Ullmann 1985.

Study characteristics
Methods	8‐week, cross‐over trial: 3 doses of MPH (0.3 mg/kg, 0.5 mg/kg, 0.8 mg/kg) placebo Phases: 2 Phase 1: 4‐week fixed increase in MPH dose Phase 2: 4‐week randomised, cross‐over trial The trial was conducted over 3 years
Participants	Number of participants screened: not stated Number of participants included: 86 Number of participants followed up: 86 (67 boys, 19 girls) Number of withdrawals: 0 Diagnosis of ADHD: DSM‐III (ADD (15.1%), ADD‐H (70.9%), other (14.0%)) Age: mean 8.6 years (SD 1.8; range not stated) IQ: > 70 MPH‐naive: not stated Ethnicity: African American (17.4%), other (82.6%) Country: USA Setting: not stated Comorbidity: not stated Comedication: not stated Other sociodemographics: none Inclusion criteria ADHD diagnosis according to DSM‐III Exclusion criteria Not described
Interventions	Participants were randomly assigned to 3 different doses of MPH (0.3 mg/kg, 0.5 mg/kg and 0.8 mg/kg) and placebo Administration schedule: once daily, before school Duration of each medication condition: 1 week Washout before trial initiation: dose taken in the morning to the next day's dose Titration period: 4 weeks Treatment compliance: "compliance were probably high"
Outcomes	ADHD symptoms ADD/H Comprehensive Teacher Rating Scale: completed by teachers on a weekly basis, on the last day before treatment switching
Notes	Sample calculation: no information Ethics approval: no information Comment from trial authors Order effects were non‐significant, that is, ratings were similar for the first and second weeks on each dose, regardless of the order in which doses were given Key conclusion of trial authors Results from the study show that MPH has a major effect in improving attention and is helpful in decreasing activity levels but often has only a minor effect on deficient social skills and oppositional (aggressive) 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. Ciba‐Geigy provided medication and placebo Email correspondence with trial authors: not able to find first or second trial author's contact information; therefore not able to request supplemental data necessary for meta‐analyses
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Random assignment
Allocation concealment (selection bias)	High risk	No description; only "methylphenidate in opaque capsules"
Blinding of participants and personnel (performance bias) All outcomes	High risk	No description
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Teacher rating under blinded conditions
Incomplete outcome data (attrition bias) All outcomes	Low risk	Data were pooled for a total of 86 participants Selection bias (e.g. titration after randomisation → exclusion): no
Selective reporting (reporting bias)	Unclear risk	Unable to obtain protocol