Evidence map›Paper›PMID 39344292›Full record

Observational studyJournal of child psychology and psychiatry, and allied disciplines2025

Treatments with versus without medication for children with behavioural difficulties in clinical practice: an economic evaluation with observational data.

Caitlin K Kiernan, Hermien H Dijk, Barbara J van den Hoofdakker, Pieter J Hoekstra, Annabeth P Groenman

Abstract readObservational Study
In one paragraph

Observational study in Journal of child psychology and psychiatry, and allied disciplines, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Caitlin K KiernanDepartment of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID 0000-0001-9512-0897
Hermien H DijkDepartment of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Barbara J van den HoofdakkerDepartment of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Pieter J HoekstraDepartment of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Annabeth P GroenmanDepartment of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID 0000-0002-8394-6605

Funding

ZonMw 729300013
6 · The paper itself

Abstract

backgroundEconomic evaluations of treatments for children with behavioural difficulties (i.e., characteristics of attention-deficit/hyperactivity disorder (ADHD) and/or oppositional defiant disorder (ODD)) usually rely on data of randomised controlled trials or are model-based. Findings of such studies may not be representative of cost-effectiveness and cost-utility in clinical practice. The current longitudinal study aimed to perform an economic evaluation of treatments for children with hyperactivity, impulsive behaviours, inattention, and/or behavioural difficulties using observational data that were obtained in clinical practice.

methodsParents of 209 children (aged 5-12) who were referred to 1 of 10 Dutch youth mental healthcare institutions and who received treatment with (n = 108) or without (n = 101) the use of medication, filled out questionnaires at three timepoints (baseline, and ~ 6 and ~12 months later). Propensity score matching was used to make both groups comparable. Outcomes included quality-adjusted life years (QALYs), ADHD and ODD symptom severity, and impairment. Costs were measured from a societal perspective. Incremental cost-effectiveness ratios (ICERs) were estimated, and cost-effectiveness acceptability curves (CEACs) were derived to show uncertainty around the ICER.

resultsResults did not show statistically significant differences in costs and effects between children who were treated with medication (alone or in combination with non-medication treatment) and those who were treated without medication. CEAC suggested that medication treatment has a 55% probability of being cost-effective at the €80,000 threshold and 36% at the €20,000 threshold compared with treatment without medication.

conclusionsUsing observational data, our study did not provide clear evidence of the cost-effectiveness and cost-utility of treatment with medication compared with treatment without medication in clinical practice.

Indexed as

Attention Deficit and Disruptive Behavior DisordersAttention Deficit Disorder with HyperactivityCost-Benefit AnalysisChildChild, PreschoolFemaleHumansLongitudinal StudiesMaleNetherlandsADHDbehaviour problemsEconomic evaluationlongitudinal studiespharmacotherapy

Identifiers

PMID39344292
PMCPMC11812490

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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.