MPH before trial Neurological, sensory or physical health problems
Interventions	Participants were randomly assigned to 1 of 2 possible drug condition orders of MPH and placebo MPH dose range: 0.3 mg/kg ‐0.5 mg/kg Administration schedule: twice daily Duration of each medication condition: 8 days Washout before trial initiation: no (participants were MPH‐naive) Titration period: no Treatment compliance: parents were asked to bring their packages of tablets back for pill count; no data
Outcomes	ADHD symptoms Abbreviated Parent Rating Scale (APRS), weekly Teacher Rating Scale (TRS), weekly
Notes	Sample calculation: no Ethics approval: yes Key conclusions of trial authors Teacher Rating Scale: placebo‐drug difference correlated more significantly with outcome measures than did the baseline drug difference Trial underlines the validity of a multi‐measure placebo/drug trial in evaluating the efficacy of MPH for children with attention deficit disorder 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: none Email correspondence with trial authors: August 2013. Trial author stated that data were discarded (Ramstad 2013d [pers comm]).
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Randomisation with a table of random numbers
Allocation concealment (selection bias)	Low risk	Look‐alike placebo tablets were supplied by the hospital pharmacy and were similarly administered
Blinding of participants and personnel (performance bias) All outcomes	Low risk	Double‐blind
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Double‐blind
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	No information Selection bias (e.g. titration after randomisation → exclusion): no
Selective reporting (reporting bias)	Unclear risk	No protocol available