Aman 1987

Methods	Cross‐over trial of omega‐6 PUFA versus placebo
Participants	Inclusion criteria: children with scores on the Attention Problem subscale of the Revised Behavior Problem Checklist (RBPC) and Inattention subscale of the Conners Teacher questionnaire above the 90th percentile (n = 26). Five additional children from another study diagnosed with DSM III ADD by a child psychiatrist were also included. Exclusion criteria: not stated. Mean age: 8.86 years; gender: 27 boys and 4 girls; loss to follow‐up: 1/31 Baseline IQ 101.07; Conners inattention subscale: 3.08, hyperactivity: 2.80; RBPC attention problem scale: 20.42, motor excess: 6.23 Setting: Auckland, New Zealand
Interventions	Cross‐over trial of 4 weeks of omega‐6 PUFA or placebo, 1 week washout and 4 weeks of alternate. Three capsules of PUFA or placebo were to be taken twice daily. Omega‐6 PUFA: Efamol capsules contained 360 mg linoleic acid and 45 mg gamma‐linoleic acid Placebo: 500 mg of liquid paraffin
Outcomes	ADHD symptoms Parent rated RBPC subscales: attention; motor excess Teacher rated Conners Questionnaire subscales: inattention; hyperactivity and ADD‐H Comprehensive Teacher Rating Scale (ACTeR)  subscales: attention, hyperactivity Behaviour Parent‐rated RBPC subscales: conduct; socialised aggression; anxiety‐withdrawal; psychotic behaviour Teacher‐rated Conners Questionnaire subscales: conduct; tension/anxiety and ACTeR subscales: social skills, oppositional behaviour All scales were measured at 4 weeks
Notes	Variances were not reported therefore data could not be included in a meta‐analysis
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Not stated
Allocation concealment (selection bias)	Unclear risk	Not stated
Blinding of participants and personnel (performance bias) All outcomes	Low risk	The authors stated that the trial was double‐blind and that the intervention and control were given as "indistinguishable capsules"
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Capsules "indistinguishable" and parent and teacher‐rated scales used
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	One child lost to follow‐up in the placebo group
Selective reporting (reporting bias)	Low risk	Data were reported for all outcomes
Other bias	Unclear risk	It was not clear whether the additional 5 children included in the trial would have met the original inclusion criteria. Baseline characteristics of each group were not reported. The trial was funded by Efamol Research Inc.