Created:INDEX.md (18 canonical pages), wiki/overview.md (draft, 26 verified PMIDs), OPEN-QUESTIONS.md (7 seed questions), and this log.
Searches run (live PubMed E-utilities esearch/esummary): child/adult prevalence and persistence; historical diagnosis/nosology reviews; AAP guideline; genetics/GWAS and neurobiology; medication network meta-analyses, guanfacine, MTA and adult CBT; cardiovascular safety, growth and mortality; girls/women and adult underdiagnosis; environmental/peripheral biomarkers; STARS digital therapeutic.
Verification: every cited PMID was retrieved live from PubMed in this session. The required ADD/1987 clarification is sourced to the retrieved lifespan diagnosis review rather than memory alone.
Next: full build queued per CONDITIONS-ROADMAP.md; preserve all-presentation and lifespan scope.
Built: all 18 canonical wiki pages as draft; each is 150–158 lines with 32 live-PubMed-verified records, a quantitative synthesis, evidence map, open questions, related canonical links and full references.
Literature layer: 454-paper deduplicated BIBLIOGRAPHY.md; six landmark notes (Demontis GWAS, MTA, Cortese medication network, Kessler adult prevalence, Kollins digital trial, Hinshaw female lifespan review); worldwide guideline registry with supersession chains and watch list; 84-row statistics sheet; patient-voice method, seven verified organizations, 12 multi-source themes and annotated sources.
Frontier: replaced seed questions with 24 stable tiered questions and 14 “Dots not yet connected” junctions.
Index/roadmap: added five reading paths, real artifact counts and page statuses; condition status changed from seeded to built in CONDITIONS-ROADMAP.md.
PubMed searches: 144 live E-utilities esearch queries (eight per page): the original six topic searches plus two gap-oriented searches for each domain, spanning nosology, assessment, prevalence/course, genetics, neurobiology, cognition, pediatric and adult care, girls/women/reproductive stages, comorbidity, medications, psychosocial/digital care, long-term outcomes, guidelines, biomarkers, trials, patient experience and safety. Live efetch retrieved 817 records, including a fresh fetch attempt for all 26 seed PMIDs; exact esummary rechecks resolved six cross-layer records not represented as PubmedArticle objects in the XML corpus.
Citation integrity check: 454 unique PMIDs occur anywhere in the condition and exactly the same 454 appear in the bibliography. Every one was returned by live PubMed E-utilities in this session. Every wiki body PMID is present in that page’s References section.
Official web sources verified: NICE NG87, AADPA/NHMRC Australian guideline, CADDRA 4.1, AWMF 028-045, CHADD, ADDA, ADHD Europe, CADDAC, ADHD Ireland, ADHD Australia and ADHD Foundation UK.
Could not verify cleanly: ADHD Foundation UK’s site remains live and describes services but also lists a 2025 closure notice; the organization is retained with an explicit status caveat. No clearly patient-led national ADHD organization with an accessible official site was verified for Africa, Asia or Latin America during this build; this is recorded as a coverage gap, not an absence claim.
Next independent audit: re-fetch and check all 454 unique PMIDs and 576 page reference uses against claims; scrutinize 2025–2026 papers, evidence-map relevance, quantitative transcription, guideline currency, the ADHD Foundation UK status caveat, and the negative organization-coverage finding. Promote pages to curated only after that separate pass.
Scope completed: audited all 18 wiki pages and all 13 literature artifacts (31 Markdown files), including quantitative tables, evidence maps, landmark notes, the bibliography, guideline registry, statistics sheet, patient-voice materials and open-question register.
PubMed verification: re-fetched all 454 inherited unique PMIDs through live PubMed E-utilities and resolved every record. Gap searches identified one additional relevant 2026 multicentre diagnostic-classifier study (PMID 42448769), which was fetched live, added to the biomarker synthesis and bibliography, and used to narrow the corresponding evidence-gap statement. The final condition corpus contains 455 unique PMIDs, all resolved live in this audit session; there are 2,050 PMID occurrences overall and 1,363 in the wiki layer.
Claim-to-citation audit: checked each wiki claim/evidence-map/reference pairing and the literature-layer uses against the live records. Corrected 29 discrete metadata or content fields: 18 author or collective-author attributions, three incomplete citation titles, two incorrect DOI fields, two growth-effect direction labels, and four stale or overbroad guideline/biomarker/organization-status statements. This included two references attributed to the wrong lead author. No cited PMID remains unresolved, no wiki body PMID is absent from its page reference list, and bibliography metadata now agrees with the live PubMed records.
Quantitative audit: checked the principal prevalence, diagnostic-performance, medication-effect, growth, cardiovascular, mortality, injury, suicide, misuse and digital-treatment estimates against the retrieved records. The two growth standardized mean differences are now explicitly labelled as magnitudes of reduction; no other material numerical transcription error remained.
ClinicalTrials.gov verification: individually re-queried all 11 cited NCT records through the live v2 API. All resolved and their current recruitment statuses matched the condition text; the STARS study record also matched the stated completed status, actual enrolment of 348 and two-arm design. The corpus contains 37 NCT occurrences.
Evidence-gap searches: re-ran live PubMed searches for current diagnostic/treatment biomarkers, prospective response prediction and a US adult guideline, plus 14 junction-specific searches behind “Dots not yet connected.” Replaced absolute non-existence language with dated, database-bounded positive evidence-gap statements. The current ocular-classifier evidence is acknowledged while its lack of prospective decision-impact validation is stated explicitly.
Guideline and patient-voice currency: verified the current NICE, CADDRA, German S3 and US adult-guideline positions from live official sources. Updated the German S3 entry to its 2026 version 2.0, recorded that the US adult national guideline remains in development, classified ADHD Foundation UK as historical after its 30 August 2025 closure, and added verified current organizations in Peru and Taiwan. The Africa finding remains a dated search-coverage gap, not an absence claim.
Validation: all 18 pages meet the required structure and density (150–158 lines; 32–33 references), all are now status: curated, all internal Markdown links resolve, and there are zero [unverified] flags, zero unresolved citation identifiers and zero unresolved substantive audit issues.
Result: the ADHD condition passed the independent audit and is eligible for roadmap status audited.
2026-10-12 — Periodic literature sweep (author: Claude, claude-opus-5-5)¶
Window and method. Records entered into PubMed (edat) between 2026-08-28 and 2026-10-12. This is the condition's first sweep since the 2026-08-30 audit. Every identifier came from live NCBI E-utilities (esearch/esummary/efetch), the ClinicalTrials.gov v2 API, Europe PMC or Crossref in this session. The PubMed MCP connector was not authenticated, so E-utilities served as the live equivalent. The query manifest (PubMed translations, returned IDs, NCT re-checks, retraction checks) is at literature/sweeps/2026-10-12.json.
Sources actually queried.
PubMed: one catch-all ADHD query (527 records, all screened by title and publication type) plus 15 topic queries, about 50 abstracts read in full.
Cochrane Database of Systematic Reviews through PubMed: 6 in-window records, none ADHD-specific. An all-dates CDSR × ADHD search then found an uncited 2025 review, amphetamines and blood pressure (PMID 40152309), which was back-filled.
Europe PMC: 367 title hits, 158 non-MEDLINE, mostly EPA 2026 and CINP congress abstracts plus preprints.
ClinicalTrials.gov v2: all 11 cited NCTs re-fetched, plus the 2 centanafadine pivotal trials; first-posted ≥2026-08-28 query returned 17 records; results-first-posted ≥2026-08-28 query returned 1.
Crossref updated-by checks, without mailto.
PMC full text for the centanafadine approval record.
Official guideline sites: NICE, CADDRA, AADPA, AWMF, APSARD.
Not queried or not reachable. WHO ICTRP and named non-US registries; Unpaywall (LIFEBANK_CONTACT_EMAIL unset, skipped per SOURCES.md); CENTRAL and the Cochrane Library (HTTP 403); SciELO/LILACS (HTTP 403); the CDC adult ADHD page and HAS (both HTTP 403); the NHS England taskforce page (empty HTTP 202). No regional-literature absence claim was made. Absences below are absences in PubMed, Europe PMC or ClinicalTrials.gov only.
Cochrane. No new ADHD Cochrane review appeared in the window, so nothing this condition asserts was superseded. The back-filled Chan 2025 review (56 RCTs; SBP +1.93, DBP +1.84 mmHg, HR +3.71 bpm, high certainty) adds haemodynamic magnitude and contradicts nothing.
Most important finding: centanafadine (Simtriyo) was FDA-approved on 24 July 2026 for adults and for ages ≥6 years weighing ≥20 kg. The approval carries boxed warnings for abuse/misuse/addiction and pediatric suicidality, and DEA scheduling was pending. The approval date, label and scheduling status were read verbatim from the PMC full text of Hu 2026 (PMID 42640319). Before this sweep the condition never mentioned the drug. Evidence base: two adult phase 3 RCTs (effect sizes −0.24 to −0.40; PMID 35652746); an adolescent phase 3 RCT in which only the high dose met the primary endpoint (PMID 40619095, erratum published); and a 5-RCT meta-analysis (g −0.37; PMID 42267239). There are no head-to-head trials, and sources disagree on whether it is a stimulant. This opened OQ-25.
Survived triage: wiki edits. 32 new PMIDs and 1 preprint; 10 pages demoted to draft with last-curated: 2026-10-12.
pharmacologic-treatment.md: new centanafadine section and table, plus a TL;DR sentence. Safety additions: Cochrane amphetamine BP; adult NRI GRADE review (atomoxetine serious AEs RR 2.31, which conflicts with the more favourable nonstimulant meta-analytic literature and is flagged as unresolved; PMID 42751977); T2D MACE signal below age 45 (PMID 42806384); self-harm SCCS (PMID 42731881).
red-flags-and-safety-concerns.md: self-harm risk peaks in the 90 days before medication initiation (IRR 2.58); haemodynamic magnitudes; centanafadine boxed warnings.
long-term-outcomes-and-quality-of-life.md: Norwegian IV analysis finding no causal grade effect (PMID 42803341); NeuroIMAGE >12-year trajectories showing no differences on 51 outcomes (PMID 42664720); late-life MCI/dementia HR 4.60 (PMID 42842281).
epidemiology-and-lifespan-course.md: US NHIS 9.5→12.0% and NSCH 8.8→11.6% with severe ADHD stable at 1.3–1.8%; Danish attenuation of prediagnostic risk factors 2012–2022; Norwegian post-2020 medication acceleration (PMIDs: 42767652, 42805290, 42714883, 42847285).
adult-adhd.md: adult-diagnosed versus youth-diagnosed profiles in All of Us (PMID 42747853); CBT durability (PMIDs: 42717581, 42664236); late-life cognition.
girls-women-and-hormonal-context.md: Ontario maternal-ADHD and stimulant-in-pregnancy trends (PMID 42671284); TriNetX obstetric-risk signals without an unmedicated-ADHD comparator (PMID 42671280); prenatal paracetamol umbrella review and Danish triangulation, both attenuating toward null (PMIDs: 42773841, 42660286).
biomarkers.md: structural-connectivity deviation predicting atomoxetine but not methylphenidate response (PMID 42675180); EHR foundation-model prediction (PMID 42828415).
guidelines.md: new currency-check section covering APSARD, NICE, HAS 2024, the NHS England taskforce, ASCP deprescribing and the WFADHD 2026 preprint.
clinical-trials-landscape.md: registry re-check and a new-registrations table; serdexmethylphenidate Chinese bridging RCT (PMID 42830387).
Guidelines.
NICE NG87 recommendations are unchanged (last updated 13 Sep 2019). The page now says "Last reviewed: 23 July 2026", which replaces the registry's "May 2025".
CADDRA 4.1 and AADPA are unchanged.
The APSARD US adult guideline is still unpublished: its final review stage launched on 27 Aug 2026, with publication "anticipated this fall". PubMed has no record yet.
Two pre-window documents missed by the build were back-filled: the French HAS 2024 child/adolescent guideline (known only via Sürig 2026, PMID 42674891, because HAS is 403 to us) and the NHS England Independent ADHD Taskforce final report (2025; via Khan 2026, PMID 42661151).
Also added: the ASCP adult stimulant-deprescribing Delphi (PMID 42160906) and the WFADHD International Consensus Statement 2026 update (PsyArXiv doi:10.31234/osf.io/w5n9t_v1, preprint posted 2026-10-10, not peer reviewed).
Registry: 13 → 17 entries; watch list updated.
ClinicalTrials.gov. All 13 re-fetched records resolved.
NCT06604845 (adult group CBT) changed from Enrolling by invitation to Completed, with 226 actual enrolment and no results posted.
NCT04219280 passed its 2026-08-31 primary completion and is still Active, not recruiting.
No other cited record changed status or posted results.
Centanafadine pivotal trials NCT05428033 (574) and NCT05257265 (459) are Completed with no results posted, despite approval.
Newly cited registrations: NCT07812948 (PETRA medication decision support, feasibility), NCT07805382 (estradiol/sleep/EMA pilot in girls; nearest item to D7 but not a randomized titration), NCT07834437 (Stockholm adult group CBT vs active control) and NCT07858448 (atomoxetine CV cohort).
NCT04240756 (parental stimulant + BPT via telehealth) posted results in the window; they were not read into the wiki.
Condition NCT count: 11 → 18.
Open questions. Updated OQ-1, 4, 5, 9, 12, 13, 17, 18, 19, 21 and 23, and opened OQ-25 (centanafadine's place). OQ-12 is sharper: the causal attainment evidence now points toward null, but imprecisely. OQ-23 now has converging ascertainment evidence. No question was closed. The 14 "Dots" junctions were not re-searched in this sweep, and D7 remains open (NCT07805382 is observational).
Statistics / patient voice. STATISTICS gained 17 rows plus one conflict caveat (diagnosed versus severe prevalence). The patient-voice layer was not changed. Qualitative items seen in the window were screened and not added: self-diagnosis identity in young women (screened only, PubMed ID 42834415), the PsyArXiv preprint on terminology preferences, and BMJ news on NHS waits and rationing. Organisation homepages were not re-probed this sweep.
Screened and dropped (representative). Single-site EEG/MRI/ML classifiers; case reports; FAERS disproportionality (screened only, PubMed ID 42819375); shortage time series (screened only, PubMed IDs 42860312, 42708463); mindfulness and PUFA meta-analyses (I² 91% and borderline g −0.24; nothing changes the existing Cochrane-cited position); GBD 2023 all-mental-disorders paper (no ADHD-specific figures in the abstract); the Danish ED-injury cohort (2005–2011 data); congress abstracts in Europe PMC.
Retraction checks. All 32 added PMIDs passed the PubMed publication-type check, and Crossref showed no retraction or expression of concern for any record or for the preprint DOI. Errata only: Khan 2026 and Ward 2026 (JAACAP adolescent RCT).
Integrity check. After editing, the 487 unique cited PMIDs in the condition (all PMID: citations, excluding the screened-only IDs named in this entry and the manifest) match the 487 in BIBLIOGRAPHY.md exactly. Internal Markdown links all resolve. Every wiki body PMID is in its page's References list.
Landmark note. None. The centanafadine approval is a regulatory event resting on several modest placebo-controlled trials rather than one practice-changing paper.
Read from abstract only (auditor should verify against full text). Chan 2026 self-harm, Nurkhametova 2026 (serious-AE definition), Lyhmann 2026, Dong 2026, Xu 2026, Babinski 2026 and Muneer 2026. Only the Hu 2026 approval details were verified from full text.
Next sweep / auditor should chase.
Audit and re-promote the 10 draft pages.
Watch for APSARD adult guideline publication (expected fall 2026) and add it to the registry and guidelines.md.
Record DEA scheduling for centanafadine and any first guideline position on it; look for head-to-head trials.
Window and scope. Inclusive publication dates 2026-08-28–2026-10-19, as requested, rather than only the interval since the previous sweep. Read CONVENTIONS.md, CLAUDE.md, SOURCES.md, this log, the index and open questions before changing content. Only ADHD files changed; no publishing or version-control commands were run. Exact queries, PubMed translations and returned identifiers, source-specific access results, trial checks and per-added-record retraction checks are in the search manifest.
Sources actually queried. PubMed E-utilities: one broad ADHD query, 17 major-topic queries, 17 corresponding Cochrane Database of Systematic Reviews queries, and four targeted follow-up queries (broader CDSR, APSARD, WFADHD update and centanafadine comparators). Topics covered nosology, diagnosis, epidemiology/course, genetics/neurobiology, cognition/function, childhood/adolescence, adults/aging, girls/women/hormones, comorbidity, medication, psychosocial/digital treatment, long-term outcomes, guidelines, biomarkers, trials, patient experience and safety. The topic searches returned 809 distinct IDs; 806 PubmedArticle objects were retrieved; 371 records absent from the previous search manifest and bibliography were screened by title/publication type, with selected abstracts read. Three other returned record objects were not adopted. This publication-date window differs from the previous entry-date search and includes older electronic publications receiving an in-window print date; counts are not a measure of newly discovered papers.
Cochrane priority. All 17 topic-specific CDSR searches and the broader ADHD/attention-deficit/hyperkinetic CDSR query returned zero in-window records in PubMed. No new Cochrane review was available from these searches to supersede the condition's synthesis. The Cochrane Library and CENTRAL were not searched; their documented HTTP 403 access limit remains. This is a PubMed result, not an assertion of absence across databases.
Beyond PubMed. Europe PMC REST search was queried separately for all 17 topics with FIRST_PDATE restricted to the same window: 636 distinct source/record pairs, 222 without a PMID, with DOI and full-text-availability metadata retained. None of the non-PMID conference abstracts, protocols or preliminary/preprint findings warranted a DOI-only addition; no unresolvable DOI was cited. Three journal candidates also received exact-ID Europe PMC checks: two were not yet indexed there, and the parent-training trial had an indexed record. Full-text XML for the Swedish reproductive-outcomes cohort and the parent–teacher review was read through Europe PMC. Crossref resolved the added papers' DOIs and supplied title and updated-by checks, without mailto. Unpaywall was skipped because LIFEBANK_CONTACT_EMAIL is unset; no personal contact address was obtained or transmitted.
Non-US trials and regional limits. Queried WHO ICTRP with ADHD (HTTP 403), ISRCTN with ADHD (HTTP 200 cookie/JavaScript challenge, no usable results), and the legacy EU Clinical Trials Register with ADHD (147 results; first page of eight read). The EU register was a successful supplementary search, not a complete modern CTIS review. CTIS, ChiCTR and CTRI were not searched. SciELO and LILACS could not be searched (HTTP 403 access limits documented in SOURCES.md); no absence or cross-region transport claim is inferred from that coverage.
ClinicalTrials.gov. Individually retrieved all 18 already cited NCT records through the v2 API, and queried ADHD studies by first posting, last update and first results posting in the window (17, 62 and 1 records respectively). The 13 individual snapshots preserved in the prior manifest match on status, results presence and first-results date. The other five registrations cited by that sweep were re-fetched; their last-update dates precede it, and status/results agree with its wiki text. The completed adult CBT trial still has no posted results. The previously deferred parent-treatment trial's posted results were read: its intervention is parent medication before a child-treatment strategy that both arms receive. The child CGI-Severity means are descriptive; the module posts no comparative analysis and has change-score/CGI-score and observed/imputed-denominator wording needing reconciliation. No efficacy conclusion or reconstructed significance test was added (NCT04240756; NCT06604845).
Survived triage: four bibliography records, one journal synthesis update. Added Komargodski 2026 pregnancy/offspring meta-analysis (PMID 42887725), Benz 2026 ADHD/SUD evidence synthesis (PMID 42872812) and DuPaul 2026 online versus face-to-face parent-training trial (PMID 42330190) as metadata-only entries, explicitly pending full-text appraisal. Publisher routes for these supplied metadata/redirects, HTTP 403 challenges or HTTP 429, not readable article bodies; their numerical abstracts were not promoted into wiki claims. Added the full-text-checked Stockholm cohort (Kopp Kallner 2026, PMID 42864120) to the girls/women page and statistics: Table 2 gives recorded reproductive-outcome incidence and adjusted association; Table 4 shows lower odds for both longest-treated and untreated groups relative to short treatment. Preserved the authors' inability to control for ADHD severity and other persistence/ascertainment confounding, rather than describing medication as causally protective. Opened OQ-26 to design the causal follow-up. No landmark note was warranted.
Screened and withheld. The parent–teacher agreement review (screened PubMed record 42865956) was read in full; its stated total of 8,796 differs from the sum of Table 1 sample sizes (10,972). It adds no necessary change to the existing multi-informant diagnostic approach, and its quantitative synthesis was not adopted. The new centanafadine review largely re-synthesizes covered placebo-controlled trials. Small classifiers, mechanistic associations, case reports, conference abstracts and preliminary preprints did not justify expanding the wiki.
Guidelines and regulatory follow-up. Retrieved APSARD, NICE and AADPA official pages directly, CADDRA's official overview through browsing after direct HTTP 403, and the AAP official ADHD landing-page search result. APSARD still announces final review and anticipated fall publication; CADDRA presents edition 4.1; NICE still records the 23 July 2026 review. Corrected stale May 2025 wording within the registry's NICE notes/watch list. AWMF returned a JavaScript shell and did not permit re-confirming its document version. HAS was search-visible, but direct retrieval failed TLS verification and browser retrieval returned HTTP 502; its PDF was not appraised. The WFADHD 2026 update was retrieved as a Europe PMC preprint, with no peer-reviewed publication returned by the targeted PubMed query. The previously pending centanafadine scheduling follow-up advanced: OIRA/Reginfo.gov lists a Schedule III interim final rule received 14 October, still pending review. Updated pharmacologic treatment, the registry watch list and OQ-25 with that distinction; no effective scheduling date was claimed.
Statistics and patient organisations. Re-fetched the CDC child ADHD statistics page successfully and back-filled its pre-window 2024 parent-survey estimate, labelled separately from the already catalogued paper's different estimate; the discrepancy remains unresolved. The NHS collection landing page was retrieved through its public data gateway, but no current numeric release was verified or added. Re-probed the nine previously listed organisations: ADDA, ADHD Europe, CADDAC, ADHD Australia, APDA Peru and Taiwan served content; CHADD and ADHD Ireland were blocked on direct requests, and the historical UK foundation's domain did not resolve. CHADD campaign listings were search-visible but were not used for a new claim. Added directly retrieved CADDAC October awareness-month material and ADHD Australia's 9 October ADHD Assist material to the patient-source layer and advocacy page, retaining aggregate organisational priorities only, with no efficacy claim or identifying testimony.
Changed files/status. Bibliography now 491 papers; 26 open questions; six landmark notes and 17 guideline/secondary-guidance entries unchanged in count. Five wiki pages changed: clinical trials, pharmacologic treatment, guidelines, girls/women and patient experience. All five are draft with last-curated 2026-10-19; 11 of 18 wiki pages now await independent review. Updated index, open questions, bibliography, guideline registry, statistics and annotated patient sources; added the manifest at its sole permitted path. Changed non-log Markdown files carry current frontmatter. No page was promoted by its author.
Citation controls. All four added records passed canonical PubMed identifier and publication-type checks and matching Crossref DOI/title/updated-by checks; no retraction or expression-of-concern flag was present. The initial XML extraction mistakenly included reference-list identifiers; it was corrected to ./PubmedData/ArticleIdList/ArticleId and consistency asserted for all 806 retrieved article records before final triage. Those apparent identifier conflicts are not findings about the source literature.
Validation. All condition Markdown links resolve, every wiki body PMID is present in its page’s References, and the 491 unique cited PMIDs match the bibliography. The four additions have complete two-source retraction checks, all five edited wiki pages carry the current date and draft status, and the actual site-builder mapping resolves the new manifest to sweeps/2026-10-19.json. No full-site generation, strict build or publication was run because this task is confined to ADHD source files and publishing is handled separately. These are author consistency checks, not an independent audit.
Next sweep / independent auditor. Appraise the three metadata-only additions in full before using their estimates, especially pregnancy comparator/timing differences. Verify the five changed pages independently and revisit the ten-page draft backlog. Watch for a final effective centanafadine scheduling rule and APSARD adult-guideline publication; continue to check for peer review of the WFADHD update. Reconcile the parent-treatment results with a publication and obtain the completed adult CBT trial's results when posted. Resolve the CDC/paper prevalence discrepancy and the parent–teacher review's sample counts. For OQ-26, seek replication with severity, contraception and healthcare-contact adjustment across regions. Retry HAS/modern non-US registries and re-run the 14 Dots junction searches, still last comprehensively checked on 2026-08-30. Public patient resources were checked this time; future sweeps should prefer outcome evaluations over further campaign cataloguing.