Researcher to be sacked after reporting high rates of ADHD

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[sSRI-Research] Researcher to be sacked after reporting high

rates of ADHD

 

 

 

http://bmj.bmjjournals.com/

 

Jeffrey Katz, Ph.D ... president of Children and

Adults with Attention-Deficit/Hyperactivity Disorder

(CHADD BMJ 2005;330:691 (26 March),

doi:10.1136/bmj.330.7493.691

 

PubMed Citation

Articles by Lenzer, J.

 

Related content

 

Child and adolescent psychiatry

 

Research and publication ethics

 

Researcher to be sacked after reporting high rates of

ADHD

 

New York Jeanne Lenzer

 

A US researcher who said that doctors and

psychologists may be

overdiagnosing attention deficit hyperactivity

disorder (ADHD) in children

has been placed on administrative leave " with intent

to terminate " her

employment. The move came after charges of scientific

misconduct against

her, and her computers have been seized.

 

Dr Gretchen LeFever, a clinical psychologist and

associate professor in the

department of paediatrics at the East Virginia Medical

School, was notified

that the school intends to terminate her employment

with effect from the end

of March.

 

Her work has been controversial. She first made

headline news in 1999 when

she reported that 8% to 10% of elementary school

pupils in southeastern

Virginia were being prescribed drugs for ADHD, a

percentage two to three

times the estimated national average (American Journal

of Public Health

1999;89:1359-64).

 

Criticism grew after she published the results of a

2002 study showing that

the prevalence of the disorder among children in

grades 2 to 5 had risen to

17% (Psychology in the Schools 2002;39:63-71).

 

In December Gerald Pepe, interim dean of the medical

school, wrote to Dr

LeFever charging her with " jeopardising the rights of

children " and

deviating from a research protocol.

 

Dr LeFever denies the charges and said she believes

she is being sacked for

reasons relating to her concern about widespread use

of drugs. She said the

charge that she jeopardised the rights of children

arose during a multisite

study in which parents and teachers filled out surveys

about children and

ADHD. The medical school's internal review board had

ruled that such a study

was " exempt " from consent requirements. It said

consent was not needed

because the board determined that " study subjects were

the adults who

answered the survey. "

 

After the charges were made against Dr LeFever the

medical school approached

the Office of Human Research Protection for

clarification and determined

that both children and parents were participants and

therefore her study was

not exempt.

 

Dr LeFever said many similar studies had been carried

out under an exempt

status when parents filled out surveys about their

children. " I clearly

stated what I was doing, and the IRB [internal review

board] approved

everything I did. If there was a mistake, it was the

IRB's. "

 

One of her main critics is Jeffrey Katz, a clinical

psychologist in Virginia

Beach and the local coordinator of the Children and

Adults with

Attention-Deficit/Hyperactivity Disorder group.

<Jeffrey Katz, Ph.D is

president of Children and Adults with

Attention-Deficit/Hyperactivity

Disorder (CHADD) in that part of Virginia - Vince>.

Dr Katz questioned her

claim that the condition had been diagnosed in 17% of

children in grades 2

to 5.

 

He said, " When somebody like Dr LeFever makes these

claims that are

apparently not based on good research, it minimises a

very real problem.

Parents won't bring their children in for evaluation,

because they are

afraid that medication will be automatically

prescribed. They think it's a

bad thing and the sole treatment. But medication can

have significant

benefits. "

In May 2004 an anonymous whistleblower charged Dr

LeFever with " scientific

misconduct. " The whistleblower pointed out a

discrepancy between Dr LeFever's

published report of the wording of the survey question

and the actual

question used for her 2002 study. In the original

survey parents were asked:

" Does your child have attention or hyperactivity

problems, known as ADD or

ADHD? " The published version of the question was " Has

your child been

diagnosed with attention or hyperactivity problems

known as ADD or ADHD? "

 

Dr LeFever counters that the difference in wording was

a simple oversight

resulting from repeated revision of the article. " The

findings are validated

by the rate of ADHD medication treatment, " she said.

" Of the children in our

study with ADHD, 84% were on ADHD medication. "

 

William Pelham, professor of psychology, paediatrics

and psychiatry at the

State University of New York, Stony Brook, dismissed

the criticism of Dr

LeFever over the wording of the survey question as

" ridiculous. " Dr Pelham,

who is also a researcher in ADHD, said the wording

used by Dr LeFever and

her colleagues is " commonplace " among researchers

doing surveys. He added

that drug companies' funding of community groups and

research has created

obstacles for experts who question the use of

stimulants.

 

Julie Zito, associate professor of pharmacy and

psychiatry at the University

of Maryland, who reported in 2000 that preschool

children as young as 2 to 4

years old were increasingly being prescribed

stimulants (JAMA

2000;283:1025-30), said that the rise in the use of

stimulant drugs is

probably due to many factors, including wider

diagnostic criteria, direct to

consumer advertising, and advocacy for ADHD.

 

But Dr LeFever's detractors say the altered wording of

her survey may have

contributed to the high prevalence of ADHD that she

reported. Tim Tjersland,

a clinical psychologist in Virginia Beach, said he

tried to verify Dr

LeFever's findings for his doctoral thesis. " We could

not replicate [her

results]. When people say ADHD is overdiagnosed,

that's a very severe and

serious accusation. "

 

David Antonuccio, a professor of psychiatry and

behavioural sciences at the

University of Nevada School of Medicine, said, " This

is a case of shooting

the messenger. Dr LeFever has since been vindicated by

recent CDC [Centers

for Disease Control and Prevention] data and other

studies showing alarming

increases in the use of psychotropic drugs in

children. "

 

Officials at the medical school would only confirm

that Dr LeFever is on

administrative leave but did not respond to other

questions about her

pending termination.

 

 

 

© 2005 BMJ Publishing Group Ltd

 

 

 

 

 

 

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