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• W2153489985 abstract "The Puccini opera Tosca, beloved by many for more than a century, may finally be upstaged by a project of the same name—at least in the minds of child mental health aficionados waiting for research findings to advance their care for children. The upstart? The Treatment of Severe Child Aggression study (TOSCA). Like the opera, TOSCA is best appreciated in 3 acts, although the stage and the players differ for each act of our new TOSCA. The first act must open with a brief review of the history of randomized controlled trials (RCTs) and their role in improving public health. Arguably, one area where we have seen the greatest advances in children’s health during the past 50 years has been in the treatment of children’s cancers, specifically acute lymphoblastic leukemia. Before that time, nearly all children developing this form of leukemia succumbed to the illness. In contrast, current 5-year survival rates have reached 90%, with just a fraction of afflicted children ultimately dying of pediatric leukemia. 1 Kersey J.H. Fifty years of studies of the biology and therapy of childhood leukemia. Blood. 1997; 90: 4243-4251 PubMed Google Scholar How have these advances been accomplished? In the late 1960s and early 1970s, children benefited from a systematic “war on cancer” supported by legislation and a massive influx of funds into research at the National Cancer Institute. 2 National Cancer Institute. Developmental therapeutics. Milestone: National Cancer Act of 1971. http://dtp.nci.nih.gov/timeline/noflash/milestones/M4_Nixon.htm. Accessed June 9, 2014. Google Scholar In the pediatric oncology area, many multisite, placebo-controlled RCTs were launched, comparing various medications and medication combinations on children’s leukemia outcomes (e.g., survival rates). Most children who developed leukemia were enrolled in these clinical trials, such that every child with leukemia had the benefit of receiving treatment within a high-quality RCT that offered the best available chemotherapeutic treatment at the time or another experimental treatment that one hoped would be even better. 1 Kersey J.H. Fifty years of studies of the biology and therapy of childhood leukemia. Blood. 1997; 90: 4243-4251 PubMed Google Scholar Most importantly, the information obtained from the careful study of each child’s treatment responses during that era benefited future generations of children, as new knowledge of the most efficacious interventions was gradually distilled from these studies. Risperidone Added to Parent Training and Stimulant Medication: Effects on Attention-Deficit/Hyperactivity Disorder, Oppositional Defiant Disorder, Conduct Disorder, and Peer AggressionJournal of the American Academy of Child & Adolescent PsychiatryVol. 53Issue 9PreviewIn this study, we aimed to expand on our prior research into the relative efficacy of combining parent training, stimulant medication, and placebo (Basic therapy) versus parent training, stimulant, and risperidone (Augmented therapy) by examining treatment effects for attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD) symptoms and peer aggression, symptom-induced impairment, and informant discrepancy. Full-Text PDF" @default.
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• W2153489985 date "2014-09-01" @default.
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• W2153489985 title "TOSCA: No Longer Just an Opera" @default.
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• W2153489985 doi "https://doi.org/10.1016/j.jaac.2014.06.008" @default.
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