Australian ADHD Guidelines Conflicts Allegedly Properly Managed

I noted on November 23 that the Australian government had pulled draft ADHD treatment guidelines due to concerns that they leaned heavily upon the work of Harvard's Joseph Biederman who's embroiled in all kinds of controversy and investigations due to his taking millions from pharma companies while allegedly doing unbiased research. A couple of days later the Royal Australasian College of Physicians announced that no such pull back would happen.

"The body charged with setting new guidelines for the treatment of ADHD has refused to release details of payments by drug companies to its experts, but has said conflicts of interest are being properly 'managed.'

"The comment by the Royal Australasian College of Physicians comes after health experts this week called on federal Health Minister Nicola Roxon to appoint a new panel to draft ADHD treatment guidelines that was free of conflicts of interest.

"Ms Roxon yesterday brushed aside criticism of the panel as well as concerns that its draft ADHD guidelines had been tainted by drug company payments to a US expert.

"Instead, she said she expected new ADHD treatment guidelines would be released in the 'very near future.'"

Yes, nothing to see here, move along. What's stunning is that Biederman's work is reportedly cited in the draft guideline 50 times. That doesn't sit well with every Aussie psychiatrist, however.

"Monash University child psychiatry expert George Halasz said more scrutiny was needed of this panel's links to the drugs industry, as well as the panel that drafted the original 1997 guidelines because there was a risk of 'systemic dysfunction.'

"'Clearly there are question marks about bias and conflicts of interest,' he said.

"'There is no dominant theory about what ADHD is.'

"'When there's no dominant theory you have to ask why there are people who insist on declaring the case is closed, when it's just false.'"

At least in Australia they are willing to thrash out the tricky issues involved. I fear we don't do such a good job in the States. It'll be interesting to see where this whole process winds up.

Of interest as well is that a reported 60,000 kids were on ADHD drugs in Oz in 2007. The nation has 21 million people or so. In the US, we have about 300 million people with 2.5 million-plus kids on ADHD meds. If the US ADHD diagnosing and treating rate of kids were the same as Australia's, you'd expect about 850,000 American kids to have an ADHD diagnosis. Instead, we have three times-plus that many, so perhaps they are actually doing something right in Australia, regardless of where this current guidelines process ends up.