Representativeness of Participants in a Clinical Trial for Attention-Deficit/Hyperactivity Disorder?: Comparison With Adults From a Large Observational Study
Open accessAbstract
Article AbstractBackground: Clinical trials have demonstrated that pharmacotherapies can safely treat attention-deficit/hyperactivity disorder (ADHD) in adulthood. Eligibility criteria in these trials may significantly limit their external validity by excluding a significant portion of adults with ADHD in the general population. In particular, exclusion criteria may frequently exclude individuals with comorbid mental health conditions, which are common in the adult ADHD population. Method: We addressed the representativeness of clinical trials by comparing 146 adult clinical trial participants with DSM-IV ADHD and a community sample composed of 124 adults with DSM-IV ADHD and 123 non-ADHD controls. Subjects were compared on socioeconomic status, Hollingshead occupational code, cognitive measures, lifetime psychopathology, and Global Assessment of Functioning (GAF) scale ratings. Results: Adults with ADHD in the community sample had higher rates of lifetime psychiatric comorbidity, lower GAF scores, and lower occupational codes than those in the clinical trial. The clinical trial eligibility criteria would have excluded 61% of community sample adults with ADHD. This excluded portion of the community sample had higher rates of lifetime psychiatric comorbidity and lower GAF scores than clinical trial participants. Conclusions: Adults with ADHD participating in the clinical trial had less evidence of functional impairment and endorsed less psychiatric comorbidity than the majority of community sample subjects with ADHD. This suggests that findings from clinical trials may have limited external validity for adults with ADHD in the general population, particularly for those adults with ADHD with the greatest burden of comorbid psychopathology.J Clin PsychiatrySubmitted: May 08, 2009; accepted July 14, 2009. Online ahead of print: August 10, 2010 (doi:10.4088/JCP.09m05344pur). Corresponding author: Craig B. H. Surman, MD, Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Ste 2000, 185 Alewife Brook Pkwy, Cambridge, MA 02138 (csurman@partners.org).
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
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?
Findings from one RCT in US adults with ADHD suggest that approximately 31% of individuals with ADHD presenting for routine clinical care would meet eligibility for participation in the RCT.
“Findings from one RCT in US adults with ADHD suggest that approximately 31% of individuals with ADHD presenting for routine clinical care would meet eligibility for participation in the RCT.8”
From Evaluating ADHD medication trial representativeness: a Swedish population-based study comparing hypothetically trial-eligible and trial-ineligible individuals (2025) · cites this paper as [8]
The Results and Discussion report that 61% of the community sample would have been ineligible, implying 39% eligible—not approximately 31%. The Methods also say the community sample came from both hospital referrals and advertisements, rather than solely from people presenting for routine clinical care. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredRandomized trial conclusions are limited by sample sizes and treatment lengths too short to detect rare but serious substance-related events, by generalizability questions, and by ethical concerns about withholding effective treatment.
“Conclusions from randomized clinical trials have been constrained by sample sizes and treatment durations that may be insufficient to detect rare-yet-serious substance-related events, questions regarding generalizability, and ethical concerns about withholding efficacious treatments (24, 25).”
From ADHD Medication and Substance-Related Problems (2017) · cites this paper as [25]
The Introduction and Discussion (pages not provided) support the generalizability concern: adults in ADHD trials may not represent adults with ADHD in the community. The paper describes a six-week trial and exclusions for substance abuse, but does not say that trial size or duration prevents detection of rare serious substance-related events, or discuss ethical concerns about withholding effective treatment. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe percentage of ineligible adults in this study aligns with the 61% of adults with ADHD in a community sample reported by Surman and colleagues to be excluded due to stringent eligibility criteria.
“The percentage of ineligible adults aligns with that previously reported in one single RCT by Surman and colleagues,8 who found that 61% of adults with ADHD in a community sample would be excluded due to stringent eligibility criteria.”
These findings are based on one RCT in a specific country and refer to adults only.
“However, these findings are based on one RCT in a specific country and refer to adults only.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Kessler, R. C., Adler, L., Barkley, R., Biederman, J., Conners, C. K., Demler, O., Faraone, S. V., Greenhill, L. L., Howes, M. J., Secnik, K., et al. (2006) · American Journal of Psychiatry · doi:10.1176/ajp.2006.163.4.716 · Cited by 3,886 · see citing works
Self-citationBest Estimate of Lifetime Psychiatric Diagnosis
Leckman, J. F. (1982) · Archives of General Psychiatry · doi:10.1001/archpsyc.1982.04290080001001 · Cited by 1,418 · see citing works
Mannuzza, S. (1993) · Archives of General Psychiatry · doi:10.1001/archpsyc.1993.01820190067007 · Cited by 1,368 · see citing works
A Family Study of Schizoaffective, Bipolar I, Bipolar II, Unipolar, and Normal Control Probands
Gershon, E. S. (1982) · Archives of General Psychiatry · doi:10.1001/archpsyc.1982.04290100031006 · Cited by 987 · see citing works
(1993) · American Journal of Psychiatry · doi:10.1176/ajp.150.12.1792 · Cited by 950 · see citing works
Self-citationAttention deficit hyperactivity disorder adults: Comorbidities and adaptive impairments
Murphy, K., & Barkley, R. A. (1996) · Comprehensive Psychiatry · doi:10.1016/s0010-440x(96)90022-x · Cited by 700 · see citing works
McGough, J. J., Smalley, S. L., McCracken, J. T., YANG, M. H., Del’Homme, M., Lynn, D. E., & Loo, S. K. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.9.1621 · Cited by 398 · see citing works
Spencer, T., Biederman, J., Wilens, T., Doyle, R., Surman, C., Prince, J., Mick, E., Aleardi, M., Herzig, K., & Faraone, S. (2005) · Biological Psychiatry · doi:10.1016/j.biopsych.2004.11.043 · Cited by 385 · see citing works
Self-citationGender effects on Attention-Deficit/Hyperactivity disorder in adults, revisited
Biederman, J., Faraone, S. V., Monuteaux, M. C., Bober, M., & Cadogen, E. (2004) · Biological Psychiatry · doi:10.1016/j.biopsych.2003.12.003 · Cited by 385 · see citing works
Self-citationFaraone, S. V., Biederman, J., Spencer, T., Mick, E., Murray, K., Petty, C., Adamson, J. J., & Monuteaux, M. C. (2006) · American Journal of Psychiatry · doi:10.1176/ajp.2006.163.10.1720 · Cited by 329 · see citing works
Self-citationGender differences in a sample of adults with attention deficit hyperactivity disorder.
Biederman, J., Faraone, S., Spencer, T., Wilens, T., Mick, E., & Lapey, K. A. (1994) · Psychiatry Research · doi:10.1016/0165-1781(94)90092-2 · Cited by 327 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 2
- [5]First M Spitzer R Gibbon M Structured Clinical Interview for DSM-IV Axis I Disorders 1997 American Psychiatric Press Washington, DC
- [9]Hollingshead AB Four Factor Index of Social Status 1975 Yale University Press New Haven, CT
Cited by
Sorted by citations
Kennedy-Martin, T., Curtis, S., Faries, D., Robinson, S., & Johnston, J. (2015) · Trials · doi:10.1186/s13063-015-1023-4 · Cited by 878 · see citing works
ADHD Medication and Substance-Related Problems
Quinn, P. D., Chang, Z., Hur, K., Gibbons, R. D., Lahey, B. B., Rickert, M. E., Sjölander, A., Lichtenstein, P., Larsson, H., & D’Onofrio, B. M. (2017) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2017.16060686 · Cited by 187 · see citing works
Philipsen, A., Jans, T., Graf, E., Matthies, S., Borel, P., Colla, M., Gentschow, L., Langner, D., Jacob, C., Groß-Lesch, S., et al. (2015) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2015.2146 · Cited by 175 · see citing works
Chang, Z., Ghirardi, L., Quinn, P. D., Asherson, P., D’Onofrio, B. M., & Larsson, H. (2019) · Biological Psychiatry · doi:10.1016/j.biopsych.2019.04.009 · Cited by 175 · see citing works
Surman, C. B. H., Biederman, J., Spencer, T., Miller, C. A., McDermott, K. M., & Faraone, S. V. (2013) · ADHD Attention Deficit and Hyperactivity Disorders · doi:10.1007/s12402-012-0100-8 · Cited by 155 · see citing works
Self-citationEffect of Psychostimulants on Brain Structure and Function in ADHD
Spencer, T. J., Brown, A., Seidman, L. J., Valera, E. M., Makris, N., Lomedico, A., Faraone, S. V., & Biederman, J. (2013) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.12r08287 · Cited by 152 · see citing works
Self-citationBiederman, J., Petty, C. R., Day, H., Goldin, R. L., Spencer, T. J., Faraone, S. V., Surman, C. B. H., & Wozniak, J. R. (2012) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0b013e3182475267 · Cited by 135 · see citing works
Self-citationGinsberg, Y., & Lindefors, N. (2011) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.111.092940 · Cited by 99 · see citing works
Huss, M., Ginsberg, Y., Tvedten, T., Arngrim, T., Philipsen, A., Carter, K., Chen, C.-W., & Kumar, V. (2013) · Advances in Therapy · doi:10.1007/s12325-013-0085-5 · Cited by 61 · see citing works
Morris, S. S. J., Musser, E. D., Tenenbaum, R. B., Ward, A. R., Martinez, J. F., Raiker, J. S., Coles, E. K., & Riopelle, C. (2019) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-019-00593-8 · Cited by 57 · see citing works
Jans, T., Jacob, C., Warnke, A., Zwanzger, U., Groß‐Lesch, S., Matthies, S., Borel, P., Hennighausen, K., Haack‐Dees, B., Rösler, M., et al. (2015) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12443 · Cited by 56 · see citing works
Long-term functional outcome in adult prison inmates with ADHD receiving OROS-methylphenidate
Ginsberg, Y., Hirvikoski, T., Grann, M., & Lindefors, N. (2012) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-012-0317-8 · Cited by 54 · see citing works
Goodman, D. W., Mitchell, S., Rhodewalt, L., & Surman, C. B. H. (2016) · Drugs & Aging · doi:10.1007/s40266-015-0327-0 · Cited by 59 · see citing works
Self-citationDo stimulants improve functioning in adults with ADHD?
Surman, C. B. H., Hammerness, P. G., Pion, K., & Faraone, S. V. (2013) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2012.02.010 · Cited by 47 · see citing works
Self-citationOerbeck, B., Øvergaard, K. R., Aspenes, S. T., Pripp, A. H., Mørdre, M., Aase, H., Reichborn‐Kjennerud, T., & Zeiner, P. (2017) · BMC Psychiatry · doi:10.1186/s12888-017-1204-7 · Cited by 45 · see citing works
Philipsen, A., Graf, E., Jans, T., Matthies, S., Borel, P., Colla, M., Gentschow, L., Langner, D., Jacob, C., Groß-Lesch, S., et al. (2014) · ADHD Attention Deficit and Hyperactivity Disorders · doi:10.1007/s12402-013-0120-z · Cited by 44 · see citing works
Asherson, P., Bushe, C., Saylor, K. E., Tanaka, Y., Deberdt, W., & Upadhyaya, H. (2014) · Journal of Psychopharmacology · doi:10.1177/0269881114542453 · Cited by 49 · see citing works
Long-Term Treatment Outcome in Adult Male Prisoners With Attention-Deficit/Hyperactivity Disorder
Ginsberg, Y., Långström, N., Larsson, H., & Lindefors, N. (2015) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0000000000000395 · Cited by 36 · see citing works
Garcia-Argibay, M., Chang, Z., Brikell, I., Kuja-Halkola, R., D'Onofrio, B. M., Lichtenstein, P., Newcorn, J. H., Faraone, S. V., Larsson, H., & Cortese, S. (2025) · The Lancet Psychiatry · doi:10.1016/s2215-0366(24)00396-1 · Cited by 31 · see citing works
Self-citationAssessment of Physician Practices in Adult Attention-Deficit/Hyperactivity Disorder
Goodman, D. W., Surman, C. B. H., Scherer, P. B., Salinas, G. D., & Brown, J. J. (2012) · The Primary Care Companion For CNS Disorders · doi:10.4088/pcc.11m01312 · Cited by 30 · see citing works
Self-citationAdult Attention-Deficit/Hyperactivity Disorder Treatment and Cardiovascular Implications
Hammerness, P. G., Surman, C. B. H., & Chilton, A. (2011) · Current Psychiatry Reports · doi:10.1007/s11920-011-0213-3 · Cited by 24 · see citing works
Self-citationBoesen, K., Gøtzsche, P. C., & Ioannidis, J. P. A. (2021) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796021000147 · Cited by 24 · see citing works
Boesen, K., Saiz, L. C., Erviti, J., Storebø, O. J., Gluud, C. N., Gøtzsche, P. C., & Jørgensen, K. J. (2017) · BMJ Evidence-Based Medicine · doi:10.1136/ebmed-2017-110716 · Cited by 22 · see citing works
Geissler, J. M., Jans, T., Banaschewski, T., Becker, K., Renner, T., Brandeis, D., Döpfner, M., Dose, C., Hautmann, C., Holtmann, M. H., et al. (2018) · Trials · doi:10.1186/s13063-018-2635-2 · Cited by 21 · see citing works
Jans, T., Graf, E., Jacob, C., Zwanzger, U., Groß‐Lesch, S., Matthies, S., Perlov, E., Hennighausen, K., Jung, M., Rösler, M., et al. (2012) · ADHD Attention Deficit and Hyperactivity Disorders · doi:10.1007/s12402-012-0092-4 · Cited by 16 · see citing works
Extended-release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults
Boesen, K., Paludan‐Müller, A. S., Gøtzsche, P. C., & Jørgensen, K. J. (2022) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012857.pub2 · Cited by 21 · see citing works
Hodgkins, P., Dittmann, R., Sorooshian, S., & Banaschewski, T. (2013) · Expert Review of Neurotherapeutics · doi:10.1586/ern.13.31 · Cited by 13 · see citing works
Extended‐release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults
Boesen, K., Danborg, P., Gøtzsche, P., & Jørgensen, K. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012857 · Cited by 27 · see citing works
ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives
Bogdańska-Chomczyk, E., Majewski, M. K., & Kozłowska, A. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms262211020 · Cited by 15 · see citing works
Lyhmann, I., Widding‐Havneraas, T., Bjelland, I., Markussen, S., Elwert, F., Chaulagain, A., Mykletun, A., & Halmøy, A. (2024) · BMJ Mental Health · doi:10.1136/bmjment-2024-301003 · Cited by 10 · see citing works
Clinical Trials Studying Suicide Risk Reduction: Who is Excluded From Participation
Lawrence, R. E., Jaffe, C., Zhao, Y., Wang, Y., & Goldberg, T. E. (2024) · Archives of Suicide Research · doi:10.1080/13811118.2024.2322128 · Cited by 8 · see citing works
Clinical Assessment of ADHD in Adults
Surman, C. B. H. (2012) · Humana Press eBooks · doi:10.1007/978-1-62703-248-3_2 · Cited by 8 · see citing works
Self-citationObservational Epidemiology Within Randomized Clinical Trials: Getting a Lot for (Almost) Nothing
Howard, G., & Howard, V. J. (2012) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2011.08.003 · Cited by 8 · see citing works
Selbst- und Fremdwahrnehmung von Beeinträchtigungen exekutiver Funktionen bei Erwachsenen mit ADHS
Rizzo, P., Steinhausen, H., & Drechsler, R. (2012) · Zeitschrift für Psychiatrie Psychologie und Psychotherapie · doi:10.1024/1661-4747/a000108 · Cited by 8 · see citing works
Jans, T., & Jacob, C. (2013) · Humana Press eBooks · doi:10.1007/978-1-62703-248-3_10 · Cited by 7 · see citing works
Shared and distinct patterns of atypical cortical morphometry in children with autism and anxiety
Yin, S., Hong, S., Martino, A. D., Milham, M. P., Park, B., Benkarim, O. M., Bethlehem, R. A. I., Bernhardt, B. C., & Paquola, C. (2021) · Cerebral Cortex · doi:10.1093/cercor/bhab502 · Cited by 6 · see citing works
Huang, V., Hogan, D. B., Ismail, Z., Maxwell, C. J., Smith, E. E., & Callahan, B. L. (2020) · Canadian Geriatrics Journal · doi:10.5770/cgj.23.416 · Cited by 4 · see citing works
Crescenzo, F. D., Зиганшина, Л. Е., Yudina, E. V., Kaplan, Y. C., Ciabattini, M., Wei, Y., & Hoyle, C. H. V. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013044 · Cited by 6 · see citing works
Attention deficit hyperactivity disorder in prison inmates
Ginsberg, Y. (2012) · Figshare · Cited by 2 · see citing works
Adams, S. M., Meraz, R., O’Reilly, L. M., Riley, T. N., Froehlich, T. E., Chang, Z., Quinn, P. D., & D'Onofrio, B. M. (2026) · Biological Psychiatry Global Open Science · doi:10.1016/j.bpsgos.2026.100698 · Cited by 1 · see citing works
Peyre, H., Purper-Ouakil, D., & Mouren, M. (2012) · Neuropsychiatrie de l Enfance et de l Adolescence · doi:10.1016/j.neurenf.2011.05.006 · Cited by 1 · see citing works
In Memoriam: Professor Joseph Biederman’s Contributions to Child and Adolescent Psychiatry
Faraone, S. V., Newcorn, J. H., Wozniak, J. R., Joshi, G., Coffey, B. J., Uchida, M., Wilens, T. E., Surman, C. B. H., & Spencer, T. J. (2024) · Journal of Attention Disorders · doi:10.1177/10870547231225818 · Cited by 1 · see citing works
Self-citationKan onda cirklar brytas? Om ADHD med antisocialitet och ADHD-behandling på Norrtäljeanstalten.
Ginsberg, Y. (2013) · Socialmedicinsk tidskrift · doi:10.62607/smt.v90i3.43286
Surman, C. B. H., Hammerness, P. G., & Miller, K. (2009) · Current Attention Disorders Reports · doi:10.1007/s12618-009-0018-z
Self-citationCarrión, J. J. S. (2013) · Papers Revista de Sociologia · doi:10.5565/rev/papers/v99n1.539
Neiss, H., Schupp, J., & Behrens, J. (2014) · SSRN Electronic Journal · doi:10.2139/ssrn.2439256
The Sociology of Medical Evaluation: Case Studies
Carrión, J. J. S. (2013) · Dialnet (Universidad de la Rioja)
Employment Acquisition, Work Productivity, and Job Retention
London, J. B., Molinero, A. M., & McCue, M. P. (2011)
Graf, E., Perlov, M. E., Philipsen, A., Jung, H. M., Schulte-Altedorneburg, M., Poustka, L., Bliznak, L., & Gentschow, L. (2013)
Boesen, K., Paludan‐Müller, A. S., & Ioannidis, J. P. A. (2021) · medRxiv · doi:10.1101/2021.12.07.21267067
redacció, E. D. (2013) · Papers Revista de Sociologia · doi:10.5565/rev/papers/v99n1.1806
Surman, C. B. H., Walsh, D. M., & Bond, J. B. (2024) · Journal of Attention Disorders · doi:10.1177/10870547231218041
Self-citationHow Should We Think About Study Drugs? From Efficacy to Equality
Evans, N. G., & Bird, S. (2026) · Neuroethics · doi:10.1007/s12152-026-09665-1
Nurkhametova, D., Yudina, E. V., Wei, Y., Abakumova, T. R., & Зиганшина, Л. Е. (2026) · International Journal of Risk & Safety in Medicine · doi:10.1177/09246479261461033
- Authors
- Surman, C. B. H., Monuteaux, M. C., Petty, C. R., Faraone, S. V., Spencer, T. J., Chu, N. F., & Biederman, J.
- Affiliations
- Massachusetts General Hospital (US)
- SUNY Upstate Medical University (US)
- Corresponding author
- Surman, Craig B. H.
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2010-08-10
- Volume
- 71
- Issue
- 12
- Pages
- 1612-1616
- ISSN
- 0160-6689 (ISSN-L)
- PMC
- PMC3737773
- OpenAlex
- W1996472589
- Cited by
- 54
- References
- 11
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 4 · 2022: 1 · 2021: 3 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 4 · 2015: 5 · 2014: 2 · 2013: 11 · 2012: 9
- FWCI
- 5.23
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R29MH57511, R01MH057934, R29MH057511, R01MH-57934)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics in Clinical Research
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
- Keywords
- adult ADHD, clinical trial representativeness, generalizability, inclusion and exclusion criteria, psychiatric comorbidity, functional disability, Global Assessment of Functioning, occupational status, socioeconomic status
- MeSH terms
- Adult, Attention Deficit Disorder with Hyperactivity, Clinical Trials as Topic, Cognition, Female, Humans, Male, Mental Health, Middle Aged, Occupations, Psychiatric Status Rating Scales, Residence Characteristics, Sampling Studies, Severity of Illness Index, Social Class, United States, Comorbidity, Selection Bias, Patient Selection, Observation, Diagnostic and Statistical Manual of Mental Disorders
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
