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Cited by 700Substance Abuse Treatment and OutcomesMobile Health and mHealth ApplicationsDigital Mental Health Interventions

A Smartphone Application to Support Recovery From Alcoholism: A Randomized Clinical Trial

Open access
Gustafson, David H., McTavish, Fiona M., Chih, Ming-Yuan, Atwood, Amy K., Johnson, Roberta A., Boyle, Michael G., Levy, Michael S., Driscoll, Hilary +4 more·2014·JAMA Psychiatry
DOI 10.1001/jamapsychiatry.2013.4642PMC PMC4016167
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Abstract

IMPORTANCE: Patients leaving residential treatment for alcohol use disorders are not typically offered evidence-based continuing care, although research suggests that continuing care is associated with better outcomes. A smartphone-based application could provide effective continuing care. OBJECTIVE: To determine whether patients leaving residential treatment for alcohol use disorders with a smartphone application to support recovery have fewer risky drinking days than control patients. DESIGN, SETTING, AND PARTICIPANTS: An unmasked randomized clinical trial involving 3 residential programs operated by 1 nonprofit treatment organization in the Midwestern United States and 2 residential programs operated by 1 nonprofit organization in the Northeastern United States. In total, 349 patients who met the criteria for DSM-IV alcohol dependence when they entered residential treatment were randomized to treatment as usual (n = 179) or treatment as usual plus a smartphone (n = 170) with the Addiction-Comprehensive Health Enhancement Support System (A-CHESS), an application designed to improve continuing care for alcohol use disorders. INTERVENTIONS: Treatment as usual varied across programs; none offered patients coordinated continuing care after discharge. A-CHESS provides monitoring, information, communication, and support services to patients, including ways for patients and counselors to stay in contact. The intervention and follow-up period lasted 8 and 4 months, respectively. MAIN OUTCOMES AND MEASURES: Risky drinking days--the number of days during which a patient's drinking in a 2-hour period exceeded 4 standard drinks for men and 3 standard drinks for women, with standard drink defined as one that contains roughly 14 g of pure alcohol (12 oz of regular beer, 5 oz of wine, or 1.5 oz of distilled spirits). Patients were asked to report their risky drinking days in the previous 30 days on surveys taken 4, 8, and 12 months after discharge from residential treatment. RESULTS: For the 8 months of the intervention and 4 months of follow-up, patients in the A-CHESS group reported significantly fewer risky drinking days than did patients in the control group, with a mean of 1.39 vs 2.75 days (mean difference, 1.37; 95% CI, 0.46-2.27; P = .003). CONCLUSIONS AND RELEVANCE: The findings suggest that a multifeatured smartphone application may have significant benefit to patients in continuing care for alcohol use disorders. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01003119.

Integrity signals

Registry

Crossref · 10.1001/jamapsychiatry.2013.4642

Cites

32 of 32 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 24 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    A-CHESS patients were more likely than control patients to report abstinence at all three time points (P=.032).

    “A-CHESS patients were also more likely than control-group patients to report abstinence at all 3 time points (P = .032).”
    • Also stated in: § COMMENT · plain
      “higher likelihood of consistent abstinence (51.9% vs. 39.6%; P = .032)”
    Quote in the paperSubstantial claim
  • Findingown data

    Over the 12-month period comprising the 8-month intervention and 4-month follow-up, patients assigned to A-CHESS reported significantly fewer risky drinking days than control patients (mean 1.39 vs 2.75; P=.003; 95% CI .46 to 2.27).

    “For the 8 months of the intervention and 4 months of follow-up, patients in the A-CHESS group reported significantly fewer risky drinking days than patients in the control group (M = 1.39 vs. 2.75, respectively; P = .003; 95% CI [.46, 2.27]).”
    • Also stated in: § Risky Drinking Days · plain
      “Patients in the A-CHESS group reported significantly fewer risky drinking days (Table 2) than patients in the control group for the intervention and follow-up period (P = .003)”
    • Also stated in: § COMMENT · plain
      “Patients who received treatment as usual plus A-CHESS reported a lower average number of risky drinking days (1.39 vs. 2.75; P = .003)”
    Quote in the paperSubstantial claim
  • Findingreasoning

    In this study, 8 months of A-CHESS cost about $597 per patient.

    “In this study, 8 months of A-CHESS cost about $597/patient, based on 1 hour/month of counselor time at $90/hour divided by 50 patients, 1 hour/month for system administrator time at $50/hour divided by 170 patients, $60/month for each data plan, and $100 to buy each phone.”
    Quote in the paperSubstantial claim
  • Findingown data

    Perceived competence at 4 months mediated the relationship between intervention and number of risky drinking days at 8 months.

    “Of the 3 constructs, only perceived competence at 4 months was found to mediate the relationship between intervention and number of risky drinking days at 8 months (path: B [95% CI], P-value) (a: 0.219 [.004, .434], P = .046; b: −.969 [1.650, −.289], P = .005)”
    • Also stated in: § COMMENT · plain
      “One of self-determination theory’s 3 constructs (competence) was a significant mediator.”
    Quote in the paperSubstantial claim
  • Findingown data

    No significant differences were found between A-CHESS and control groups overall or by month for any of the measured negative consequences of drinking.

    “No significant differences were found between groups overall or by month for any of the negative consequences (not eating properly, hurting someone, having one’s status damaged, having money problems, losing a job, being arrested, having an accident, or involvement with the DCFS).”
    • Also stated in: § COMMENT · plain
      “but no difference in negative consequences of drinking.”
    Quote in the paperSubstantial claim
  • May combine two claims. 24
  • Classified as probably not a substantial claim. 17

  • May combine two claims.

    Findingown data

    A-CHESS patients had greater odds of reporting abstinence in the previous 30 days than control patients at months 8 and 12, but not at month 4.

    “The odds of reporting abstinence in the previous 30 days (Table 3) were greater for A-CHESS than control-group patients, with significant differences at months 8 and 12 (Ps = .038, .014, respectively) but not at month 4 (P = .132).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The difference in risky drinking days between A-CHESS and control was significant at months 4 and 12 but not at month 8.

    “Patients in the A-CHESS group reported significantly fewer risky drinking days (Table 2) than patients in the control group for the intervention and follow-up period (P = .003) and at months 4 (P = .020) and 12 (P =.032), but not month 8 (P = .096).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    During the 8-month intervention, A-CHESS patients used the system on average 40% of days (mean 97.36 days; median 103) and viewed a mean of 1,967 pages (median 1,745).

    “During the 8-month intervention period, patients randomized to the A-CHESS group used the system, on average, 40% of days (mean number of days of use: 97.36; median: 103) and viewed a mean number of 1,967 pages (median: 1,745).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    349 patients met DSM-IV alcohol dependence criteria upon entering residential treatment and were randomized, with 179 assigned to control and 170 to A-CHESS.

    “349 patients who met the criteria for DSM-IV alcohol dependence when they entered residential treatment. 179 were randomized to the control group and 170 to the treatment group.”
    • Also stated in: § Study Design and Participants · plain
      “The A-CHESS study was an un-blinded randomized trial with 349 patients who met the criteria for DSM-IV alcohol dependence upon entering treatment at 3 residential programs operated by one nonprofit in the Midwestern US and 2 programs operated by another nonprofit in the Northeastern US.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Baseline self-report of the number of previous times in treatment was not significant when included as a covariate in the primary analysis.

    “The closest collected measure was patients’ baseline self-report of the number of previous times in treatment (mean = 4.67; SD = 9.15; range = 0 to 50), which was not significant when included as a covariate in the primary analysis.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Significant effects were found for the individual BAM items of keeping busy and abstinence confidence, and for the BAM protection score.

    “Significant effects were found for the individual items of keeping busy and abstinence confidence, and for the BAM protection score (eTable 2).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    On average, 20 calls were required per patient to complete 3 phone surveys.

    “On average, 20 calls were required per patient to complete 3 phone surveys.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    During the intervention, patients completed 3,751 weekly BAMs and shared 97.0% (3,637) of them with counselors.

    “During the intervention, patients completed 3,751 weekly BAMs and shared 97.0% (3,637) of these with counselors.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Of 170 patients who received A-CHESS, 122 (71.7%) pressed the panic button at least once; 98 went beyond the panic button main page to at least one other page.

    “Of the 170 patients who received A-CHESS, 122 (71.7%) pressed the panic button at least once. Because patients could press the button in error, intended use was defined as going beyond the panic button main page to at least one other page; 98 did this.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Patients were much more willing to share their BAM results (93.5% allowed this) than to share that they had had a lapse (41.9% allowed this).

    “Patients were much more willing to share their BAM results (93.5% allowed this) than that they had had a lapse (41.9% allowed this).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The closest collected measure to AUD severity was baseline self-report of the number of previous times in treatment (mean=4.67; SD=9.15; range=0 to 50).

    “The closest collected measure was patients’ baseline self-report of the number of previous times in treatment (mean = 4.67; SD = 9.15; range = 0 to 50)”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Most enrolled patients were unemployed (79%).

    “Most patients were white (80%), male (61%), and unemployed (79%); most used or abused drugs in addition to alcohol (63%).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    One counselor estimated she spent 2 hours per week to follow 120 patients.

    “One counselor estimated she spent 2 hours/week to follow 120 patients.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Mean patient age was 38 years (SD=10; median=39).

    “Mean patient age was 38 years (SD = 10; median = 39).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Most enrolled patients were white (80%).

    “Most patients were white (80%), male (61%), and unemployed (79%); most used or abused drugs in addition to alcohol (63%).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Most enrolled patients were male (61%).

    “Most patients were white (80%), male (61%), and unemployed (79%); most used or abused drugs in addition to alcohol (63%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Among A-CHESS patients, the number of risky drinking days was significantly predicted by the number of pages viewed and the number of days used, but not by the number of services used.

    “The number of risky drinking days was significantly predicted by the number of pages viewed (per 100 pages: B = 0.036, P = .007, 95% CI [−0.069, −0.002) and days used (B = −0.01, P = .007, 95% CI [−0.02, −0.00], but not the number of services used (B = −0.06, P = .465, 95% CI [−0.22, 0.10]).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Most enrolled patients used or abused drugs in addition to alcohol (63%).

    “Most patients were white (80%), male (61%), and unemployed (79%); most used or abused drugs in addition to alcohol (63%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The effects of program, month, and the group-by-month interaction on risky drinking days were not significant.

    “The effects of program, month, and the group-by-month interaction were not significant (Ps = .536, .649, and .865, respectively).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    About 1 in 4 AUD patients remain continuously abstinent in the first year after treatment.

    “It has been estimated that about 1 in 4 AUDs patients remain continuously abstinent in the first year after treatment.4”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] Miller WR Walters ST Bennett ME How effective is alcoholism treatment in the United States? J Stud Alcohol 2001 62 2 211 20 11327187

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    Patients in the treatment group received a smartphone while control patients did not, and the app included a weekly self-assessment, possibly producing an assessment effect and more counselor contact than for control patients.

    “Patients in the treatment group received a smartphone while those in the control group did not, and the app included a weekly self-assessment, possibly producing an assessment effect31 and more counselor contact than for those in the control group.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [31] McCambridge J Kypri K Can simply answering research questions change behaviour? Systematic review and meta analysis of brief alcohol intervention trials PLoS ONE 2011 6 10 e23748 21998626 PMC3187747

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    SDT was chosen because evidence suggested that its 3 constructs could be causal mechanisms affecting CHESS targets, and because SDT is broad and fundamental enough to cover a complex, multifaceted eHealth intervention such as CHESS.

    “SDT was chosen because evidence suggested that SDT’s 3 constructs could be causal mechanisms that would affect CHESS targets, and because SDT is broad and fundamental enough to cover a complex, multifaceted eHealth intervention such as CHESS.12”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [12] Pingree S Hawkins R Baker T DuBenske L Roberts LJ Gustafson DH The value of theory for enhancing and understanding e-Health interventions Am J Prev Med 2010 38 1 103 109 20117565 PMC2826889

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Patients were included in the analysis if they provided any outcome data according to the intention-to-treat principle.

    “Patients were included in the analysis if they provided any outcome data according to the intention-to-treat principle.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The literature supports the effectiveness of continuing care in improving outcomes for AUDs, as well as for computer-based interventions for AUDs.

    “The literature supports the effectiveness of continuing care in improving outcomes for AUDs,22 as well as for computer-based interventions for AUDs.23-27”
    Quote in the paperSubstantial claim0 of 6 sources checked
    • cites [22] McKay JR Is there a case for extended interventions for alcohol and drug use disorders? Addiction 2005 100 1594 1610 16277622

      Not checked in the free run.

    • cites [23] Hester RK Squires DD Delaney HD The Drinker’s Checkup: 12-month outcomes of a controlled programal trial of a stand-alone software program for problem drinkers J Subst Abuse Treat 2005 28 159 169 15780546

      Not checked in the free run.

    • cites [24] Hester RK Delaney HD Campbell W Handmaker N A web application for moderation training: Initial results of a randomized programal trial J Subst Abuse Treat 2009 37 266 276 19339137 PMC2739257

      Not checked in the free run.

    • cites [25] Kypri K Saunders JB Williams SM Web-based screening and brief intervention for hazardous drinking: A double-blind randomized controlled trial Addiction 2004 99 1410 1417 15500594

      Not checked in the free run.

    • cites [26] Kypri K Langley JD Saunders JB Cashell-Smith ML Herbison P Randomized controlled trial of web-based alcohol screening and brief intervention in primary care JAMA Intern Med 2008 168 530 536 18332300

      Not checked in the free run.

    • cites [27] Carroll K Ball SA Martino S Nich C Babuscio TA Rounsaville BJ Enduring effects of a computer-assisted training program for cognitive behavioral therapy: A 6-month follow-up of CBT4CBT Drug Alcohol Depend 2009 100 178 181 19041197 PMC2742309

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The theoretical basis of A-CHESS is self-determination theory (SDT), which posits that meeting 3 needs contributes to adaptive functioning: being perceived as competent, feeling related to others, and feeling internally motivated and not coerced.

    “The theoretical basis of A-CHESS is self-determination theory (SDT), which posits that meeting 3 needs contributes to an individual’s adaptive functioning: being perceived as competent, feeling related to others, and feeling internally motivated and not coerced in one’s actions.10,11”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [10] Ryan RM Deci EL Self-regulation and the problem of human autonomy: Does psychology need choice, self-determination, and will? J Pers 2006 74 6 1557 1586 17083658

      Not checked in the free run.

    • cites [11] Ryan RM Deci EL Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being Am Psychol 2000 55 1 68 78 11392867

      Not checked in the free run.

  • May combine two claims.

    Premisenone given

    Treatment as usual varied across programs, and none offered patients coordinated continuing care after discharge.

    “Treatment as usual varied across programs; none offered patients coordinated continuing care after discharge.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    The study involved only patient self-report, without urine testing, and each survey asked about drinking only in the past 30 days, which does not capture a complete picture and can under- or over-estimate drinking behavior.

    “The study involved only patient self-report, without urine testing, and each survey asked about drinking only in the past 30 days, which does not capture a complete picture of each patient’s drinking and can under- or over-estimate drinking behavior.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    The results were consistent when all 2- and 3-way interactions were included in the model, with significant effects of A-CHESS overall and at months 4 and 12, but not at month 8.

    “The results were consistent when all 2- and 3-way interactions were included in the model, with significant effects of A-CHESS overall (main effect; P = .003) and at months 4 and 12 (simple effects; Ps = .002 and .044), but not at month 8 (P = .259) or for any other factor or interaction (all Ps > .05).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    Randomization used a computer-generated random allocation sequence with blocks of 8, implemented using sequentially numbered containers.

    “Within each program, patients were randomized to control or A-CHESS in a 1:1 ratio using a computer-generated random allocation sequence with blocks of 8. Randomization was implemented using sequentially numbered containers.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductcitation

    The primary outcome was analyzed with mixed-effects models that account for correlated measurements within patients, use all available data (allowing intention-to-treat rather than only complete-case analysis), and provide unbiased estimates when data are missing at random.

    “The primary outcome, risky drinking days, was analyzed with mixed-effects models. These models account for correlated measurements within patients, use all available data (allowing for intention-to-treat rather than only complete-case analysis), and provide unbiased estimates when data are missing at random.18”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [18] White IR Horton NJ Carpenter J Pocock SJ Strategy for intention to treat analysis in randomised trials with missing outcome data BMJ 2011 342 d40 21300711 PMC3230114

      Not checked in the free run.

    • Rests on an assumption: The missing outcome data in this trial are missing at random.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    AUD severity was not collected.

    “AUD severity was not collected.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    No patients withdrew from the study, although 21 control patients and 14 A-CHESS patients did not provide data for any of the 3 surveys.

    “No patients withdrew from the study, although 21 patients in the control group and 14 patients in the A-CHESS group did not provide data for any of the 3 surveys.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The study was approved by the Institutional Review Board at the University of Wisconsin-Madison and registered at clinicaltrials.gov (NCT01003119).

    “The study was approved by the Institutional Review Board at the University of Wisconsin – Madison and registered at clinicaltrials.gov (NCT01003119).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Premisereasoning

    Compared with traditional care, technology can give personalized care while using less counselor time and be available at the moment of greatest need.

    “Compared to traditional care, technology can give personalized care while using less counselor time and be available at the moment of greatest need.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Planned recruitment of 175 patients per group was estimated from an effect size of h=0.34, α=.05, .80 power, and 20% attrition.

    “Planned recruitment of 175 patients per group was estimated from the effect size (h = 0.34) observed in a telephone-based intervention,17 α = .05, .80 power, and 20% attrition.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [17] McKay JR Lynch KG Shepard DS The effectiveness of telephone-based continuing care in the programal management of alcohol and cocaine use disorders: 12-month outcomes J Consult Clin Psychol 2004 72 967 979 15612844

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    The study involved only 2 treatment organizations and 5 programs, and most patients were white males in their 30s and 40s.

    “The study involved only 2 treatment organizations and 5 programs, and most patients were white males in their 30s and 40s.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    The promising results of this trial point to the possible value of a smartphone intervention for treating AUDs and perhaps other chronic illnesses.

    “The promising results of this trial in continuing care for AUDs point to the possible value of a smartphone intervention for treating AUDs and perhaps other chronic illnesses.”
    Quote in the paperSubstantial claim
37 of 37

  • The paper relies on this without support.

    No other large randomized trial has been reported about the effectiveness of mobile technology for continuing care of AUDs.

    “To our knowledge, no other large randomized trial has been reported about the effectiveness of mobile technology for the continuing care of AUDs.”

  • The paper relies on this without support.

    The missing outcome data in this trial are missing at random.

    “provide unbiased estimates when data are missing at random.”

  • The paper relies on this without support.

    The modified 8-item set derived from the SIP-R adequately captures negative consequences of drinking.

    “Because of these departures from the established instrument, the 8 items were examined individually rather than as a single scale.”
3 of 3

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?

  • A-CHESS researchers partially predicted the number of days of consumption based on the level of app use by the user.

    “researchers using an application designed to provide support to people with alcoholism (Addiction—Comprehensive Health Enhancement Support System or A-CHESS) were able to partially predict the number of days of consumption based on the level of use of the application by the user (i.e., number of times spent on the application, number of pages viewed) (104).”

    From Mobile intervention for individuals with psychosis, dual disorders, and their common comorbidities: A literature review (2019) · cites this paper as [104]

    The Results (Post-Hoc Analyses) report that pages viewed and days of A-CHESS use significantly predicted the number of risky drinking days. The citing sentence calls these days of consumption generally, whereas the paper’s outcome was specifically risky drinking days. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Digital interventions for SUDs have demonstrated efficacy for screening and assessment, treatment and recovery, as stand-alone tools or as adjuncts to clinician-delivered interventions.

    “Digital interventions for SUDs have demonstrated efficacy for screening and assessment 251- 253 , treatment 254,255 and recovery 250,256 , as stand- alone tools or as adjuncts to clinician- delivered in terventions.”

    From Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention (2023) · cites this paper as [256]

  • A-CHESS has been previously tested in a randomized trial involving 349 study participants and found to reduce risky drinking days and improve abstinence.

    “The A-CHESS mobile phone app has been previously tested in a randomized trial involving 349 study participants and found to reduce risky drinking days and improve abstinence [19].”

    From Successful Organizational Strategies to Sustain Use of A-CHESS: A Mobile Intervention for Individuals With Alcohol Use Disorders (2015) · cites this paper as [19]

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.

  • A-CHESS randomization count conflicts with the group totals

    Minor

    The results say 179 patients were assigned to A-CHESS, while the abstract assigns 179 to control and 170 to treatment.

  • Pages-viewed estimate falls outside its confidence interval

    Minor

    The reported coefficient is positive, but both confidence-interval bounds are negative.

  • Replacement reasons exceed the stated total

    Minor

    The four listed replacement counts sum to 117, rather than the stated 113.

    Reported 113 · recomputed 117

  • Mediation estimate falls outside its confidence interval

    Minor

    The reported path-b estimate is −0.969, but its interval runs from positive 1.650 to −0.289 and does not contain that estimate.

4 of 4

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. [7]McLellan AT Carise D Kleber HD Can the national addiction treatment infrastructure support the public’s demand for quality care? J Subst Abuse Treat 2003 25 2 117 121 14680015

Cited by

Sorted by citations

Related

Authors
Gustafson, D. H., McTavish, F. M., Chih, M.-Y., Atwood, A. K., Johnson, R. A., Boyle, M. G., Levy, M. S., Driscoll, H., Chisholm, S. M., Dillenburg, L., Isham, A., & Shah, D.
Affiliations
  • University of Wisconsin–Madison (US)
  • North Shore Medical Center (US)
  • Fayette Companies, Peoria, Illinois
  • North Shore Community College (US)
Corresponding author
Gustafson, David H.
ORCID
Venue
JAMA Psychiatry
Publisher
American Medical Association (AMA)
Published
2014-05-01
Volume
71
Issue
5
Pages
566
ISSN
2168-622X (ISSN-L)
DOI
10.1001/jamapsychiatry.2013.4642
PMC
PMC4016167
OpenAlex
W2117046315
Semantic Scholar
de54f8c9ced006ca5e986e3dfc871b4effb0fed8
Cited by
692
References
32
Citations by year
2026: 25 · 2025: 45 · 2024: 49 · 2023: 57 · 2022: 66 · 2021: 69 · 2020: 63 · 2019: 62 · 2018: 81 · 2017: 52 · 2016: 49 · 2015: 50 · 2014: 24
FWCI
44.19
Type
journal article
Language
en
Open access
Locations
  • JAMA Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Alcohol Abuse and Alcoholism (R01AA017192)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords
mobile application, alcoholism, continuing care, residential treatment, recovery support, hazardous drinking, post-discharge follow-up, mobile health
MeSH terms
Adult, Aftercare, Alcoholism, Female, Humans, Male, Middle Aged, Patient Compliance, Patient Education as Topic, Psychotherapy, Group, Software, Temperance, Therapy, Computer-Assisted, Midwestern United States, Cognitive Behavioral Therapy, Substance Abuse Treatment Centers, Case Management, Personal Autonomy, Cell Phone, Secondary Prevention, Motivational Interviewing

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.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-06.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.

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 ›

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