methylphenidate

any non-serious adverse event, proportion (non-comparative cohorts)

51.2% (95% CI 41.2% to 61.1%; 49 studies, 13,978 participants), n = 13978

Not recorded as a finding: closest node, adverse-reaction-incidence-ungraded, requires no severity classification applied; this figure explicitly excludes serious events (a severity classification), so it is a near-miss rather than a match, and there is no comparator arm

With non-comparative cohort studies, the proportion of participants on methylphenidate with any non-serious adverse events was 51.2% (95% CI 41.2% to 61.1%; 49 studies, 13,978 participants).

PMID:29744873 · one of two readings recorded this

any serious adverse event proportion, non-comparative cohort studies

1.20%, 95% CI 0.70% to 2.00%; 50 studies, 162,422 participants, n = 162422

Not recorded as a finding: single-arm proportion with no placebo/no-intervention contrast to anchor an absence-contrast edge

In the non-comparative cohort studies, the proportion of participants on methylphenidate experiencing any serious adverse event was 1.20% (95% CI 0.70% to 2.00%; 50 studies, 162,422 participants).

PMID:29744873 · one of two readings recorded this

any serious adverse event, proportion (non-comparative cohorts)

increases, 1.20% (95% CI 0.70% to 2.00%; 50 studies, 162,422 participants), n = 162422

In the non-comparative cohort studies, the proportion of participants on methylphenidate experiencing any serious adverse event was 1.20% (95% CI 0.70% to 2.00%; 50 studies, 162,422 participants).

PMID:29744873 · one of two readings recorded this

non-serious adverse event proportion, non-comparative cohort studies

51.2%, 95% CI 41.2% to 61.1%; 49 studies, 13,978 participants, n = 13978

With non-comparative cohort studies, the proportion of participants on methylphenidate with any non-serious adverse events was 51.2% (95% CI 41.2% to 61.1%; 49 studies, 13,978 participants).

PMID:29744873 · one of two readings recorded this

adverse cardiac events, incidence

no effect

There were no differences in the number of adverse cardiac events between participants with methylphenidate treatment and placebo or atomoxetine.

PMID:30127314 · one of two readings recorded this

adverse cardiac events, incidence, methylphenidate vs placebo/atomoxetine

no effect

Not recorded as a finding: no outcome node for adverse cardiac event incidence

There were no differences in the number of adverse cardiac events between participants with methylphenidate treatment and placebo or atomoxetine.

PMID:30127314 · one of two readings recorded this

adverse cardiac events, methylphenidate versus placebo or atomoxetine

no effect

Not recorded as a finding: no outcome node for adverse cardiac event incidence

There were no differences in the number of adverse cardiac events between participants with methylphenidate treatment and placebo or atomoxetine.

PMID:30127314 · one of two readings recorded this

heart rate and systolic blood pressure, post- versus pre-treatment change, atomoxetine versus methylphenidate

decreases

Not recorded as a finding: active comparator (atomoxetine), not a contrast against absence of methylphenidate

Children and adolescents treated with atomoxetine had more significant increases post- vs. pre-treatment HR (p = 0.025) and SBP (p < 0.001) than those treated with methylphenidate.

PMID:30127314 · one of two readings recorded this

heart rate (HR), atomoxetine vs methylphenidate post- vs pre-treatment change

increases, p = 0.025 (favouring greater increase with atomoxetine), p = 0.025

Children and adolescents treated with atomoxetine had more significant increases post- vs. pre-treatment HR (p = 0.025) and SBP (p < 0.001) than those treated with methylphenidate.

PMID:30127314 · one of two readings recorded this

heart rate (HR), post- vs pre-treatment change vs placebo

increases, p < 0.001

Children/adolescents and adults treated with methylphenidate had more significant increases in post- vs. pre-treatment HR (p < 0.001) and SBP (p < 0.001) than those treated by placebo.

PMID:30127314 · one of two readings recorded this

heart rate (HR), post- vs pre-treatment change vs placebo, meta-analysis

increases, p < 0.001

Not recorded as a finding: no outcome node for heart rate exists; heart-rate-variability-recovery is a different construct (post-exercise recovery HRV, not raw HR)

Children/adolescents and adults treated with methylphenidate had more significant increases in post- vs. pre-treatment HR (p < 0.001) and SBP (p < 0.001) than those treated by placebo.

PMID:30127314 · one of two readings recorded this

heart rate, post- versus pre-treatment change, methylphenidate versus placebo

increases

Not recorded as a finding: no outcome node for heart rate

Children/adolescents and adults treated with methylphenidate had more significant increases in post- vs. pre-treatment HR (p < 0.001) and SBP (p < 0.001) than those treated by placebo.

PMID:30127314 · one of two readings recorded this

systolic blood pressure, post- versus pre-treatment change, methylphenidate versus placebo

increases

Children/adolescents and adults treated with methylphenidate had more significant increases in post- vs. pre-treatment HR (p < 0.001) and SBP (p < 0.001) than those treated by placebo.

PMID:30127314 · one of two readings recorded this

systolic blood pressure (SBP), atomoxetine vs methylphenidate post- vs pre-treatment change

increases, p < 0.001 (favouring greater increase with atomoxetine)

Children and adolescents treated with atomoxetine had more significant increases post- vs. pre-treatment HR (p = 0.025) and SBP (p < 0.001) than those treated with methylphenidate.

PMID:30127314 · one of two readings recorded this

systolic blood pressure (SBP), post- vs pre-treatment change vs placebo

increases, p < 0.001

Children/adolescents and adults treated with methylphenidate had more significant increases in post- vs. pre-treatment HR (p < 0.001) and SBP (p < 0.001) than those treated by placebo.

PMID:30127314 · one of two readings recorded this

serious and non-serious adverse events, parallel versus crossover trial designs

no effect

We found no differences in serious and non-serious adverse events, and no risk of period and carryover effects.

PMID:30928951 · one of two readings recorded this

serious and non-serious adverse events; period and carryover effects

no effect

We found no differences in serious and non-serious adverse events, and no risk of period and carryover effects.

PMID:30928951 · one of two readings recorded this

teacher-rated ADHD symptoms, combined first-period/parallel-trial end versus last-period crossover end

Χ²=3.25, df=1, p=0.07, I²=69.2%, p = 0.07

We also found no differences when combining the end of first-period crossover trials with the end of parallel trials and comparing them to the end of last-period crossover trials (Χ²=3.25, df=1, p=0.07, I²=69.2%).

PMID:30928951 · one of two readings recorded this

teacher-rated ADHD symptoms, comparing parallel vs crossover trial-design estimates

no effect, Χ²=1.06, df=1, p=0.30, I²=5.5%, p = 0.3

Not recorded as a finding: this platform holds no node for the endpoint

When comparing methylphenidate with placebo or no-treatment on ADHD symptoms, we found no differences between the end of parallel trials and the first-period from crossover trials (Χ²=1.06, df=1, p=0.30, I²=5.5%).

PMID:30928951 · one of two readings recorded this

teacher-rated ADHD symptoms, end of parallel trials versus first-period crossover trials

Χ²=1.06, df=1, p=0.30, I²=5.5%, p = 0.3

When comparing methylphenidate with placebo or no-treatment on ADHD symptoms, we found no differences between the end of parallel trials and the first-period from crossover trials (Χ²=1.06, df=1, p=0.30, I²=5.5%).

PMID:30928951 · one of two readings recorded this

combined insomnia, pooled relative risk versus placebo

increases

Increased pooled relative risks (RRs) were found for methylphenidate-associated sleep-related AEs for insomnia (general), initial insomnia, middle insomnia, combined insomnia, and sleep disorder.

PMID:31090281 · one of two readings recorded this

initial insomnia, pooled relative risk versus placebo

increases

Increased pooled relative risks (RRs) were found for methylphenidate-associated sleep-related AEs for insomnia (general), initial insomnia, middle insomnia, combined insomnia, and sleep disorder.

PMID:31090281 · one of two readings recorded this

insomnia (general), pooled relative risk versus placebo

increases

Increased pooled relative risks (RRs) were found for methylphenidate-associated sleep-related AEs for insomnia (general), initial insomnia, middle insomnia, combined insomnia, and sleep disorder.

PMID:31090281 · one of two readings recorded this

methylphenidate-associated sleep-related adverse events (insomnia general, initial insomnia, middle insomnia, combined insomnia, sleep disorder), pooled relative risk from blinded placebo-controlled studies

increases

Not recorded as a finding: this platform holds no node for the endpoint

Increased pooled relative risks (RRs) were found for methylphenidate-associated sleep-related AEs for insomnia (general), initial insomnia, middle insomnia, combined insomnia, and sleep disorder.

PMID:31090281 · one of two readings recorded this

middle insomnia, pooled relative risk versus placebo

increases

Increased pooled relative risks (RRs) were found for methylphenidate-associated sleep-related AEs for insomnia (general), initial insomnia, middle insomnia, combined insomnia, and sleep disorder.

PMID:31090281 · one of two readings recorded this

sleep disorder, pooled relative risk versus placebo

increases

Increased pooled relative risks (RRs) were found for methylphenidate-associated sleep-related AEs for insomnia (general), initial insomnia, middle insomnia, combined insomnia, and sleep disorder.

PMID:31090281 · one of two readings recorded this

sleep-related adverse events — insomnia (general), initial insomnia, middle insomnia, combined insomnia, sleep disorder

increases

Increased pooled relative risks (RRs) were found for methylphenidate-associated sleep-related AEs for insomnia (general), initial insomnia, middle insomnia, combined insomnia, and sleep disorder.

PMID:31090281 · one of two readings recorded this

sleep-related adverse events — insomnia (general), initial insomnia, middle insomnia, combined insomnia, sleep disorder — pooled relative risk vs placebo

increases

Not recorded as a finding: this platform holds no node for the endpoint

Increased pooled relative risks (RRs) were found for methylphenidate-associated sleep-related AEs for insomnia (general), initial insomnia, middle insomnia, combined insomnia, and sleep disorder.

PMID:31090281 · one of two readings recorded this

ADHD core symptoms, pooled standardised mean difference, and neuropsychological parameters (inattention, inhibition)

decreases, SMD=-0.578, 95% CI (-1.063 to -0.092); inattention -0.959 (-1.711 to -0.208); inhibition -0.469 (-0.872 to -0.066)

At the study first endpoint, MPH was significantly more efficacious than NF on ADHD core symptoms (ADHD symptoms combined: SMD=-0.578, 95% CI (-1.063 to -0.092)) and on two neuropsychological parameters (inattention:-0.959 (-1.711 to -0.208); inhibition:-0.469 (-0.872 to -0.066)).

PMID:31221690 · one of two readings recorded this

ADHD core symptoms, pooled standardised mean difference (SMD), methylphenidate versus neurofeedback

decreases, SMD=-0.578, 95% CI (-1.063 to -0.092)

Not recorded as a finding: this platform holds no node for the endpoint

At the study first endpoint, MPH was significantly more efficacious than NF on ADHD core symptoms (ADHD symptoms combined: SMD=-0.578, 95% CI (-1.063 to -0.092)) and on two neuropsychological parameters (inattention:-0.959 (-1.711 to -0.208); inhibition:-0.469 (-0.872 to -0.066)).

PMID:31221690 · one of two readings recorded this

ADHD core symptoms, standardised mean difference pooled across trials

decreases, SMD=-0.578, 95% CI (-1.063 to -0.092)

At the study first endpoint, MPH was significantly more efficacious than NF on ADHD core symptoms (ADHD symptoms combined: SMD=-0.578, 95% CI (-1.063 to -0.092)) and on two neuropsychological parameters (inattention:-0.959 (-1.711 to -0.208); inhibition:-0.469 (-0.872 to -0.066)).

PMID:31221690 · one of two readings recorded this

ADHD core symptoms, standardised mean difference (SMD) pooled across head-to-head randomised trials of methylphenidate versus neurofeedback

decreases, SMD=-0.578, 95% CI (-1.063 to -0.092)

Not recorded as a finding: the comparison was against another active treatment

At the study first endpoint, MPH was significantly more efficacious than NF on ADHD core symptoms (ADHD symptoms combined: SMD=-0.578, 95% CI (-1.063 to -0.092)) and on two neuropsychological parameters (inattention:-0.959 (-1.711 to -0.208); inhibition:-0.469 (-0.872 to -0.066)).

PMID:31221690 · one of two readings recorded this

inattention, neuropsychological parameter SMD

decreases, -0.959, 95% CI (-1.711 to -0.208)

At the study first endpoint, MPH was significantly more efficacious than NF on ADHD core symptoms (ADHD symptoms combined: SMD=-0.578, 95% CI (-1.063 to -0.092)) and on two neuropsychological parameters (inattention:-0.959 (-1.711 to -0.208); inhibition:-0.469 (-0.872 to -0.066)).

PMID:31221690 · one of two readings recorded this

inhibition, neuropsychological parameter SMD

decreases, -0.469, 95% CI (-0.872 to -0.066)

At the study first endpoint, MPH was significantly more efficacious than NF on ADHD core symptoms (ADHD symptoms combined: SMD=-0.578, 95% CI (-1.063 to -0.092)) and on two neuropsychological parameters (inattention:-0.959 (-1.711 to -0.208); inhibition:-0.469 (-0.872 to -0.066)).

PMID:31221690 · one of two readings recorded this

treatment dropout rate

increases, OR=0.412, 0.186 to 0.913 (favouring lower dropout with neurofeedback)

Dropouts were significantly lower in NF versus MPH (OR=0.412, 0.186 to 0.913).

PMID:31221690 · one of two readings recorded this

treatment dropouts, odds ratio

increases

Dropouts were significantly lower in NF versus MPH (OR=0.412, 0.186 to 0.913).

PMID:31221690 · one of two readings recorded this

all-cause drop-out rate

no effect, OR = 1.679, 95% CI = 0.681 to 4.138, p = 0.260, p = 0.26

Not recorded as a finding: no outcome node for all-cause treatment drop-out (distinct from withdrawal-due-to-adverse-events, which requires an adverse event as the stated reason for discontinuation)

The current meta-analysis showed no significant difference in drop-out rate between subjects receiving methylphenidate and those taking placebos (k = 4, OR = 1.679, 95% CI = 0.681 to 4.138, p = 0.260).

PMID:31685858 · one of two readings recorded this

all-cause trial drop-out rate

no effect, OR = 1.679, 95% CI 0.681-4.138, p = 0.26

The current meta-analysis showed no significant difference in drop-out rate between subjects receiving methylphenidate and those taking placebos (k = 4, OR = 1.679, 95% CI = 0.681 to 4.138, p = 0.260).

PMID:31685858 · one of two readings recorded this

all-cause trial drop-out rate, odds ratio

no effect, OR = 1.679, 95% CI = 0.681 to 4.138, p = 0.26

Not recorded as a finding: no outcome node for all-cause drop-out (distinct from AE-specific withdrawal)

The current meta-analysis showed no significant difference in drop-out rate between subjects receiving methylphenidate and those taking placebos (k = 4, OR = 1.679, 95% CI = 0.681 to 4.138, p = 0.260).

PMID:31685858 · one of two readings recorded this

treatment discontinuation due to adverse events, publication-bias-adjusted estimate

increases, adjusted OR = 5.531, 95% CI 1.326 to 23.069

The adjusted ESs by Duval and Tweedie's trim and fill test showed significantly higher rate of treatment discontinuation due to adverse events in subjects receiving methylphenidate than those taking placebos (adjusted OR = 5.531, 95% CI = 1.326 to 23.069).

PMID:31685858 · one of two readings recorded this

treatment discontinuation due to adverse events, publication-bias-adjusted odds ratio

increases, adjusted OR = 5.531, 95% CI = 1.326 to 23.069

Not recorded as a finding: publication-bias-adjusted (Duval-and-Tweedie trim-and-fill) sensitivity estimate for the same endpoint already claimed from the primary unadjusted analysis

The adjusted ESs by Duval and Tweedie's trim and fill test showed significantly higher rate of treatment discontinuation due to adverse events in subjects receiving methylphenidate than those taking placebos (adjusted OR = 5.531, 95% CI = 1.326 to 23.069).

PMID:31685858 · one of two readings recorded this

treatment discontinuation due to adverse events, raw pooled estimate

no effect, OR = 4.815, 95% CI 0.981 to 23.628, p = 0.053, p = 0.053

Similarly, there was no significant difference in the rate of treatment discontinuation due to adverse events between subjects treated with methylphenidate and those receiving placebos (k = 4, OR = 4.815, 95% CI = 0.981 to 23.628, p = 0.053).

PMID:31685858 · one of two readings recorded this

ADHD symptoms, participant-rated scales

decreases, SMD -0.59, 95% CI -1.25 to 0.06, n = 138

Not recorded as a finding: no outcome node for ADHD symptom severity; instrument not named as a single scale

The effect of IR methylphenidate on ADHD symptoms when measured with participant-rated scales was moderate, but the certainty of the evidence is very low (SMD -0.59, 95% CI -1.25 to 0.06; I2 = 69%; 2 trials, 138 participants; end scores).

PMID:33460048 · one of two readings recorded this

gastrointestinal complications

increases, RR 1.96, 95% CI 1.13 to 2.95

The use of IR methylphenidate in these trials increased the risk of gastrointestinal complications (RR 1.96, 95% CI 1.13 to 2.95) and loss of appetite (RR 1.77, 95% CI 1.06 to 2.96).

PMID:33460048 · one of two readings recorded this

gastrointestinal complications, adverse event

increases, RR 1.96, 95% CI 1.13 to 2.95

Not recorded as a finding: no outcome node for gastrointestinal adverse event incidence

The use of IR methylphenidate in these trials increased the risk of gastrointestinal complications (RR 1.96, 95% CI 1.13 to 2.95) and loss of appetite (RR 1.77, 95% CI 1.06 to 2.96).

PMID:33460048 · one of two readings recorded this

gastrointestinal complications, risk ratio

increases, RR 1.96, 95% CI 1.13 to 2.95

Not recorded as a finding: no outcome node for GI-specific adverse events

The use of IR methylphenidate in these trials increased the risk of gastrointestinal complications (RR 1.96, 95% CI 1.13 to 2.95) and loss of appetite (RR 1.77, 95% CI 1.06 to 2.96).

PMID:33460048 · one of two readings recorded this

loss of appetite

increases, RR 1.77, 95% CI 1.06 to 2.96

The use of IR methylphenidate in these trials increased the risk of gastrointestinal complications (RR 1.96, 95% CI 1.13 to 2.95) and loss of appetite (RR 1.77, 95% CI 1.06 to 2.96).

PMID:33460048 · one of two readings recorded this

loss of appetite, adverse event

increases, RR 1.77, 95% CI 1.06 to 2.96

Not recorded as a finding: no outcome node for appetite-loss adverse event incidence

The use of IR methylphenidate in these trials increased the risk of gastrointestinal complications (RR 1.96, 95% CI 1.13 to 2.95) and loss of appetite (RR 1.77, 95% CI 1.06 to 2.96).

PMID:33460048 · one of two readings recorded this

loss of appetite, risk ratio

increases, RR 1.77, 95% CI 1.06 to 2.96

Not recorded as a finding: no outcome node for appetite-specific adverse events

The use of IR methylphenidate in these trials increased the risk of gastrointestinal complications (RR 1.96, 95% CI 1.13 to 2.95) and loss of appetite (RR 1.77, 95% CI 1.06 to 2.96).

PMID:33460048 · one of two readings recorded this

participant-rated ADHD symptoms

SMD -0.59, 95% CI -1.25 to 0.06, n = 138

The effect of IR methylphenidate on ADHD symptoms when measured with participant-rated scales was moderate, but the certainty of the evidence is very low (SMD -0.59, 95% CI -1.25 to 0.06; I2 = 69%; 2 trials, 138 participants; end scores).

PMID:33460048 · one of two readings recorded this

participant-rated ADHD symptoms, standardised mean difference

SMD -0.59, 95% CI -1.25 to 0.06, n = 138

Not recorded as a finding: no outcome node for ADHD symptom severity

The effect of IR methylphenidate on ADHD symptoms when measured with participant-rated scales was moderate, but the certainty of the evidence is very low (SMD -0.59, 95% CI -1.25 to 0.06; I2 = 69%; 2 trials, 138 participants; end scores).

PMID:33460048 · one of two readings recorded this

inattention symptom improvement, ADRA2A MspI genotype G-allele carriers

increases, mean difference 0.31, 95% CI 0.15-0.47

However, G allele carriers of the MspI polymorphism showed a relationship with significantly inattention symptoms improvement (P < .001, mean difference:0.31, 95% CI: 0.15, 0.47).

PMID:34797323 · one of two readings recorded this

inattention symptom improvement, by ADRA2A MspI genotype

increases, mean difference 0.31, 95% CI 0.15-0.47

However, G allele carriers of the MspI polymorphism showed a relationship with significantly inattention symptoms improvement (P < .001, mean difference:0.31, 95% CI: 0.15, 0.47).

PMID:34797323 · one of two readings recorded this

any NDD, methylphenidate-stratified subgroup

no effect, HR = 0.94, 95% CI 0.79-1.11

Stratified by medication type, results showed a consistent pattern with HRs for methylphenidate 0.94 (95% CI 0.79;1.11) and amphetamines 1.15 (95% CI 0.65;2.05) and for atomoxetine 1.03 (95% CI 0.64;1.65) for any NDD (Table 3).

PMID:40148550 · one of two readings recorded this

any NDD, pooled with Danish cohort (meta-analysis)

no effect, pooled HR = 1.00, 95% CI 0.83-1.20, n = 8342

With a total population of 3155 children exposed and 5187 in the discontinuation group, pooled HR estimates for any NDD, ADHD, and ASD were 1.00 (95% CI 0.83;1.20), 1.09 (95% CI 0.71;1.68), and 0.89 (95% CI 0.67;1.18), respectively.

PMID:40148550 · one of two readings recorded this

any NDD, stratified by medication type (methylphenidate)

HR 0.94, 95% CI 0.79-1.11

Stratified by medication type, results showed a consistent pattern with HRs for methylphenidate 0.94 (95% CI 0.79;1.11) and amphetamines 1.15 (95% CI 0.65;2.05) and for atomoxetine 1.03 (95% CI 0.64;1.65) for any NDD (Table 3).

PMID:40148550 · one of two readings recorded this

ADHD symptoms, teacher-rated, ADHD Rating Scale (ADHD-RS)

decreases, n = 1728

Not recorded as a finding: no outcome node for ADHD symptom severity

methylphenidate versus placebo or no intervention may improve teacher-rated ADHD symptoms (standardised mean difference (SMD) -0.74, 95% confidence interval (CI) -0.88 to -0.61; I² = 38%; 21 trials; 1728 participants; very low-certainty evidence).

PMID:41342306 · one of two readings recorded this

ADHD symptoms, teacher-rated (ADHD-RS)

decreases, SMD -0.74, 95% CI -0.88 to -0.61, n = 1728

methylphenidate versus placebo or no intervention may improve teacher-rated ADHD symptoms (standardised mean difference (SMD) -0.74, 95% confidence interval (CI) -0.88 to -0.61; I² = 38%; 21 trials; 1728 participants; very low-certainty evidence).

PMID:41342306 · one of two readings recorded this

adverse events considered non-serious

increases, RR 1.23, 95% CI 1.11 to 1.37, n = 5342

methylphenidate may cause more adverse events considered non-serious versus placebo or no intervention (RR 1.23, 95% CI 1.11 to 1.37; I² = 72%; 35 trials 5342 participants; very low-certainty evidence).

PMID:41342306 · both readings recorded this

adverse events considered non-serious, risk ratio

increases, RR 1.23, 95% CI 1.11 to 1.37, n = 5342

Not recorded as a finding: no outcome node distinguishes non-serious/graded adverse events from the generic ungraded adverse-reaction node

methylphenidate may cause more adverse events considered non-serious versus placebo or no intervention (RR 1.23, 95% CI 1.11 to 1.37; I² = 72%; 35 trials 5342 participants; very low-certainty evidence).

PMID:41342306 · one of two readings recorded this

teacher-rated ADHD symptoms

decreases, SMD -0.74, 95% CI -0.88 to -0.61, n = 1728

methylphenidate versus placebo or no intervention may improve teacher-rated ADHD symptoms (standardised mean difference (SMD) -0.74, 95% confidence interval (CI) -0.88 to -0.61; I² = 38%; 21 trials; 1728 participants; very low-certainty evidence).

PMID:41342306 · one of two readings recorded this

teacher-rated ADHD symptoms, standardised mean difference

decreases, SMD -0.74, 95% CI -0.88 to -0.61, n = 1728

Not recorded as a finding: no outcome node for ADHD symptom severity

methylphenidate versus placebo or no intervention may improve teacher-rated ADHD symptoms (standardised mean difference (SMD) -0.74, 95% confidence interval (CI) -0.88 to -0.61; I² = 38%; 21 trials; 1728 participants; very low-certainty evidence).

PMID:41342306 · one of two readings recorded this