ArticleNeuropsychiatric disease and treatment2026
A Random Forest-Based Risk Prediction Model for Non-Response to Methylphenidate in Children with Attention Deficit Hyperactivity Disorder.
Article in Neuropsychiatric disease and treatment, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To develop and validate a prediction model based on the random forest algorithm to assess the risk of non-response to methylphenidate (MPH) in children with attention deficit hyperactivity disorder (ADHD), thereby providing decision support for individualized clinical treatment. Methods: A total of 150 children with ADHD who received MPH treatment were prospectively and consecutively enrolled. Based on changes in the Swanson, Nolan, and Pelham Rating Scale, Fourth Edition (SNAP-IV) scores after 3 months of treatment, patients were classified into a treatment response group (n = 116) and a non-response group (n = 34). Differences in clinical characteristics, pre-treatment clinical assessment scales, and laboratory parameters were compared. A random forest algorithm was used to construct the prediction model. Feature importance was evaluated based on the decrease in node impurity. Results: Serum 25-hydroxyvitamin D [25(OH)D], cortisol, S100β protein, brain-derived neurotrophic factor (BDNF), and urinary catecholamines were lower in the treatment non-response group. The combined subtype of ADHD, higher SNAP-IV total score, lower 25(OH)D levels, and lower dopamine levels were independent risk factors for non-response. In the random forest model, SNAP-IV score had the highest feature importance. The model, incorporating clinical characteristics, pre-treatment clinical assessment scales, and laboratory indicators, demonstrated excellent predictive performance in the test set (AUC=0.883; 95% confidence interval: 0.811-0.956) and an overall accuracy of 86.67%. Conclusion: The random forest-based prediction model can accurately identify children with ADHD who are unlikely to respond to MPH treatment.
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