Wallace 1994.

Study characteristics
Methods	Double‐blind, single‐participant, randomised, cross‐over trial: MPH placebo Conducted in 11 hospitalised children with ADHD
Participants	Number of participants screened: not stated Number of participants included: 11 Number followed up: 11 Number of withdrawals: 0 Diagnosis of ADHD: DSM‐III‐R (subtype not described) Age: mean 9 years 5 months (range 4‐13 years) IQ: not stated MPH‐naive: not stated Ethnicity: not stated Country: USA Setting: inpatient Comorbidity type: not stated Other sociodemographics: none Inclusion criteria Children diagnosed with ADHD who were hospitalised at a psychiatric hospital Exclusion criteria Not stated
Interventions	Participants were randomly assigned to 1 of 2 conditions: MPH and placebo on a daily basis Mean MPH dosage: not stated Administration schedule: daily Duration of each medication condition: MPH 2‐7 days, placebo 3‐6 days Washout before trial initiation: not described Medication‐free period between interventions: none Titration period: "Prior to trial commencement, all participants were treated with MPH for a period long enough to determine the dose believed to have optimal effectiveness and minimal side effects" Treatment compliance: not described
Outcomes	ADHD symptoms Abbreviated CTRS (15‐item): rated by teachers and by day and night nursing staff Serious AEs Side effects mentioned but not reported Non‐serious AEs Side effects mentioned but not reported
Notes	Sample calculation: not stated Ethics approval: not stated Comment from trial authors Assigning highly consistent rates would reduce variance in measurements Key conclusions of trial authors n‐of‐1 trial is useful for evaluating the effectiveness of MPH in individual patients with ADHD Short duration of MPH action allows for multiple cross‐over trials over a brief time Comment from review authors Data are not reported in a suitable form for meta‐analysis; therefore we could use no data from this trial Exclusion of MPH non‐responders/children who have previously experienced AEs while taking MPH before randomisation: yes, see titration before randomisation Any withdrawals due to AEs: no Funding source: The Veterans Administration Medical Center, Vermont Email correspondence with trial authors: we could find no contact information; therefore, we could not get additional data through personal email correspondence with trial authors
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Sequence was determined by "coin toss method"
Allocation concealment (selection bias)	Unclear risk	Allocation concealment not described
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	"After completion of each trial, the treatment code was broken" Method of blinding not described
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not stated
Incomplete outcome data (attrition bias) All outcomes	Low risk	All data appear to have been reported. Selection bias (e.g. titration after randomisation → exclusion): no, but trial length was changed according to MPH response
Selective reporting (reporting bias)	High risk	Protocol not identified "Also trial length increased as effect size decreased, implying that if clinical effects were unconvincing, the trial was extended. The trials examined here did have trial length designated at commencement by the treating psychiatrist (generally 10 days). However, trials were extended, if after the predetermined number of days, the graphed data appeared equivocal."