Evaluation of individual subjects in the analog classroom setting: I. Examples of graphical and statistical procedures for within-subject ranking of responses to different delivery patterns of methylphenidate
Describes graphical and statistical methods to evaluate differences in response patterns of children with attention deficit hyperactivity disorder (ADHD) to different treatment conditions with methylphenidate (MP) in a double-blind crossover study of 4 conditions (3 patterns of delivery of MP and a placebo control). Ss were evaluated across an 11-hr (7 AM to 6 PM) laboratory school day, and classroom behavior was assessed at regular intervals with the SKAMP rating scale of impairment and the CLAM rating scale of symptom presence. Graphical displays of the time courses of behavior ratings across each double-blind test day were developed for each individual. Expert clinicians judged these graphs and used this information to rank-order the test days from best to worst. A within-S variant of Kendall's W evaluated concordance of rankings; generalized κ evaluated the reliability of rankings across conditions; and ANOVA evaluated whether the conditions differed in terms of consensus ranks for the study as a whole. Results support the use of expert judges in summarizing and evaluating repeated classroom behavior measures to determine response patterns. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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