Evidence map›Paper›PMID 24477798›Full record

ArticleJAMA psychiatry2014

Serious transport accidents in adults with attention-deficit/hyperactivity disorder and the effect of medication: a population-based study.

Zheng Chang, Paul Lichtenstein, Brian M D'Onofrio, Arvid Sjölander, Henrik Larsson

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JAMA psychiatry, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03221244 (Virtual Reality Attention Management Program for Improving Attention in Children), which is not on this map. Cited by 149 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
149citing papers in PubMed, 15 pooled it
15.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03221244 narecruitingnot on this mapstarted 2016, after this paper: background citation

Virtual Reality Attention Management Program for Improving Attention in Children

TypeinterventionalSponsorUniversity of California, DavisRan2016 to 2027Enrolled50ConditionsADHDArmsVR Treatment, VR Active Control
3 · Its place in the literature

Who cites it

149 citing papers in PubMed, 15 syntheses or guidelines pooled it, 293 citations in OpenAlex.

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  19. ADHD and metabolic syndrome: behavioral and weight-related pathways to cardiovascular risk.European archives of psychiatry and clinical neuroscience · 2026
    Article
  20. Stimulant Medications and Bone Health.Current osteoporosis reports · 2026
    Review

89 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

Zheng ChangDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Paul LichtensteinDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Brian M D'OnofrioDepartment of Psychological and Brain Sciences, Indiana University, Bloomington.
Arvid SjölanderDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Henrik LarssonDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Karolinska Institutet · SEIndiana University Bloomington · US

Funding

Quasi-experimental studies of early risk factors for severe psychopathologyR01HD061817 · NICHD · TRUSTEES OF INDIANA UNIVERSITY · PI D'ONOFRIO, BRIAN M, LICHTENSTEIN, PAUL · 2010 to 2013
$1.3M
NICHD NIH HHS HD061817NICHD NIH HHS R01 HD061817
6 · The paper itself

Abstract

importanceStudies have shown that attention-deficit/hyperactivity disorder (ADHD) is associated with transport accidents, but the magnitude of the association remains unclear. Most important, it is also unclear whether ADHD medication reduces this risk.

objectivesTo estimate the association between ADHD and the risk of serious transport accidents and to explore the extent to which ADHD medication influences this risk among patients with ADHD. DESIGN, SETTING, AND

participantsIn total, 17,408 patients with a diagnosis of ADHD were observed from January 1, 2006, through December 31, 2009, for serious transport accidents documented in Swedish national registers. The association between ADHD and accidents was estimated with Cox proportional hazards regression. To study the effect of ADHD medication, we used stratified Cox regression to compare the risk of accidents during the medication period with the risk during the nonmedication period within the same patients. MAIN OUTCOMES AND MEASURES: Serious transport accident, identified as an emergency hospital visit or death due to transport accident.

resultsCompared with individuals without ADHD, male patients with ADHD (adjusted hazard ratio, 1.47; 95% CI, 1.32-1.63) and female patients with ADHD (1.45; 1.24-1.71) had an increased risk of serious transport accidents. In male patients with ADHD, medication was associated with a 58% risk reduction (hazard ratio, 0.42; 95% CI, 0.23-0.75), but there was no statistically significant association in female patients. Estimates of the population-attributable fractions suggested that 41% to 49% of the accidents in male patients with ADHD could have been avoided if they had been receiving treatment during the entire follow-up. CONCLUSIONS AND RELEVANCE: Attention-deficit/hyperactivity disorder is associated with an increased risk of serious transport accidents, and this risk seems to be possibly reduced by ADHD medication, at least among male patients. This should lead to increased awareness among clinicians and patients of the association between serious transport accidents and ADHD medication.

Indexed as

RegistriesAccidents, TrafficAdolescentAdultAttention Deficit Disorder with HyperactivityFemaleHumansMaleMiddle AgedProportional Hazards ModelsRiskSex FactorsSwedenYoung Adult

Identifiers

PMID24477798
PMCPMC3949159
OpenAlexW2120831849

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.