The DOI matches its Crossref record; 47 of the 48 references it cites were found in a registry or an index; none of the 43 sources its claims cite is checked for support yet.
Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up
Open accessAbstract
Objective To evaluate the hypothesis of stimulant medication effect on physical growth in the follow-up phase of the Multimodal Treatment Study of Children With ADHD.Method Naturalistic subgroups were established based on patterns of treatment with stimulant medication at baseline, 14-, 24-, and 36-month assessments: not medicated (n = 65), newly medicated (n = 88), consistently medicated (n = 70), and inconsistently medicated (n = 147). Analysis of variance was used to evaluate effects of subgroup and assessment time on measures of relative size (z scores) obtained from growth norms.Results The subgroup x assessment time interaction was significant for z height (p <.005) and z weight (p <.0001), due primarily to divergence of the newly medicated and the not medicated subgroups. These initially stimulant-naïve subgroups had z scores significantly >0 at baseline. The newly medicated subgroup showed decreases in relative size that reached asymptotes by the 36-month assessment, when this group showed average growth of 2.0 cm and 2.7 kg less than the not medicated subgroup, which showed slight increases in relative size.Conclusions Stimulant-naïve school-age children with Combined type attention-deficit/hyperactivity disorder were, as a group, larger than expected from norms before treatment but show stimulant-related decreases in growth rates after initiation of treatment, which appeared to reach asymptotes within 3 years without evidence of growth rebound.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
In the MTA 3-year follow-up, stimulant-naive children with ADHD Combined type who started and continued stimulant medication showed declines in relative height and weight compared with a stimulant-untreated clinical control subgroup, with no evidence of growth rebound. The authors conclude that stimulant-related growth slowing can persist up to 3 years and may warrant revision of monitoring recommendations.
Key findings
- Naturalistic subgroup × assessment time interactions were significant for z height (p < .005) and z weight (p < .0001); decomposition showed the “starting medication” contrast accounted for 92% of the height interaction and 72.8% of the weight interaction.
- The newly medicated subgroup (n = 88) diverged from the not medicated subgroup (n = 65): by 36 months, newly medicated children were 3.04 cm shorter and 2.71 kg lighter than not medicated children; the abstract reports average growth of 2.0 cm and 2.7 kg less than the not medicated subgroup. The not medicated subgroup showed slight increases in relative size.
- At 36 months, z height/z weight were: not medicated 0.541/0.756; newly medicated 0.073/0.293; consistently medicated −0.120/0.156; LNCG 0.234/0.425. Exposure regressions showed negative slopes for years treated (z height 0.589 − 0.218[years], p < .0001; z weight 0.776 − 0.183[years], p < .0004) and dose-related height reduction (z height 0.493 − 0.0117[mg/kg], p = .0010) but not weight (p = .2486).
- No growth rebound was supported: newly medicated children increased slightly from 24 to 36 months, but the not medicated subgroup did too, and treated groups did not exceed the untreated clinical control. Findings did not support delayed maturation; untreated ADHD children grew faster than norms/LNCG.
Methods
- MTA follow-up of 579 children aged 7.0–9.9 years with ADHD Combined type from seven North American sites. Naturalistic subgroups were based on SCA-PI reports of stimulant use in the 30 days before baseline, 14-, 24-, and 36-month assessments: not medicated (n = 65), newly medicated (n = 88), consistently medicated (n = 70), and inconsistently medicated (n = 147); complete data were available for 370 of 485 follow-up children.
- CDC 2000 growth norms converted height and weight to z scores. Two-way ANOVA tested subgroup, assessment time, and interaction; orthogonal decomposition compared starting medication and consistency of medication; regression related cumulative exposure/dose to 36-month relative size. A local normative comparison group of classmates provided comparison at 24 and 36 months (213 of 279).
Limitations
- The authors state the most important limitation is lack of random assignment to the naturalistic subgroups; subgroups were formed by initial MTA assignment and later self-selection to start, stop, or continue medication, so the never-medicated group may have been selected for good behavioral response and medicated groups may have included poor behavior-therapy responders.
- The authors state follow-up covered only 3 years, participants were 10–12 years old at the 36-month assessment, and ultimate adult size was not addressed; only immediate-release methylphenidate was systematically evaluated, while Adderall and controlled-release formulations were not evaluated.
- The authors state medication use was defined from SCA-PI reports and the specific contributions of dose or consistency were not adequately evaluated; planned weekend/summer medication holidays were not evaluated. Evident from the text: the observational subgroup design cannot establish causality and may be confounded by selection or indication.
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Claims the paper makes
37 Own result · 28 Not checked yet · 20 Own method · 12 Own interpretation · 7 No basis given
None of the sources cited for this claim have been checked yet.
In the paper
“at the 36-month assessment, there were no group differences apparent.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > RESULTS
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“which accounted for 92% of the interaction for height (F 3,441 = 11.77;p < .0001)”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > RESULTS
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- The authors state this as an assumption: Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
- The authors state this as an assumption: z scores for height and weight are expected to remain constant over time based on an assumption of normal growth rates during the MTA protocol.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“which showed slight increases in relative size.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Abstract
plainn = 65 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- The authors state this as an assumption: Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
- The authors state this as an assumption: z scores for height and weight are expected to remain constant over time based on an assumption of normal growth rates during the MTA protocol.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The newly medicated subgroup manifested a slight increase in relative size from the 24-to 36-month assessment.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- The authors state this as an assumption: Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
- The authors state this as an assumption: z scores for height and weight are expected to remain constant over time based on an assumption of normal growth rates during the MTA protocol.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Stimulant-naı ¨ve school-age children with Combined type attention-deficit/hyperactivity disorder were, as a group, larger than expected from norms before treatment”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- The authors state this as an assumption: Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and 72.8% for weight (F 3,438 = 21.76;p < .0001)”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > RESULTS
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- The authors state this as an assumption: Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
- The authors state this as an assumption: z scores for height and weight are expected to remain constant over time based on an assumption of normal growth rates during the MTA protocol.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The stimulant-untreated clinical control group was taller and heavier than average (not medicated: z height 0.541 and z weight 0.765)”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > RESULTS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- The authors state this as an assumption: Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
- The authors state this as an assumption: z scores for height and weight are expected to remain constant over time based on an assumption of normal growth rates during the MTA protocol.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For those left untreated with stimulant medication, the growth rate over the next 3 years was greater as opposed to less than that of the LNCG (the classmate control group) or the population norms.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > DISCUSSION
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- The authors state this as an assumption: Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The fitted equations had negative slopes indicating significant exposure-related reduction in relative height”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > RESULTS
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- The authors state this as an assumption: Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
- The authors state this as an assumption: z scores for height and weight are expected to remain constant over time based on an assumption of normal growth rates during the MTA protocol.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and z weight (p < .0001)”
- Also stated in: § RESULTS · plain
“and z weight (F 9,1,068 = 8.88; p < .0001)”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- The authors state this as an assumption: Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
- The authors state this as an assumption: z scores for height and weight are expected to remain constant over time based on an assumption of normal growth rates during the MTA protocol.
- Also stated in: § RESULTS · plain
- It may state two separate claims as one. 30
- Probably not a substantial claim. 19
- The quote only partly states this claim. 1
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At the baseline assessment, the consistently medicated subgroup was smaller than the inconsistently medicated subgroup, and this difference was maintained over time”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > RESULTS
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- The authors state this as an assumption: Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
- The authors state this as an assumption: z scores for height and weight are expected to remain constant over time based on an assumption of normal growth rates during the MTA protocol.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The consistency of medication contrast was also significant, but this was due to a main effect of group without an interaction with assessment time.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > RESULTS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- The authors state this as an assumption: Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
- The authors state this as an assumption: z scores for height and weight are expected to remain constant over time based on an assumption of normal growth rates during the MTA protocol.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“newly medicated: z height 0.073 and z weight 0.293”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > RESULTS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- The authors state this as an assumption: Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
- The authors state this as an assumption: z scores for height and weight are expected to remain constant over time based on an assumption of normal growth rates during the MTA protocol.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“consistently medicated: z height j0.120 and z weight 0.156”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > RESULTS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- The authors state this as an assumption: Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
- The authors state this as an assumption: z scores for height and weight are expected to remain constant over time based on an assumption of normal growth rates during the MTA protocol.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“By the 36-month assessment, this subgroup was significantly smaller than the stimulant-untreated clinical control group (not medicated), even though it was nominally larger than the LNCG.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > DISCUSSION
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- The authors state this as an assumption: Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
- The authors state this as an assumption: z scores for height and weight are expected to remain constant over time based on an assumption of normal growth rates during the MTA protocol.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and 4.21 cm shorter and 3.51 kg lighter than the not medicated subgroup.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > RESULTS
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- The authors state this as an assumption: Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
- The authors state this as an assumption: z scores for height and weight are expected to remain constant over time based on an assumption of normal growth rates during the MTA protocol.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and 1.1 cm shorter and 0.7 kg lighter than the LNCG.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > RESULTS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- The authors state this as an assumption: Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
- The authors state this as an assumption: z scores for height and weight are expected to remain constant over time based on an assumption of normal growth rates during the MTA protocol.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“but was slightly smaller at baseline and did not increase in relative size as much as the not medicated group over the 3-year follow-up.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > DISCUSSION
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- The authors state this as an assumption: Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
- The authors state this as an assumption: z scores for height and weight are expected to remain constant over time based on an assumption of normal growth rates during the MTA protocol.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“was at 36 months 3.04 cm shorter and 2.71 kg lighter than the not medicated subgroup”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > RESULTS
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- The authors state this as an assumption: Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
- The authors state this as an assumption: z scores for height and weight are expected to remain constant over time based on an assumption of normal growth rates during the MTA protocol.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The consistently medicated subgroup was 2.3 cm shorter and 1.5 kg lighter than the LNCG”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > RESULTS
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- The authors state this as an assumption: Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
- The authors state this as an assumption: z scores for height and weight are expected to remain constant over time based on an assumption of normal growth rates during the MTA protocol.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“This difference in annual growth rates may be present for up to 3 years of treatment and accumulate to result in a difference of about 2.0 cm in height and about 2.0 kg in weight.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Clinical Implications
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“which suggests lack of effectiveness for stimulant medication at the 36-month assessment in the presence of lingering but significant stimulantrelated reduction in growth rate”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Limitations
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, the self-selection to stay not medicated was based largely on satisfactory results with the assigned behavioral treatment, whereas decisions to continue or start medication were not necessarily based on satisfaction with treatment results.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Limitations
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The excess dopamine is dispersed by blood flow, reaches the pituitary, and retards growth in these animals.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > DISCUSSION
What the sources say
- Not checked yetcites Bosse et al., 1997 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“These subgroups did not differ in severity of ADHD symptoms or initial relative size at the baseline assessment.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one. The quote only partly states this claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Both randomization and self-selection operated to form these naturalistic subgroups.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > RESULTS
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“To support the hypothesis of growth rebound, the growth rates of the stimulant-treated groups would have to exceed that of the stimulant-untreated clinical control group, which did not occur in this study.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > DISCUSSION
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: The naturalistic subgroups do not differ on unmeasured factors that affect growth.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Compliance with initial randomly assigned treatment conditions was not perfect during the treatment phase, and adherence to these conditions waned during the follow-up phases of the MTA”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > METHOD
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Consensus reviews and statements decades apart (see NIH Consensus Committee, 1998;Roche et al., 1979) discounted the clinical significance of this hypothesis, based on prevailing views that short-term growth suppression may occur but does not result in longterm effects on ultimate size.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Abstract
What the sources say
- Not checked yetcites NIH Consensus Committee, 1998
- Not checked yetcites Roche et al., 1979 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The comparison of these two subgroups in terms of growth velocity after initiating medication revealed the time course of stimulant-related reduction in annual growth rate, which was maximal in the first year, decreased in the second year, and absent in the third year of treatment.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > DISCUSSION
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- The authors state this as an assumption: Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
- The authors state this as an assumption: z scores for height and weight are expected to remain constant over time based on an assumption of normal growth rates during the MTA protocol.
- Rests on an assumption: The naturalistic subgroups do not differ on unmeasured factors that affect growth.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“It is notable that the four subgroups did not differ on initial size at birth (birth weight), age, parent or teacher ratings of ADHD symptoms, sex, expected adult size (mid-parent size), welfare status, or maternal smoking (Table 2).”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > RESULTS
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The evidence of growth rebound is inconsistent and mostly circumstantial.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A fourth limitation was the definition of medication use based on information from the SCA-PI.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“the prevailing view is stated, indicating that the literature supports short-term decrements in rate of weight acquisition but not height acquisition, and no long-term effect on ultimate height.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Clinical Implications
What the sources say
- Not checked yetcites p 44S
hedged- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The authors may not put it forward as true. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“consistency of these classifications by medication have been considered as well, as in the naturalistic subgroups described here and in previous publications on the findings of the MTA follow-up”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“the use of summer (or periodic) holidays, which represent relatively long intervals of nontreatment interspersed within blocks of medication use in clinical practice, has been proposed as a strategy to mitigate stimulant-related reductions in growth rates (Safer et al., 1975)”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Limitations
What the sources say
- Not checked yetcites Safer et al., 1975 source
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A fifth limitation was the lack of evaluation of planned medication holidays on the weekends or during the summer”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“for the management of possible treatment-related side effects recommends the regular assessment of weight (but not height) as a Bclinical guideline[ but not as a Bminimal standard[ (p 29S)”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Clinical Implications
What the sources say
- Not checked yetcites American Academy of Child and Adolescent Psychiatry (2002)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“in 1998, 4 years after the initiation of the MTA, another stimulant, the 75:25 ratio of D,L-amphetamine (once used for weight control [Obetrol]) was renamed Adderall and was evaluated for the treatment of ADHD”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“were developed and became widely used in clinical practice, rapidly replacing the prescription of multiple daily doses of immediaterelease stimulant medications for the treatment of ADHD”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Limitations
What the sources say
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“and soon after became widely used in clinical practice”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“During the first two stages of treatment to titrate dose and select among alternative stimulants, weekly to monthly monitoring of both height and weight is suggested (Table 2, p 38S)”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Clinical Implications
What the sources say
- Not checked yetcites Table 2, p 38S
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“other definitions are possible and some have been considered here (i.e., total exposure in terms of milligrams consumed or days treated)”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Limitations
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“In this report the intent-to-treat evaluation of assigned treatment revealed that at 14 months the two groups assigned to systematic stimulant medication showed an initial reduction in growth rate for height (j1.23 cm/year) and weight (j2.48 kg/year), which dissipated by the 24-month assessment.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Abstract
What the sources say
- Not checked yetcites MTA Cooperative Group, 2004b
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Because Adderall was not available when the MTA was initiated, its effect was not evaluated and thus could not be reported here.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The practice parameter of the American Academy of Child and Adolescent Psychiatry (2002) regarding the use of stimulant medication (presently under revision) suggests that height and weight be measured before initiating treatment (p 28S)”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Clinical Implications
What the sources say
- Not checked yetcites American Academy of Child and Adolescent Psychiatry (2002)
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Two different definitions of medication use have been considered for the MTA analyses of efficacy (i.e., within 30 days before an assessment and 50% of the days since the previous assessment)”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Mattes and Gittelman (1983) evaluated groups of children with continuous treatment for 1 to 4 years and documented stimulant-related growth deficit that accumulated with the duration of treatment.It was still present during the final year of observation in the group treated for 4 years with methylphenidate, suggesting that growth slowing did not abate during continuous treatment.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Abstract
What the sources say
- Not checked yetcites Mattes and Gittelman (1983)
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“but recommendations for long-term monitoring are not explicitly provided”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Clinical Implications
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Spencer et al. (1996) proposed that maturational lag characterized the clinical condition of ADHD, which produced a reduction in growth rate that was correlated with but not necessarily a result of treatment with stimulant medication.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Abstract
What the sources say
- Not checked yetcites Spencer et al. (1996) source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Because these controlled-release formulations were not available or used when the MTA was initiated or during the initial two follow-up phases, they were not evaluated and could not be reported here.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thus, it is possible that the never-medicated group was pared down to good responders and the medicated groups enriched with poor Beh responders.”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Limitations
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“Adderall was shown to be effective in a double-blind study (Swanson et al., 1998)”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Limitations
What the sources say
- Not checked yetcites Swanson et al., 1998
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The authors state this as an assumption.
Baseline z scores are expected to be near zero based on an assumption of normal size at entry to the MTA.
“Based on an assumption of normal size at entry to the MTA, the baseline z scores are expected to be near zero”
The authors state this as an assumption.
z scores for height and weight are expected to remain constant over time based on an assumption of normal growth rates during the MTA protocol.
“and based on the assumption of normal growth rates during the MTA implementation of the MTA protocol, the z scores for height and weight are expected to remain constant over time.”
The paper relies on this without support.
The naturalistic subgroups do not differ on unmeasured factors that affect growth.
“The most important limitation of this study is the lack of random assignment to the subgroups that were evaluated here.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The reduction in weight gain appears to be somewhat more pronounced than that for height (over a 3-year period about 3 kg less than predicted) [39, 139].”
From European guidelines on managing adverse effects of medication for ADHD (2011) · cites this paper as [139]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The Multimodal Treatment of Attention Deficit Hyperactivity Disorder (MTA) study results identified stimulants as having a more persistent effect on decreasing growth velocity compared to most previous studies.110”
From Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents (2019) · cites this paper as [110]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Diminished growth was in the range of 1 to 2 cm from predicted adult height.”
From Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents (2019) · cites this paper as [110]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The results of the MTA study were particularly noted among children who were on higher and more consistently administered doses of stimulants.110”
From Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents (2019) · cites this paper as [110]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“The effects diminished by the third year of treatment, but no compensatory rebound growth was observed.110”
From Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents (2019) · cites this paper as [110]
In the citing paper
“Current data indicate that the initial effect of stimulants on growth appears to attenuate over time [39, 114, 139] and early studies of the adult outcomes of children treated with stimulant medications have suggested that final adult height is not affected [55, 71].”
From European guidelines on managing adverse effects of medication for ADHD (2011) · cites this paper as [139]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > RESULTS
“not medicated: z height 0.541 and z weight 0.765”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Clinical Implications
“| Not med | 65 | 0.617 0.915 0.113 0.621 0.954 0.118 0.652 | 0.975 0.121 | 0.756 | 1.01 | 0.125 |”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“Inconsistently (n = 147) | 58:89 | 80:67 | 68:79 | 74:73”
§ Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-up > Additional information
Reported 74 · recomputed 92
Citations
Cites
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Metadata
- Authors
- SWANSON, J. M., ELLIOTT, G. R., GREENHILL, L. L., WIGAL, T., ARNOLD, L. E., VITIELLO, B., HECHTMAN, L., EPSTEIN, J. N., PELHAM, W. E., ABIKOFF, H. B., NEWCORN, J. H., MOLINA, B. S. G., HINSHAW, S. P., WELLS, K. C., HOZA, B., JENSEN, P. S., GIBBONS, R. D., HUR, K., STEHLI, A., DAVIES, M., MARCH, J. S., CONNERS, C. K., CARON, M., & VOLKOW, N. D.
- Affiliations
- University of California, Irvine (US)
- McGill University (CA)
- University of California, Los Angeles (US)
- University of Vermont (US)
- University of Illinois Chicago (US)
- Duke University (US)
- Brookhaven National Laboratory (US)
- Corresponding author
- SWANSON, JAMES M.
- ORCID
- SWANSON, JAMES M.
- ELLIOTT, GLEN R.
- GREENHILL, LAURENCE L.
- ARNOLD, L. EUGENE
- VITIELLO, BENEDETTO
- HECHTMAN, LILY
- EPSTEIN, JEFFERY N.
- PELHAM, WILLIAM E.
- ABIKOFF, HOWARD B.
- NEWCORN, JEFFREY H.
- MOLINA, BROOKE S.G.
- HINSHAW, STEPHEN P.
- HOZA, BETSY
- JENSEN, PETER S.
- GIBBONS, ROBERT D.
- STEHLI, ANNAMARIE
- DAVIES, MARK
- VOLKOW, NORA D.
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2007-08
- Volume
- 46
- Issue
- 8
- Pages
- 1015-1027
- ISSN
- 0890-8567 (ISSN-L)
- OpenAlex
- W2082384177
- Cited by
- 323
- References
- 48
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 8 · 2023: 10 · 2022: 8 · 2021: 9 · 2020: 9 · 2019: 13 · 2018: 15 · 2017: 17 · 2016: 14 · 2015: 22 · 2014: 26 · 2013: 13 · 2012: 20
- FWCI
- 19.53
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- Funders
- U.S. Department of Health and Human Services
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- AstraZeneca
- GlaxoSmithKline
- Celgene
- H. Lundbeck A/S
- National Institutes of Health (n01mh12011-0-0-1, n01mh012009-007, n01mh012012-001)
- National Institute of Mental Health (N01MH 12011, U01MH50461, N01MH-12012, U01MH50440, U01MH050467, MH-50467, U01 MH50477, U01MH050440, N01 MH12009, U01MH50467, U01MH050461)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- stimulant medication, physical growth, attention deficit hyperactivity disorder, combined type ADHD, height z-score, weight z-score, medication adherence
- MeSH terms
- Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Behavior Therapy, Child, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Male, Severity of Illness Index, Time Factors
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