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Cited by 1,665Substance Abuse Treatment and OutcomesAlcohol Consumption and Health EffectsBehavioral Health and Interventions

Effectiveness of brief alcohol interventions in primary care populations

Open access
Kaner, Eileen FS, Beyer, Fiona R, Muirhead, Colin, Campbell, Fiona, Pienaar, Elizabeth D, Bertholet, Nicolas, Daeppen, Jean B, Saunders, John B +1 more·2018·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd004148.pub4PMC PMC6491186
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Abstract

Cochrane systematic review updating evidence on brief interventions in primary care. 68 RCTs showed moderate-certainty evidence that brief interventions reduce alcohol consumption by an average of 20 grams of alcohol per week compared to control at one year follow-up in adults.

Integrity signals

Registry

Crossref · 10.1002/14651858.cd004148.pub4

Cites

325 of 325 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

75 of 278 cited sources checked · 51 supported · 4 flagged · accuracy not yet measured

  • Premisecitation

    At a population level, most alcohol-related harm is not due to drinkers with severe alcohol dependence but attributable to a much larger group of excessive (hazardous and harmful) drinkers whose consumption exceeds recommended drinking levels.

    “At a population level, most alcohol-related harm is not due to drinkers with severe alcohol dependence but attributable to a much larger group of excessive (hazardous and harmful drinkers) whose consumption exceeds recommended drinking levels (Anderson 1991).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Anderson 1991 source

      Split into 2 atoms — 0 confirmed, 1 partially supported, 1 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
  • Findingcitation

    Many included studies were published before CONSORT reporting guidelines appeared in 2010.

    “This was largely because many included studies were published before CONSORT reporting guidelines appeared in 2010 (Schulz 2010).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Schulz 2010 source

      The Background to CONSORT (p. 2) says the first CONSORT statement appeared in 1996 and was revised in 2001; 2010 was a further update, not the guidelines’ first appearance. The paper does not discuss the citing authors’ included studies or when they were published. (LLM, conf=0.86)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
  • Study design and conductown data

    Lane 2008 had high risk of bias for incomplete outcome data because loss to follow-up was greater than 30%.

    “Loss to follow-up > 30%.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Lane 2008 source

      The Results report 184 study participants, and the Follow-up section reports 133 followed up and 51 lost—an overall loss of 27.7%, not greater than 30%. Loss in the control group alone was 30 of 97 (30.9%), but the unqualified statement does not specify that group. The paper does not itself assign a risk-of-bias rating. (LLM, conf=0.88)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
  • Premisecitation

    There has been uncertainty about extrapolation of brief intervention to real world routine primary care.

    “there has been uncertainty about extrapolation to real world routine primary care (Heather 2014;Holder 1999;Kaner 2001).”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites Heather 2014 source
    • cites Holder 1999 source
    • cites Kaner 2001

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Findingown data

    Seven studies compared brief intervention to no or minimal intervention and reported gamma-glutamyltransferase (GGT).

    “We included seven studies that compared brief intervention to no or minimal intervention and reported gamma-glutamyltransferase (GGT) (Aalto 2000;Beckham 2007;Noknoy 2010;Romelsjö 1989;Scott 1990;Tomson 1998;Wallace 1988).”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites Aalto 2000 source
    • cites Beckham 2007 source
    • cites Noknoy 2010 source
  • Classified as probably not a substantial claim. 411
  • May combine two claims. 97
  • The quote only partly states this claim. 4

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

    Study design and conductcitation

    In D'Onofrio 2012, incomplete outcome data was judged to be at high risk of attrition bias for all outcomes.

    “Incomplete outcome data (attrition bias) All outcomes High risk”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites D'Onofrio 2012 source

      The Limitations section acknowledges missing data at 6 and 12 months but says the mixed-model analyses were designed to handle them with little bias. The Methods section likewise describes including participants with missing data; the paper does not judge attrition bias to be high risk for all outcomes. No page numbers were available in our copy. (LLM, conf=0.84)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Premisecitation

    Early identification and secondary prevention of alcohol problems, using screening and brief interventions in primary care, has long been advocated as a strategy to reduce excessive drinking and is the focus of a great deal of research.

    “Early identification and secondary prevention of alcohol problems, using screening and brief interventions in primary care, has long been advocated as a strategy to reduce excessive drinking and is the focus of a great deal of research (O'Donnell 2014).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites O'Donnell 2014 source

  • Classified as probably not a substantial claim.

    Premisecitation

    The process of screening for alcohol consumption or having the effects of drinking assessed may influence reported drinking behaviour, independent of any further brief intervention input.

    “These definitions describe how the very process of screening for alcohol consumption or having the effects of drinking assessed may influence reported drinking behaviour, independent of any further brief intervention input.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites McCambridge 2011 source

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

    Premisecitation

    The true impact of alcohol on the health of individuals and the wider community is difficult to estimate because of the many effects resulting from alcohol use, including increased levels of violence, accidents and suicide.

    “The true impact of alcohol on the health of individuals and the wider community is difficult to estimate because of the many effects resulting from alcohol use, including increased levels of violence, accidents and suicide (GBD 2017).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites GBD 2017 source

      The Alcohol section (page not available) reports a substantial health burden from alcohol use, and the Limitations section says estimates of alcohol consumption rely on limited data and carry significant uncertainty. These passages support the broad point that alcohol’s impact is difficult to estimate, but they do not establish the claim’s stated reason—that difficulty arises from its many effects—or clearly link alcohol use to the listed increases in violence, accidents, and suicide. (LLM, conf=0.82)

      Experimental — accuracy not yet measured

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

    Premisecitation

    The concepts of screening reactivity and assessment reactivity have been defined.

    “the concepts of screening reactivity and assessment reactivity have been defined (McCambridge 2011).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites McCambridge 2011 source

      The Discussion describes assessment reactivity as a possible effect of answering research-assessment questions on drinking behaviour. The Results distinguish minimal screening from longer assessments and from no screening, but the paper does not define screening reactivity as a separate concept. No page numbers are available in our copy. (LLM, conf=0.78)

      Experimental — accuracy not yet measured

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

    Findingown data

    In 14 trials reporting baseline frequency of drinking convertible to days drinking per week, the mean was 2.07 days/week.

    “We included 14 trials that reported baseline measures of frequency of drinking which could be converted to days drinking per week; the mean value was 2.07 days/week (Aalto 2000;Bernstein 2010;Cherpitel 2009;Daeppen 2007;Fleming 1997;Fleming 2010;Helstrom 2014;Monti 2007;Noknoy 2010;Rubio 2010;Schaus 2009;Senft 1997;Soderstrom 2007;Spirito 2004).”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites Aalto 2000 source
    • cites Bernstein 2010 source
    • cites Cherpitel 2009 source

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

    Findingcitation

    One trial reported mean corpuscular volume (MCV) for this comparison.

    “One trial reported mean corpuscular volume (MCV) for this comparison (Seppa 1992).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Seppa 1992 source

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

    Findingcitation

    A further six studies reported the change between baseline and the end of follow-up in the quantity of alcohol consumed in a specified time period and the corresponding standard deviation.

    “A further six studies reported the change between baseline and the end of follow-up (change score) in the quantity of alcohol consumed in a specified time period and the corresponding standard deviation (Bischof 2008;Fernández 1997;Field 2010;Huas 2002;Ockene 1999;Romelsjö 1989).”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites Bischof 2008 source
    • cites Fernández 1997

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Field 2010 source

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

    Findingcitation

    Frequency of drinking in terms of number of days drinking each week or each month was reported by 11 trials at 6 or 12 months.

    “Frequency of drinking in terms of number of days drinking each week or each month was reported by 11 trials at 6 or 12 months (Bernstein 2010;Cherpitel 2009;Crawford 2004;Curry 2003;Daeppen 2007;Field 2010;Fleming 2010;Helstrom 2014;Maisto 2001;Senft 1997;Spirito 2004).”
    Quote in the paperNot a substantial claim2 of 3 sources checked
    • cites Bernstein 2010 source
    • cites Cherpitel 2009 source
    • cites Crawford 2004 source

      The Sample size and data analysis section says the trial measured percentage of days abstinent over a 13-week period at both 6 and 12 months; the outcomes table reports that measure. This captures drinking frequency indirectly, but the paper does not report it as the number of days drinking each week or month. As one of the cited trials, it also cannot establish the citing sentence’s total of 11 trials. (LLM, conf=0.82)

      Experimental — accuracy not yet measured

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

    Findingown data

    Of these 51 studies, 27 reported quantity and corresponding standard deviation at 12 months.

    “Of these, 27 studies reported quantity and corresponding standard deviation at 12 months (Altisent 1997;Beich 2007;Bernstein 2010;Blow 2006;Córdoba 1998;Crawford 2004;Daeppen 2007;D'Onofrio 2008;D'Onofrio 2012;Drummond 2014;Fleming 1997;Fleming 1999;Fleming 2004;Fleming 2010;Helstrom 2014;Kaner 2013;Lock 2006;Maisto 2001;Richmond 1995;Rubio 2010;Schaus 2009;Scott 1990;Senft 1997;Soderstrom 2007;”
    Quote in the paperNot a substantial claim2 of 3 sources checked
    • cites Altisent 1997

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Beich 2007 source
    • cites Bernstein 2010 source

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

    Findingown data

    A measure of alcohol-related consequences or harm was reported by 21 studies.

    “A measure of alcohol-related consequences or harm (e.g.Drinker Inventory of Consequences -DrInC; Alcohol Problems Quesionnaire -APQ) was reported by 21 studies (Blow 2006;Cherpitel 2009;D'Onofrio 2012;Drummond 2009;Drummond 2014;Fleming 2010;Heather 1987;Helstrom 2014;Kaner 2013;Lane 2008;Longabaugh 2001;McDevitt-Murphy 2014;McIntosh 1997;Mello 2008;Monti 2007;Romelsjö 1989;Schaus 2009;Spirito 200”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites Blow 2006 source
    • cites Cherpitel 2009 source
    • cites D'Onofrio 2012 source

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

    Study design and conductown data

    Two trials were not included in the modality subgroup analysis because they contained arms with both intervention types.

    “Two trials were not included in this subgroup analysis because they contained arms that included both intervention types (Drummond 2014;Kaner 2013).”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites Drummond 2014 source
    • cites Kaner 2013

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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

    Interpretationcitation

    It is possible that screening alone might represent an impetus for change.

    “Therefore, it is possible that screening alone might represent an impetus for change (McCambridge 2011).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites McCambridge 2011 source

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

    Study design and conductcitation

    Beich 2007 had low risk of bias for allocation concealment.

    “Allocation concealment (selection bias) Low risk Screening questionnaires went into a sealed envelope which had a symbol on the front which had to be uncovered scratch card style (p.594)”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Beich 2007 source

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

    Study design and conductown data

    Beich 2007 had unclear risk of bias for random sequence generation.

    “Random sequence generation (selection bias) Unclear risk Sequence generation not described.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Beich 2007 source

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

    Study design and conductreasoning

    Bernstein 2010 had unclear risk of bias for blinding of treatment providers.

    “Blinding of treatment providers Unclear risk Appears that peer educators who delivered the intervention only saw intervention participants but this is not clear”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Bernstein 2010 source

      The Procedures section (page not available) says peer educators delivered the intervention to the intervention group, and the Study Protocol section says research assistants who performed assessments were blinded. The paper does not say whether peer educators also saw control participants or explicitly rate the risk of bias for provider blinding; the cited assessment is therefore only partly grounded in its account. (LLM, conf=0.78)

      Experimental — accuracy not yet measured

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

    Study design and conductnone given

    Beich 2007 had high risk of bias for blinding of treatment providers.

    “Blinding of treatment providers High risk”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Beich 2007 source

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

    Study design and conductown data

    Bernstein 2010 did not use intention-to-treat analysis.

    “ITT: no.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Bernstein 2010 source

      The Outcomes Analysis section describes the primary comparisons but does not identify them as intention-to-treat analyses; the Results section reports only 72% follow-up at 12 months. However, the Sensitivity Analysis includes participants lost to follow-up by counting them as having made no quit attempt. Thus, 'ITT: no' may describe the primary analysis, but it overlooks an analysis that accounts for all enrollees. (LLM, conf=0.78)

      Experimental — accuracy not yet measured

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

    Study design and conductown data

    Bernstein 2010 had high risk of bias for blinding of participants.

    “Blinding of participants High risk No reported attempt to blind participants.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Bernstein 2010 source

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

    Study design and conductcitation

    Beich 2007 used intention-to-treat analysis.

    “ITT: yes.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Beich 2007 source

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given

    Bernstein 2010 had low risk of bias for random sequence generation.

    “Random sequence generation (selection bias) Low risk”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Bernstein 2010 source

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

    Study design and conductown data

    Bernstein 2010 had unclear risk of bias for incomplete outcome data.

    “Incomplete outcome data (attrition bias) All outcomes Unclear risk Loss to follow-up reported, but reasons not given.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Bernstein 2010 source

      The Results section (page not available) reports 70% follow-up at 3 months and 72% at 12 months, and the Sensitivity Analysis describes attrition as considerable. These passages support the reported loss to follow-up, but the paper does not itself assign an ‘unclear risk’ rating for incomplete outcome data; that is the citing authors’ assessment. (LLM, conf=0.82)

      Experimental — accuracy not yet measured

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

    Study design and conductnone given

    Beich 2007 had high risk of bias for blinding of participants.

    “Blinding of participants High risk”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Beich 2007 source

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

    Study design and conductcitation

    In Crawford 2004, allocation concealment was judged to be at unclear risk of selection bias.

    “Allocation concealment (selection bias) Unclear risk”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Crawford 2004 source

      The Procedures section (page unavailable) says allocation used computer-generated lists and opaque envelopes bearing patient identification numbers. It does not say whether the envelopes were sealed or opened in sequence, and it does not itself judge selection-bias risk. The reported method provides a basis for uncertainty, but not the stated risk judgment. (LLM, conf=0.76)

      Experimental — accuracy not yet measured

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

    Study design and conductreasoning

    In Crawford 2004, selective reporting was judged to be at low risk of reporting bias.

    “Selective reporting (reporting bias) Low risk”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Crawford 2004 source

      The Patient assessment and Sample size and data analysis sections describe the trial’s outcome measures and analyses, but do not judge the risk of selective reporting. The Discussion describes limitations without making a reporting-bias assessment. A low-risk judgment cannot be verified from our copy of this paper. (LLM, conf=0.73)

      Experimental — accuracy not yet measured

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

    Study design and conductcitation

    In Crawford 2004, blinding of treatment providers was judged to be at low risk of bias.

    “Blinding of treatment providers Low risk”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Crawford 2004 source

      The Methods describe the trial as single-blind, and the Results report a test of researchers’ blinding. Neither passage says treatment providers were blinded or judges their blinding to be at low risk of bias. A search for provider blinding and risk-of-bias language found no such assessment in our copy. (LLM, conf=0.75)

      Experimental — accuracy not yet measured

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

    Study design and conductcitation

    In Crawford 2004, random sequence generation was judged to be at low risk of selection bias.

    “Random sequence generation (selection bias) Low risk”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Crawford 2004 source

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

    Study design and conductcitation

    In Crawford 2004, blinding of participants was judged to be at high risk of bias.

    “Blinding of participants High risk”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Crawford 2004 source

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

    Study design and conductcitation

    In Crawford 2004, blinding of outcome assessment was judged to be at low risk of detection bias for all outcomes.

    “Blinding of outcome assessment (detection bias) All outcomes Low risk”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Crawford 2004 source

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

    Study design and conductcitation

    In Crawford 2004, the study used intention-to-treat analysis.

    “ITT: yes.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Crawford 2004 source

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

    Study design and conductown data

    In Crawford 2004, incomplete outcome data was judged to be at high risk of attrition bias for all outcomes.

    “Incomplete outcome data (attrition bias) All outcomes High risk”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Crawford 2004 source

      The Results report that only 384 of 599 randomised patients (64.1%) completed the 12-month interview, and the Discussion identifies difficult follow-up as a limitation. This supports concern about attrition, but the paper does not judge incomplete data to be at high risk of bias for all outcomes; it also notes that follow-up rates were similar between trial arms. (LLM, conf=0.82)

      Experimental — accuracy not yet measured

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

    Study design and conductcitation

    In D'Onofrio 2012, random sequence generation was judged to be at unclear risk of selection bias.

    “Random sequence generation (selection bias) Unclear risk”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites D'Onofrio 2012 source

      The Methods (Setting and Participants; page unavailable) report a 100-block randomization procedure and sealed envelopes. Our copy does not judge random sequence generation to be at unclear risk of selection bias; searches for that assessment and for how the sequence was generated did not find it. (LLM, conf=0.75)

      Experimental — accuracy not yet measured

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

    Study design and conductcitation

    In D'Onofrio 2012, allocation concealment was judged to be at unclear risk of selection bias.

    “Allocation concealment (selection bias) Unclear risk”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites D'Onofrio 2012 source

      The Methods (Setting and Participants; page unavailable) say research associates were provided sealed envelopes for a block-randomization procedure. The paper does not judge allocation concealment to be at unclear risk of selection bias, so that risk-of-bias rating cannot be verified from our copy. (LLM, conf=0.76)

      Experimental — accuracy not yet measured

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

    Study design and conductcitation

    In D'Onofrio 2012, the study used intention-to-treat analysis.

    “ITT: yes.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites D'Onofrio 2012 source

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based).

    Study design and conductcitation

    In D'Onofrio 2012, blinding of treatment providers was judged to be at low risk of bias.

    “Blinding of treatment providers Low risk”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites D'Onofrio 2012 source

      The Methods (Measurements; page unavailable) say that independent raters of intervention recordings were blinded, but those raters were not the treatment providers. The Methods (Study Interventions; page unavailable) describe the practitioners who delivered the intervention without stating whether they were blinded or assessing their risk of bias. Our copy therefore does not verify the low-risk judgment for provider blinding. (LLM, conf=0.72)

      Experimental — accuracy not yet measured

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

    Study design and conductcitation

    In D'Onofrio 2012, selective reporting was judged to be at low risk of reporting bias.

    “Selective reporting (reporting bias) Low risk”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites D'Onofrio 2012 source

      The Methods section, “Primary and Secondary Outcomes” (page unavailable), lists the study outcomes, but does not judge the risk of selective reporting. Searches for “selective reporting,” “reporting bias,” and prespecified outcomes found no low-risk assessment in our copy. (LLM, conf=0.76)

      Experimental — accuracy not yet measured

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

    Study design and conductcitation

    In D'Onofrio 2012, blinding of outcome assessment was judged to be at low risk of detection bias for all outcomes.

    “Blinding of outcome assessment (detection bias) All outcomes Low risk”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites D'Onofrio 2012 source

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

    Study design and conductcitation

    In D'Onofrio 2012, blinding of participants was judged to be at low risk of bias.

    “Blinding of participants Low risk”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites D'Onofrio 2012 source

      The Methods (Measurements; page unavailable) say that research associates and independent adherence raters were blinded, but do not say whether participants were blinded. The Methods (Study Interventions; page unavailable) describe different care across groups, without assessing the risk of bias from participant blinding. Our copy therefore does not establish the claimed low-risk judgment. (LLM, conf=0.77)

      Experimental — accuracy not yet measured

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

    Study design and conductown data

    McDevitt-Murphy 2014 had high risk of bias for blinding of treatment providers because treatment providers were not blinded.

    “Not blinded.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites McDevitt-Murphy 2014 source

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

    Study design and conductcitation

    Mertens 2014 had low risk of bias for blinding of outcome assessment because research interviewers conducting follow-up were blinded to randomisation status.

    “Research interviewers conducting followup were blinded to randomisation status”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Mertens 2014 source

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

    Findingcitation

    Two included studies took place in college health clinics.

    “Two studies took place in college health clinics (Fleming 2010; Schaus 2009)”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites Fleming 2010 source
    • cites Schaus 2009 source

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

    Premisereasoning

    The Gentilello 1999 trial is included in a Cochrane Review of brief interventions in patients admitted to hospital.

    “the trial is included in a Cochrane Review of brief interventions in patients admitted to hospital.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Gentilello 1999 source

      The Methods describe a randomized trial of a brief intervention for patients at a trauma center, conducted on or near hospital discharge. Our copy does not say whether the trial was included in a Cochrane Review; a search for that review found no confirming passage. (LLM, conf=0.82)

      Experimental — accuracy not yet measured

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

    Findingcitation

    One included study took place in a public sexual health clinic.

    “one in a public sexual health clinic (Lane 2008)”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Lane 2008 source

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

    Findingcitation

    One included study took place in a veterans' affairs medical centre.

    “one in a veterans' affairs medical cen- tre (McDevitt-Murphy 2014)”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites McDevitt-Murphy 2014 source

  • May combine two claims.

    Findingown data

    Two trials reported adverse events related to driving outcomes but concluded they were equivalent in both study arms.

    “two trials reported adverse events related to driving outcom es but concluded they were equivalent in both study arm s”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Heterogeneity in the meta-analysis of quantity of drinking at 12 months was substantial (I2 = 73%) but not unexplained; interventions differed in content and delivery.

    “Heterogeneity was substantial (73%) but not unexplained; interventions dif f ered in content and delivery.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Half the included trials (51%) reported participants' ethnicity; most participants were Caucasian (n = 28 trials, 78%).

    “Half the included trials (51%) reported participants' ethnicity; most participants were Caucasian (n = 28 trials, 78%).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Extended interventions were based on motivational interviewing in five studies.

    “Extended interventions were based on motivational interviewing (five studies), MET (two studies), multiple FRAMES sessions (two studies), or CBT (one study) approaches.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    General practitioners, nurse practitioners, health psychologists or trainee health psychologists administered the interventions.

    “General practitioners, nurse practitioners, health psychologists or trainee health psychologists administered the interventions.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    In the remaining studies, there were between two and five sessions, where individual sessions varied from one to a maximum of 60 minutes.

    “In the remaining studies, there were between two and five sessions, where individual sessions varied from one to a maximum of 60 minutes.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    All interventions provided feedback on the screening outcome plus structured advice about potential risks of heavy drinking and ways to reduce consumption.

    “All interventions provided feedback on the screening outcome plus structured advice about potential risks of heavy drinking and ways to reduce consumption.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Extended interventions were based on CBT in one study.

    “Extended interventions were based on motivational interviewing (five studies), MET (two studies), multiple FRAMES sessions (two studies), or CBT (one study) approaches.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The median treatment duration was 25 minutes and IQR 7.5 to 30.0 minutes.

    “The median duration was 25 minutes and IQR 7.5 to 30.0 minutes.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The median efficacy/effectiveness score was 8.5 and IQR 7 to 10.5.

    “The median was 8.5 and IQR 7 to 10.5 (Table 2).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    22 studies could not be included in meta-analyses, either because outcomes were not reported at 12 months, or outcome measures differed from those prespecified for this review (such as AUDIT score).

    “We could not include 22 studies in metaanalyses (Aalto 2000;Bazargan-Hejazi 2005;Beckham 2007;Crawford 2010;D'Amico 2008;Dent 2008;Désy 2010;Díez 2002;Drummond 2009;Heather 1987;Kunz 2004;L'Engle 2014;Lane 2008;McDevitt-Murphy 2014;Mello 2008;Mertens 2014;Noknoy 2010;Rodríguez 2003;Segatto 2011;Sommers 2006;Tait 2004;Woolard 2013), either because outcomes were not reported at 12 months, or outcome”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Aalto 2000 source
    • cites Bazargan-Hejazi 2005 source
    • cites Beckham 2007 source

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

    Findingnone given

    Previously, the overall mean baseline consumption in 21 trials reporting these data was 313 g/week.

    “Previously, the overall mean baseline consumption in 21 trials reporting these data was 313 g/week”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Eight trials focused on adolescents, young adults, or both.

    “Eight trials focused on adolescents, young adults, or both (D'Amico 2008;Mertens 2014;Monti 2007;Segatto 2011;Spirito 2004;Spirito 2011;Tait 2004;Walton 2010).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    The mean percentage of male participants was 70%.

    “The mean percentage of male participants was 70%.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Findingnone given

    In 27 studies, feedback and structured advice were described as brief Intervention and assumed to be based on FRAMES where not reported.

    “described as brief Intervention (and assumed to be based on FRAMES where not reported) (n = 27)”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Among the 45 trials that reported participants' age, the mean age was 40 years (SD 11.18).

    “Among the 45 trials that reported participants' age, the mean age was 40 years (SD 11.18).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Five categories of control condition were reported.

    “Five categories of control condition were reported.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Extended interventions were based on multiple FRAMES sessions in two studies.

    “Extended interventions were based on motivational interviewing (five studies), MET (two studies), multiple FRAMES sessions (two studies), or CBT (one study) approaches.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    In 2 studies, feedback and structured advice were based on Cognitive Behavioural Therapy (CBT) techniques.

    “or based on Cognitive Behavioural Therapy (CBT) techniques (n = 2)”
    Quote in the paperNot a substantial claim

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

    Findingown data

    This review included 69 studies (112 reports).

    “This review included 69 studies (112 reports) (Figure 1; Characteristics of included studies)”
    Quote in the paperNot a substantial claim

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

    Findingown data

    In 32 studies, feedback and structured advice were based on or informed by motivational interviewing, Motivational Enhancement Therapy (MET), or Brief Negotiated Interview (BNI).

    “based on or informed by motivational interviewing, Motivational Enhancement Therapy (MET), or Brief Negotiated Interview (BNI) (n = 32)”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Searches identified 4004 potentially relevant records.

    “Searches identified 4004 potentially relevant records which were screened by title and abstract for eligibility.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    The total duration of extended intervention sessions ranged from 60 minutes to 180 minutes.

    “The total duration of extended intervention sessions ranged from 60 minutes to 180 minutes.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Extended interventions were based on MET in two studies.

    “Extended interventions were based on motivational interviewing (five studies), MET (two studies), multiple FRAMES sessions (two studies), or CBT (one study) approaches.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    We retrieved 165 records for full text assessment.

    “We retrieved 165 records for full text assessment.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    In 11 trials added for this update that reported overall mean baseline consumption, the mean was 181 g/week (about 23 UK units).

    “Only 11 trials added for this update reported overall mean baseline consumption, which was 181 g/week (about 23 UK units).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Four trials focused on older adults (aged > 55 years, > 60 years, or > 65 years).

    “Four trials focused on older adults (aged > 55 years, aged > 60 years, or aged > 65 years) (Ettner 2014;Fleming 1999;Moore 2011;Watson 2013).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    In 11 trials reporting baseline intensity of drinking, the mean baseline value was 69 g/drinking day.

    “Baseline intensity of drinking was reported in 11 trials, in which the mean baseline value was 69 g/drinking day.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    In 21 trials reporting baseline consumption, the overall mean baseline consumption was 313 g/week (about 39 UK units).

    “Previously, the overall mean baseline consumption in 21 trials reporting these data was 313 g/week (about 39 UK units).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    We added 42 studies (73 reports) for this update.

    “We added 42 studies (73 reports) for this update.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    There was substantial heterogeneity among trials in terms of the mechanisms of screening participants for inclusion and in the content of both control and intervention arms.

    “There was substantial heterogeneity among trials in terms of the mechanisms of screening participants for inclusion and in the content of both control and intervention arms.”
    Quote in the paperNot a substantial claim

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

    Findingcitation

    Extended interventions were evaluated in 10 trials, in which the total duration was greater than 60 minutes and the number of sessions delivered ranged from two to seven.

    “Extended interventions were evaluated in 10 trials (Aalto 2000;Bischof 2008;Israel 1996;L'Engle 2014;Longabaugh 2001;Maisto 2001;Monti 2007;Moore 2011;Richmond 1995;Spirito 2011), in which the total duration was greater than 60 minutes and the number of sessions delivered to participants ranged from two to seven.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Aalto 2000 source
    • cites Bischof 2008 source
    • cites Israel 1996 source

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

    Findingnone given

    Extended interventions also provided feedback and structured advice but comprised either more than five sessions or more than 60 minutes in total.

    “Extended interventions also provided feedback and structured advice but comprised either more than five sessions or more than 60 minutes in total.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    In the extended intervention conditions, the treatment exposures ranged from 65 minutes to 175 minutes.

    “In the extended intervention conditions, the treatment exposures ranged from 65 minutes to 175 minutes .”
    Quote in the paperNot a substantial claim

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

    Findingcitation

    The previous version of this review included 29 studies (39 reports).

    “The previous version of this review included 29 studies (39 reports) (Kaner 2007).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Most studies (n = 61) compared brief intervention with minimal or no intervention.

    “Most studies (n = 61) compared brief intervention with minimal or no intervention.”
    Quote in the paperNot a substantial claim

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

    Findingreasoning

    Three of these six studies also compared an extended intervention to a brief intervention.

    “Three of these studies also compared an extended intervention to a brief intervention (Bischof 2008;Maisto 2001;Richmond 1995).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Bischof 2008 source
    • cites Maisto 2001 source
    • cites Richmond 1995 source

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

    Findingcitation

    Two trials reported number of days drinking for extended versus no or minimal intervention, and one for extended versus brief intervention.

    “Two trials reported this outcome for extended versus no or minimal intervention (Maisto 2001;Monti 2007), and one for extended versus brief intervention (Maisto 2001).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Maisto 2001 source
    • cites Monti 2007 source

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

    Findingcitation

    One trial reported intensity of drinking for extended intervention versus no or minimal intervention and versus brief intervention.

    “One trial reported this outcome for extended intervention versus no or minimal intervention and versus brief intervention (Maisto 2001).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Maisto 2001 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims. The quote only partly states this claim.

    Findingown data

    Romelsjö 1989 reported change scores whereas the other studies reported final values; only three studies reported GGT at 12 months.

    “Romelsjö 1989 reported change scores whereas the other studies reported final values; only three studies reported at 12 months.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Romelsjö 1989 source

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

    Findingcitation

    One study reported GGT for extended versus no or minimal intervention.

    “One study reported this outcome for extended versus no or minimal intervention (Israel 1996).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Israel 1996 source

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

    Findingnone given

    Longabaugh 2001 reported the number of days drinking but the number of participants assessed was not reported.

    “Longabaugh 2001 reported the number of days drinking but the number of participants assessed was not reported.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Longabaugh 2001 source

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

    Findingcitation

    Two trials reported frequency of binge drinking occasions for extended versus no or minimal intervention.

    “Two trials reported this outcome for extended versus no or minimal intervention (Longabaugh 2001;Monti 2007).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Longabaugh 2001 source
    • cites Monti 2007 source

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

    Findingown data

    Not all outcomes were reported at all time points.

    “Many studies reported at several time points, although not all outcomes were reported at all time points.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    With two exceptions, funding was provided by government institutes, research bodies or charitable foundations.

    “With two exceptions, funding was provided by government institutes, research bodies or charitable foundations.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Five studies were excluded because the intervention or comparator did not fit prespecified criteria.

    “the intervention or comparator did not fit our prespecified criteria (n = 5)”
    Quote in the paperNot a substantial claim

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

    Findingreasoning

    We excluded two trials from the original review for this update.

    “We excluded two trials from the original review for this update.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    One study (Wallace 1988) was partly funded by a pharmaceutical company and a brewers association.

    “One study was partly funded by a pharmaceutical company and a brewers association (Wallace 1988)”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Nine studies reported measures of healthcare utilisation.

    “Nine studies reported measures of healthcare utilisation (Babor 2006;Crawford 2004;Dent 2008;Désy 2010;Ettner 2014;Fleming 1997;Fleming 2010;Kaner 2013;Tait 2004).”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    Richmond 1995 reported outcomes at six months and one year.

    “Richmond 1995 reported outcomes at six months and one year.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    We excluded 46 studies.

    “We excluded 46 studies.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    Curry 2003 reported outcomes at three months and one year.

    “Curry 2003 reported outcomes at three months and one year.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Two studies reported economic evaluations.

    “two studies reported economic evaluations (Lock 2006;Watson 2013).”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    Babor 2006 recruited five managed care organisations, which provided 15 practices.

    “Babor 2006 recruited five managed care organisations, which provided 15 practices.”
    Quote in the paperNot a substantial claim

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

    Findingcitation

    The HEALTH study reported outcomes at six-months and one-year follow-up.

    “The HEALTH study reported at six-months and one-year follow-up (Ockene 1999).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Older studies tended to define higher limits for heavy or binge drinking than more recent studies.

    “Older studies tended to define higher limits (e.g.> 35 units/week by Wallace 1988) than more recent studies (e.g.> 18 drinks/week by Rubio 2010).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Kaner 2013 recruited 34 general practices with a target of 31 participants per practice.

    “Kaner 2013 recruited 34 general practices with a target of 31 participants per practice.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Most studies (n=60, 87%) reported sources of funding.

    “Most studies reported sources of funding (n = 60, 87%).”
    Quote in the paperNot a substantial claim

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

    Findingcitation

    Two studies reported on male and female participants in separate papers.

    “Two studies reported on male and female participants in separate papers (Aalto 2000;Scott 1990).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    19 studies reported the percentage of heavy or binge drinkers at 12 months.

    “The percentage of heavy or binge drinkers at 12 months was reported by 19 studies (Altisent 1997;Beich 2007;Cherpitel 2009;Córdoba 1998;Curry 2003;Daeppen 2007;D'Onofrio 2008;Drummond 2014;Ettner 2014;Fernández 1997;Fleming 1997;Fleming 1999;Fleming 2004;Kaner 2013;Rubio 2010;Scott 1990;Sommers 2013;Wallace 1988;Walton 2010).”
    Quote in the paperNot a substantial claim

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

    Findingcitation

    Two studies reported patient satisfaction measures.

    “Two studies reported patient satisfaction measures (Drummond 2009;Kaner 2013)”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Many studies reported outcomes at several time points.

    “Many studies reported at several time points, although not all outcomes were reported at all time points.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    Ockene 1999 randomised four internal medicine practice sites with an average of 111 participants per site.

    “Ockene 1999 randomised four internal medicine practice sites with an average of 111 participants per site.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Córdoba 1998 randomised 33 general practices with an average of 6.9 participants per practice.

    “Córdoba 1998 and Lock 2006 randomised 33 and 40 general practices respectively with averages of 6.9 and 2.0 participants per practice.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Definitions of binge drinking were based on exceeding government recommendations, AUDIT scores, or a trial-defined number of drinks per week (for heavy drinking) or occasion (for binge drinking).

    “Definitions of binge drinking varied, and were based on exceeding government recommendations, AUDIT scores, or a trial-defined number of drinks per week (for heavy drinking) or occasion (for binge drinking).”
    Quote in the paperNot a substantial claim

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

    Findingcitation

    The TrEAT study reported outcomes after follow-up of one and four years.

    “The TrEAT study reported after follow-up of one and four years (Fleming 1997).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Another study (Fleming 2004) was funded by a company developing diagnostic testing equipment.

    “another by a company developing diagnostic testing equipment (Fleming 2004).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Drummond 2014 recruited nine emergency departments with an average of 135 participants per site.

    “Drummond 2014 recruited nine emergency departments with an average of 135 participants per site.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    The most common reason for exclusion was that participants were not recruited from primary care settings (n=22).

    “The most common reason for exclusion was that participants were not recruited from primary care settings (n = 22).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Two studies were excluded because the trial reported implementation rather than effectiveness outcomes.

    “the trial reported implementation rather than effectiveness outcomes (n = 2).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Two studies reported costs.

    “Two studies reported costs (Drummond 2009;Ettner 2014)”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Seven studies reported on male and female participants separately in the same paper.

    “Seven studies reported on male and female participants separately in the same paper (Beich 2007;Richmond 1995;Rubio 2010;Scott 1990;Senft 1997;Seppa 1992;Wallace 1988).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Six studies reported measures of health status or quality of life.

    “six studies reported measures of health status or quality of life (Crawford 2004;Daeppen 2007;Drummond 2014;Kaner 2013;Lock 2006;Tait 2004).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Ettner 2014 recruited 31 primary care providers with a total of 1186 participants.

    “Huas 2002 randomised 88 primary care physicians with an average of 4.8 participants per physician, and Ettner 2014 recruited 31 primary care providers with a total of 1186 participants.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Lock 2006 randomised 40 general practices with an average of 2.0 participants per practice.

    “Córdoba 1998 and Lock 2006 randomised 33 and 40 general practices respectively with averages of 6.9 and 2.0 participants per practice.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Huas 2002 randomised 88 primary care physicians with an average of 4.8 participants per physician.

    “Huas 2002 randomised 88 primary care physicians with an average of 4.8 participants per physician, and Ettner 2014 recruited 31 primary care providers with a total of 1186 participants.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Definitions of binge drinking varied across studies.

    “Definitions of binge drinking varied, and were based on exceeding government recommendations, AUDIT scores, or a trial-defined number of drinks per week (for heavy drinking) or occasion (for binge drinking).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Six studies were excluded because the intervention was not conversation-based.

    “Other reasons included that the intervention was not conversation-based (n = 6)”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The funnel plot indicated asymmetry, suggesting the possibility of under-reporting of results with little or no evidence of an intervention effect.

    “The funnel plot (Figure 4) indicated asymmetry, suggesting the possibility of under-reporting of results with little or no evidence of an intervention effect.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Both men and women appeared to experience significant benefits of brief intervention (MD for men -42 g/week, 95% CI -65 to -20; for women -30 g/week, 95% CI -59 to -2).

    “Both men (3486 participants) and women (1350 participants) appeared to experience significant benefits of brief intervention (MD for men -42 g/week, 95% CI -65 to -20; for women -30 g/week, 95% CI -59 to -2).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the repeated analysis excluding four trials that recruited only men, both men and women experienced significant benefits of brief intervention, with no significant difference in treatment effect between men and women.

    “Results were similar: both men and women experienced significant benefits of brief intervention, with no significant difference in the treatment effect between men and women.”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data

    Heterogeneity was substantial (I2 = 80%) in the sensitivity analysis omitting trials at high risk of attrition bias.

    “Heterogeneity was substantial (I² = 80%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The difference between the brief intervention and minimal or no intervention arms in the percentage of heavy drinkers at 12 months was -9% (95% CI -13 to -4), although there was substantial heterogeneity (I2 = 77%).

    “The difference between the brief intervention and minimal or no intervention arms in the percentage of heavy drinkers at 12 months was -9% (95% CI -13 to -4; Analysis 1.21), although there was substantial heterogeneity (I² = 77%).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    There was very little difference between the extended intervention and minimal intervention arms for percentage of heavy drinkers and numbers of binge drinkers at 12 months.

    “There was very little difference between the extended intervention and minimal intervention arms for both outcomes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Analysis showed no significant difference between brief intervention and minimal or no intervention in GGT at 12 months; there was no heterogeneity among trials (MD -0.9 IU/L, 95% CI -3.9 to 2.1, I2 = 0%).

    “Analysis showed no significant difference between brief intervention and minimal or no intervention; there was no heterogeneity among trials (MD -0.9 IU/L, 95% CI -3.9 to 2.1, I² = 0%; Analysis 1.23).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Seppa 1992 reported no significant difference between brief intervention and minimal or no intervention in MCV, both overall (MD 0.6 fl, 95% CI -1.6 to 2.8) and for each gender separately.

    “Seppa 1992 (95 participants) reported MCV and reported no significant difference between brief intervention and minimal or no intervention, both overall (MD 0.6 fl, 95% CI -1.6 to 2.8) and for each gender separately.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Two trials reported adverse driving events but concluded there were no more in the intervention group than the control group.

    “Two trials reported adverse driving events but concluded there were no more in the intervention group than the control group (Sommers 2006;Sommers 2013).”
    Quote in the paperNot a substantial claim

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

    Findingcitation

    Blow 2006 explicitly stated that younger adult women were most likely to decrease heavy episodic drinking after the intervention.

    “However, Blow 2006 explicitly stated that younger adult women were most likely to decrease heavy episodic drinking after the intervention.”
    Quote in the paperNot a substantial claim

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

    Findingcitation

    Kaner 2013 stated that participants in the brief counselling group reported greater satisfaction than those in the patient information leaflet group.

    “Kaner 2013 stated that participants in the brief counselling group reported greater satisfaction than those in the patient information leaflet group.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    There was no difference in consumption at 12 months between participants who received an extended intervention and those who received a brief intervention, although the confidence interval was very wide (MD 2 g/week, 95% CI -42 to 45; low-quality evidence).

    “There was no difference in consumption between participants who received an extended intervention and those who received a brief intervention, although the associated confidence interval was very wide (MD 2 g/week, 95% CI -42 to 45; Analysis 3.1; low-quality evidence).”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data

    There was no significant difference between extended and minimal intervention groups in Rutgers Alcohol Problem Index score.

    “There was no significant difference between groups in Rutgers Alcohol Problem Index score.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Many trials reported that alcohol consumption reduced in both intervention and control group participants, with greater reduction in the intervention group, but the difference did not reach statistical significance.

    “Many trials reported that alcohol consumption reduced in both intervention and control group participants, with greater reduction in the intervention group, but the difference did not reach statistical significance.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    One trial reported that a significant proportion of participants reduced their drinking between screening and assessment, and so the brief intervention was delivered to some participants who were no longer eligible for such an approach.

    “One trial reported that a significant proportion of participants reduced their drinking between screening and assessment, and so the brief intervention was delivered to some participants who were no longer eligible for such an approach (McIntosh 1997).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    There was no significant difference between trials classified as effectiveness and efficacy trials in the effect of brief intervention on the quantity of alcohol consumed, although meta-regression suggested that trials with higher scores on our scale may show more intervention effect.

    “There was no significant difference between trials classified as effectiveness and efficacy trials in the effect of brief intervention on the quantity of alcohol consumed, although meta-regression suggested that trials with higher scores on our scale (i.e. more clinically representative or 'real world' trials) may show more intervention effect.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Minimal or no intervention conditions in more recent trials are more likely to provide some kind of alcohol-related advice or information, which might highlight alcohol consumption to control group participants and encourage them to decrease their consumption, reducing the difference in effect between intervention and control groups.

    “Secondly, minimal or no intervention conditions in more recent trials are more likely to provide some kind of alcohol-related advice or information, which might highlight alcohol consumption to control group participants and encourage them to decrease their consumption, reducing the difference in effect between intervention and control groups.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given

    At baseline, the mean level of consumption of participants was 244 g/week (equivalent to 30 UK standard units), although this differed according to year of publication (older studies 313 g/week versus newer studies 181 g/week).

    “At baseline, the mean level of consumption of participants was 244 g/week (equivalent to 30 UK standard units), although this differed according to year of publication (older studies 313 g/week versus newer studies 181 g/week).”
    Quote in the paperSubstantial claim

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

    Findingown data

    Most participants were male (70%).

    “Most participants were male (70%).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Mean baseline consumption was about 310 g/week, but this varied among trials from about 90 to 460 g/week (11 to 57 UK standard units).

    “Mean baseline consumption was about 310 g/week, but this varied among trials from about 90 to 460 g/week (11 to 57 UK standard units).”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Ethnicity was poorly reported, but in those trials that provided these data, most participants were white (70%).

    “Ethnicity was poorly reported, but in those trials that provided these data, most participants were white (70%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Further meta-analyses suggested that people receiving an extended intervention may reduce their consumption compared to participants receiving minimal or no intervention at 12 months, but provided no evidence that extended interventions reduce consumption any more or less than brief interventions.

    “Further meta-analyses suggested that people receiving an extended intervention may reduce their consumption compared to participants receiving minimal or no intervention at 12 months, but provided no evidence that extended interventions reduce consumption any more or less than brief interventions.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Most earlier trials took place in general practice-based primary care, whereas more recently published trials were more likely to take place in emergency departments, where the effect size appears to be smaller.

    “Finally, most earlier trials took place in general practice-based primary care, whereas more recently published trials were more likely to take place in emergency departments, where the effect size appears to be smaller (Analysis 1.10).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In the original review, mean baseline consumption was 313 g/week, whereas in newly added studies for this update it was 181 g/week.

    “In the original review, mean baseline consumption was 313 g/week (around 39 UK units/week), whereas in newly added studies for this update it was 181 g/week (around 23 UK units/week).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The addition of further data has changed the conclusion that there was no evidence of a significant effect for women; there are still only seven trials reporting data separately for 1350 women.

    “Whereas the previous published version of our review reported there was no evidence of a significant effect for women, the addition of further data has changed this conclusion, although there are still only seven trials reporting data separately for 1350 women.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Further meta-analyses demonstrated very small significant impact of brief intervention in terms of days of drinking and binge days per week, amounting to a reduction of one day per two months and no significant impact on amount consumed per drinking day.

    “Further meta-analyses demonstrated very small significant impact of brief intervention in terms of days of drinking and binge days per week, amounting to a reduction of one day per two months and no significant impact on amount consumed per drinking day.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingreasoning

    Although the trials were skewed toward the effectiveness domain, they were distributed along a continuum.

    “However, although the trials were skewed toward the effectiveness domain, they were distributed along a continuum.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    A funnel plot showed some evidence of publication bias but this diminished after adjustment for year of publication.

    “A funnel plot showed some evidence of publication bias but this diminished after adjustment for year of publication (Figure 4).”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    The significant effect for men also stands from the original review.

    “The significant effect for men also stands from the original review.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    In some papers, authors did not report information relating to certain items.

    “In some papers, authors did not report information relating to certain items.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    This update saw the inclusion of a greater proportion of trials which took place in emergency departments, which enabled us to formally compare effectiveness between emergency care and general practice.

    “This update saw the inclusion of a greater proportion of trials which took place in emergency departments, which enabled us to formally compare effectiveness between emergency care and general practice.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    At 12 months, when compared with minimal or no intervention, brief intervention reduced the quantity of alcohol consumed by 20 g/week (95% CI 12 to 28), which equates to two to three UK standard units.

    “At 12 months, when compared with minimal or no intervention, brief intervention reduced the quantity of alcohol consumed by 20 g/week (95% CI 12 to 28), which equates to two to three UK standard units.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given

    A quarter of the included trials in this review could not contribute to the meta-analysis, either because they did not report a measure of consumption that could be converted to g/week of alcohol, or because the follow-up time was too short (< 6 months).

    “A quarter of the included trials in this review could not contribute to the meta-analysis, either because they did not report a measure of consumption that could be converted to g/week of alcohol, or because the follow-up time was too short (< 6 months).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingreasoning

    Brief interventions were rarely carried out in emergency departments 10 years ago, but many of the newly added studies were, enabling subgroup analysis of brief interventions in general practice versus emergency care.

    “For example, brief interventions were rarely carried out in emergency departments 10 years ago, but many of the newly added studies were, enabling subgroup analysis of brief interventions in general practice versus emergency care.”
    Quote in the paperNot a substantial claim

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

    Findingnone given

    The addition of 42 studies to the updated review provided a lot of extra data.

    “The addition of 42 studies to the updated review provided a lot of extra data.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    There is some suggestion that screening alone may result in alcohol consumption reduction.

    “there is some suggestion that screening alone may result in alcohol consumption reduction”
    Quote in the paperNot a substantial claim

  • May combine two claims. The quote only partly states this claim.

    Findingown data

    The effect of brief interventions on alcohol consumption is robust and persists up to one year following the intervention.

    “The effect is robust and was found up to one year following the brief intervention.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    There was a suggestion of a reduced effect of brief interventions in younger people compared to the general population aged 18 years or more, and in emergency care compared to general practice, but this disappeared when adjusted for the overall reduction in effect size due to newer trials.

    “There was a suggestion of a reduced effect in younger people compared to the general population aged 18 years or more, and in emergency care compared to general practice, but this disappeared when adjusted for the overall reduction in effect size due to newer trials.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Brief interventions delivered in primary care have a small but significant impact on alcohol consumption in hazardous and harmful drinkers, reducing consumption by an average of 20 g/week compared to controls.

    “This update agrees with most other reviews in reporting a small but significant impact of brief interventions on hazardous and harmful drinkers in primary care settings.”
    • Also stated in: § A U T H O R S ' C O N C L U S I O N S Implications for practice · plain
      “This review provides moderate-quality evidence that brief interventions delivered in primary care reduce alcohol consumption in hazardous and harmful drinkers by an average of 20 g/week (the equivalent of approximately two to three UK standard drinks) compared to controls receiving usual care, screening or assessment only, or minimal alcohol advice.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    The effects of brief alcohol interventions are typically found in trials that report outcomes in terms of weekly alcohol consumption.

    “The effects of brief alcohol interventions are typically found in trials that report outcomes in terms of weekly alcohol consumption.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Brief interventions are effective at reducing excessive alcohol consumption, particularly in men.

    “We are pleased that the commentator confirms the validity of our primary review finding that brief interventions are effective at reducing excessive alcohol consumption, particularly in men.”
    Quote in the paperSubstantial claim

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

    Findingreasoning

    The current review contains both null-effect and positive-effect trials of brief intervention.

    “Nevertheless, since the current review clearly contains both null-effect and positive-effect trials of brief intervention, it is clear that we have not selectively included only work with positive outcomes.”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Of the included trials, 27 (39%) were carried out in emergency departments.

    “and 27 (39%) were carried out in emergency departments”
    Quote in the paperNot a substantial claim

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

    Findingown data

    Of the included trials, 38 (55%) delivered interventions in general practices.

    “Many interventions (n = 38, 55%) were delivered in general prac- tices”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Two included trials reported both self-reported outcomes and laboratory markers (GGT) of alcohol intake; both studies were consistent in finding that the intervention was more effective than control on the basis of both self-reported and objective outcomes.

    “Finally, two included trials reported both self-reported outcomes and laboratory markers (GGT) of alcohol intake; both studies were consistent in finding that the intervention was more effective than control on the basis of both self-reported and objective outcomes.”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    The heavy burden that alcohol use imposes on health, and its significant economic consequences, has led to national and international programmes and policies that seek to reduce consumption levels and so reduce a primary cause of avoidable ill health.

    “The heavy burden that alcohol use imposes on health, and its significant economic consequences, has led to national and international programmes and policies that seek to reduce consumption levels and so reduce a primary cause of avoidable ill health (Bailey 2011; UK Government 2012).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Bailey 2011

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites UK Government 2012

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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

    Study design and conductown data

    Two review authors independently assessed titles and abstracts for inclusion.

    “Two review authors independently assessed titles and abstracts in EndNote (EndNote 2015).”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    Specific tools to measure efficacy and effectiveness have been published which supercede the scale used in the 2007 review.

    “specific tools to measure efficacy and effectiveness have been published (Gartlehner 2006;Koppenaal 2011), which supercede the scale used in the 2007 review.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Gartlehner 2006 source
    • cites Koppenaal 2011 source

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

    Study design and conductnone given

    Two review authors independently extracted data using a piloted data extraction form.

    “Two review authors independently extracted data using a piloted data extraction form.”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    Excessive drinking is a significant cause of mortality, morbidity and social problems in many countries, with a greater global cost to health than for tobacco.

    “Excessive drinking is a significant cause of mortality, morbidity and social problems in many countries, with a greater global cost to health than for tobacco (WHO 2014).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites WHO 2014

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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

    Study design and conductnone given

    Two review authors independently assessed potential risk of bias resulting from trial design according to Cochrane's 'Risk of bias' tool.

    “Two review authors independently assessed potential risk of bias resulting from the trial design according to Cochrane's 'Risk of bias' tool as described in the Cochrane Handbook (Higgins 2011).”
    Quote in the paperNot a substantial claim

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

    Study design and conductnone given

    Two review authors independently assessed study eligibility for both the original review and this update.

    “Two review authors independently assessed the study eligibility for both the original review and this update.”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    Brief interventions can work successfully in research settings where intervention delivery and follow-up is carefully managed.

    “can work successfully in research settings where intervention delivery and follow-up is carefully managed (Flay 1986)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Flay 1986 source

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

    Premisecitation

    Some brief intervention trials have included motivational interviewing or lifestyle counselling approaches.

    “Some brief intervention trials have included motivational interviewing (Rollnick 1995) or lifestyle counselling approaches.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Rollnick 1995 source

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

    Study design and conductnone given

    Two review authors independently classified each trial on the efficacy/effectiveness spectrum.

    “Two review authors independently classified each trial (see Table 1).”
    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 conductown data

    We performed sensitivity analyses based on risk of bias, missing standard deviations, and comparison of cluster and individually randomised trials.

    “Sensitivity analyses were performed based on the following characteristics. 1. Risk of bias: the primary meta-analysis was repeated in analyses: i) including only studies at low risk of bias due to allocation concealment; and ii) excluding studies at high risk of bias due to incomplete outcome data (i.e.attrition bias).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    We used a random-effects model for all analyses because the populations and interventions evaluated by the trials were heterogeneous.

    “Because the populations and interventions evaluated by the trials were so heterogeneous, it was deemed more appropriate to use a random-effects model for all analyses (DerSimonian 1986).”
    Quote in the paperSubstantial claim

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

    Study design and conductnone given

    We assessed whether studies appeared to have incomplete reporting bias by noting in risk of bias assessments whether reported outcomes matched methods sections or published protocols.

    “We assessed whether studies appeared to have incomplete reporting bias by noting in the risk of bias assessments whether the reported outcomes matched methods sections or any published protocols.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    We constructed funnel plots to assess potential for bias related to the size of the trials.

    “We constructed funnel plots (plots of the effect estimate from each study against the effect standard error) to assess potential for bias related to the size of the trials, which could indicate possible publication bias.”
    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

    We made every effort to minimise publication bias by searching a wide range of databases and sources of grey literature and not restricting by language or publication status.

    “We made every effort to minimise publication bias by searching a wide range of databases and sources of grey literature and not restricting by language or publication status.”
    Quote in the paperNot a substantial claim

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

    Study design and conductnone given

    We resolved disagreements concerning classification by discussion to achieve consensus.

    “We resolved disagreements concerning classification by discussion to achieve consensus.”
    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 conductreasoning

    We did not conduct a sensitivity analysis on the basis of risk of bias due to blinding because it is not possible to mask the nature of the intervention to providers or participants.

    “We did not conduct a sensitivity analysis on the basis of risk of bias due to blinding because it is not possible to mask the nature of the intervention to providers or participants.”
    Quote in the paperNot a substantial claim

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

    Study design and conductreasoning

    Many domains were assessed as unclear risk of bias because there was insufficient information reported in study reports to make a clear decision.

    “Many domains were assessed as unclear risk of bias because there was insufficient information reported in study reports to make a clear decision.”
    Quote in the paperNot a substantial claim

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

    Interpretationreasoning

    Chang 1997 compared brief intervention to alcohol treatment referral, which is not an analogous control group with the included trials.

    “Chang 1997 compared brief intervention to alcohol treatment referral, which is not an analogous control group with the included trials.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    Risk of allocation concealment bias was unclear in 37 trials.

    “Risk of allocation concealment bias was unclear in 37 trials.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    In the three trials at high risk of selection bias, participants were assigned to treatment arms alternately or according to date of birth, or researchers changed the allocation process during the trial.

    “Participants in these trials were assigned to treatment arms alternately or according to date of birth, or researchers changed the allocation process during the trial.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    Clustering was accounted for in analyses by five studies.

    “Clustering was accounted for in analyses by five studies (Babor 2006;Drummond 2014;Kaner 2013;Lock 2006;Ockene 1999).”
    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 conductown data

    Researchers reported attempt to blind participants in 22 trials (32%) and were assigned low risk of bias for participant blinding at enrolment.

    “Researchers reported attempt to blind participants in 22 trials (32%) and were assigned low risk of bias for participant blinding at enrolment (Bazargan-Hejazi 2005;Curry 2003;D'Amico 2008;D'Onofrio 2008;D'Onofrio 2012;Daeppen 2007;Drummond 2009;Fleming 1997;Fleming 1999;Fleming 2010;Moore 2011;Noknoy 2010;Ockene 1999;Richmond 1995;Romelsjö 1989;Scott 1990;Segatto 2011;Spirito 2011;Tomson 1998;”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    20 studies were at unclear risk of bias for blinding.

    “We assessed 20 studies at unclear risk of bias for blinding.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Participants were blinded either because they did not know there was an alternate arm, or because the alcohol focus was masked during screening and assessment by other health-related questions.

    “Participants were blinded either because they did not know there was an alternate arm, or because the alcohol focus was masked during screening and assessment by other health-related questions.”
    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 conductown data

    Of the 19 trials in the allocation concealment sensitivity analysis, 14 were also at low risk of bias for randomisation and five were at unclear risk.

    “Of the 19 trials, 14 were also at low risk of bias for randomisation; five were assessed at unclear risk.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    Outcome assessors were reported to be blinded in 46 trials (67%) and were judged at low risk of detection bias.

    “Outcome assessors were reported to be blinded in 46 trials (67%) and were judged at low risk of detection bias (Babor 2006;Bazargan-Hejazi 2005;Bernstein 2010;Bischof 2008;Cherpitel 2009;Crawford 2004;Crawford 2010;D'Onofrio 2008;D'Onofrio 2012;Daeppen 2007;Drummond 2009;Drummond 2014;Ettner 2014;Fernández 1997;Field 2010;Fleming 1997;Fleming 1999;Fleming 2004;Fleming 2010;Heather 1987;Israel 1996”
    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 conductown data

    Seven trials were judged to be at unclear risk of reporting bias and the rest at low risk.

    “Seven were judged to be unclear and the rest low.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    These studies followed the same trend as reported in the meta-analysis and would be unlikely to change the conclusion.

    “This suggests these studies followed the same trend as reported in the meta-analysis and would be unlikely to change the conclusion.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    This result was based on only 59 participants.

    “However, this result was based on only 59 participants.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    They were based on much smaller groups of participants than the primary meta-analysis and may be confounded by the fact that attendance at multiple sessions was not always reported.

    “They were based on much smaller groups of participants than the primary meta-analysis and may be confounded by the fact that attendance at multiple sessions was not always reported (i.e.participants may not all have received a full 'extended' intervention).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationcitation

    This reduction is still likely to be beneficial at an individual level, given the number of disease conditions at least partly attributable to alcohol and given that the higher the baseline level of drinking, the stronger the effects of any given reduction in terms of all-cause mortality.

    “However, this reduction is still likely to be beneficial at an individual level, given the number of disease conditions at least partly attributable to alcohol and given that the higher the baseline level of drinking, the stronger the effects of any given reduction in terms of all-cause mortality (Rehm 2013).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Rehm 2013 source

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    It is highly unlikely that there would be any pure efficacy studies, since the trial protocol would need to be acceptable and relevant to clinicians (and ethics committees) before it could be enacted in health service contexts.

    “Moreover, it is highly unlikely that there would be any pure efficacy studies, since the trial protocol would need to be acceptable and relevant to clinicians (and ethics committees) before it could be enacted in health service contexts.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationnone given

    This finding does not apply to low risk or alcohol dependent drinkers, or necessarily to other health or social care settings.

    “This finding does not apply to low risk or alcohol dependent drinkers, or necessarily to other health or social care settings.”
    Quote in the paperSubstantial claim

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

    Interpretationcitation

    At a population level, any reduction is likely to have a significant impact on health, quality of life and healthcare resource use, given that over 5% of the global burden of disease is attributable to alcohol.

    “At a population level, any reduction is likely to have a significant impact on health, quality of life and healthcare resource use, given that over 5% of the global burden of disease is attributable to alcohol (WHO 2014).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites WHO 2014

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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

    Interpretationreasoning

    This may have reduced variation in the final scores and led to clustering of trials toward the middle of this scale.

    “This may have reduced variation in the final scores (there were not many extreme scores, particularly on the efficacy side of the scale) and led to clustering of trials toward the middle of this scale.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Although the raw subgroup analysis suggests a difference in effectiveness between settings, this result is confounded by publication date since so many of the emergency care trials are recent.

    “Although the raw subgroup analysis suggests a difference in effectiveness between settings, this result is confounded by publication date since so many of the emergency care trials are recent.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Only four trials were based in countries not defined as high income by the WHO, so this evidence cannot be assumed to apply to countries where the structure or functioning of primary care differs, or where less liberal attitudes to alcohol consumption may exist.

    “Only four trials were based in countries not defined as high income by the WHO, so this evidence cannot be assumed to apply to countries where the structure or functioning of primary care differs, or where less liberal attitudes to alcohol consumption may exist.”
    Quote in the paperSubstantial claim

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

    Interpretationreasoning

    Therefore, the statistical heterogeneity in the meta-analyses was not surprising.

    “Therefore, the statistical heterogeneity in the meta-analyses was not surprising.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationnone given

    It is possible that any intervention effect may be related to individual factors, which were combined in the overall efficacy/effectiveness score.

    “It is possible that any intervention effect may be related to individual factors, which were combined in the overall efficacy/effectiveness score.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationown data

    This lack of evidence of any difference in the current review may indicate insensitivity in our descriptive classification tool.

    “This lack of evidence of any difference in the current review may indicate insensitivity in our descriptive classification tool.”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    It has been suggested that GRADE assessments may not adequately describe the evidence base of complex interventions and an extension is required to adequately reflect them.

    “Indeed, it has been suggested that GRADE assessments may not adequately describe the evidence base of complex interventions and an extension is required to adequately reflect them (Movsisyan 2016).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Movsisyan 2016 source

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

    Study design and conductcitation

    Altisent 1997 had low risk of bias for random sequence generation.

    “Random sequence generation (selection bias) Low risk States only that assignment was made by simple randomisation (”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Altisent 1997

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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

    Study design and conductreasoning

    Aalto 2000 had unclear risk of bias for selective reporting.

    “Selective reporting (reporting bias) Unclear risk Did not specify exact alcohol outcome measures in the methods”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Aalto 2000 source

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

    Interpretationreasoning

    The reduced effect size of brief alcohol intervention may be due to the enrolment of less heavy drinkers into these types of trials as well as increasing alcohol content in control conditions.

    “which may be due to the enrolment of less heavy drinkers into these types of trials as well as increasing alcohol content in control conditions”
    Quote in the paperSubstantial claim

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

    Study design and conductcitation

    Altisent 1997 had low risk of bias for allocation concealment.

    “Allocation concealment (selection bias) Low risk Consecutively numbered, sealed envelopes (”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Altisent 1997

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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

    Study design and conductnone given

    The eligibility of all the studies was assessed by two of the review authors independently, but where they were uncertain the study was always discussed by two authors to make the final decisions as consistent as possible.

    “The eligibility of all the studies was assessed by two of the review authors independently, but where they were uncertain the study was always discussed by two authors (EK, FB) to make the final decisions as consistent as possible.”
    Quote in the paperNot a substantial claim

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

    Study design and conductnone given

    We contacted authors to clarify the reporting of data used in the meta-analyses where necessary.

    “We contacted authors to clarify the reporting of data used in the meta-analyses where necessary.”
    Quote in the paperNot a substantial claim

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

    Study design and conductnone given

    One potential weakness of the studied outcomes is that they are predominantly self-reported, so may be susceptible to social desirability bias.

    “One potential weakness of the studied outcomes is that they are predominantly self-reported, so may be susceptible to social desirability bias.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    Aalto 2000 used intention-to-treat analysis with imputation of baseline values for participants lost to follow-up.

    “ITT: outcome data were based on imputation of baseline values to participants lost to follow-up”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Aalto 2000 source

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

    Premisecitation

    A recent trial suggests that for questions about alcohol consumption social desirability bias may not be a big problem.

    “Many of the studies made efforts to minimise this effect and a recent trial suggests that for questions about alcohol consumption this may not be a big problem (albeit the participants were students, not the general public) (Kypri 2016).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kypri 2016 source

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Study design and conductnone given

    Although it can introduce bias to carry out subgroup analyses which were not pre-specified in the review protocol, each of the additional subgroup analyses in this update is backed up by findings in the wider literature.

    “Although it can introduce bias to carry out subgroup analyses which were not pre-specified in the review protocol, we feel that each of the additional subgroup analyses in this update is backed up by findings in the wider literature.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Premisenone given

    Attrition bias also tends to be high in these types of trials.

    “Attrition bias also tends to be high in these types of trials.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    Aalto 2000 had unclear risk of bias for blinding of outcome assessment.

    “Blinding of outcome assessment (detection bias) All outcomes Unclear risk Unclear whether outcome assessors were blinded.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Aalto 2000 source

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

    Study design and conductown data

    Aalto 2000 had low risk of bias for random sequence generation.

    “Random sequence generation (selection bias) Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Aalto 2000 source

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

    Study design and conductown data

    Aalto 2000 had high risk of bias for blinding of participants.

    “Blinding of participants High risk No reported attempt to blind participants.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Aalto 2000 source

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

    Study design and conductnone given

    We assessed potential bias from selective reporting by comparing the outcomes proposed in the protocols (where available) or methods sections with those in the final study report.

    “We further assessed potential bias from selective reporting by comparing the outcomes proposed in the protocols (where available) or methods sections with those in the final study report.”
    Quote in the paperNot a substantial claim

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

    Study design and conductnone given

    We made every effort to locate all existing eligible trials, regardless of publication status or language, and we searched grey literature and references in addition to bibliographic databases to reduce publication bias.

    “We made every effort to locate all existing eligible trials, regardless of publication status or language, and we searched grey literature and references in addition to bibliographic databases to reduce publication bias.”
    Quote in the paperSubstantial claim

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

    Study design and conductreasoning

    Bazargan-Hejazi 2005 had unclear risk of bias for selective reporting.

    “Selective reporting (reporting bias) Unclear risk Number of participants for follow-up in each AUDIT subgroup was not specified.However, we did not include these subgroups in analyses, so this aspect did not introduce bias”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bazargan-Hejazi 2005 source

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

    Study design and conductown data

    Beckham 2007 had unclear risk of bias for blinding of outcome assessment.

    “Blinding of outcome assessment (detection bias) All outcomes Unclear risk Blinding of outcome assessor not described.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Beckham 2007 source

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

    Study design and conductown data

    Babor 2006 had high risk of bias for blinding of participants.

    “Blinding of participants High risk No reported attempt to blind participants.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Babor 2006 source

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

    Study design and conductown data

    Beckham 2007 had unclear risk of bias for incomplete outcome data.

    “Incomplete outcome data (attrition bias) All outcomes Unclear risk Loss to follow-up not reported.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Beckham 2007 source

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductcitation

    Bazargan-Hejazi 2005 had low risk of bias for blinding of outcome assessment.

    “Blinding of outcome assessment (detection bias) All outcomes Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bazargan-Hejazi 2005 source

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

    Study design and conductown data

    Bazargan-Hejazi 2005 used intention-to-treat analysis.

    “ITT: yes.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bazargan-Hejazi 2005 source

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

    Study design and conductown data

    Altisent 1997 had high risk of bias for blinding of participants.

    “Blinding of participants High risk No reported attempt to blind participants.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Altisent 1997

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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

    Study design and conductcitation

    Babor 2006 used intention-to-treat analysis.

    “ITT: yes.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Babor 2006 source

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

    Study design and conductown data

    Beckham 2007 had unclear risk of bias for allocation concealment.

    “Allocation concealment (selection bias) Unclear risk Allocation concealment not described.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Beckham 2007 source

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

    Study design and conductown data

    Beckham 2007 did not use intention-to-treat analysis.

    “ITT: no.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Beckham 2007 source

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

    Study design and conductown data

    Altisent 1997 did not use intention-to-treat analysis.

    “ITT: no.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Altisent 1997

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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

    Study design and conductown data

    Altisent 1997 had unclear risk of bias for blinding of outcome assessment.

    “Blinding of outcome assessment (detection bias) All outcomes Unclear risk Not reported.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Altisent 1997

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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

    Study design and conductcitation

    Bazargan-Hejazi 2005 had low risk of bias for blinding of participants.

    “Blinding of participants Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bazargan-Hejazi 2005 source

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

    Study design and conductnone given

    Beckham 2007 had low risk of bias for random sequence generation.

    “Random sequence generation (selection bias) Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Beckham 2007 source

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

    Study design and conductown data

    Beckham 2007 had high risk of bias for blinding of participants.

    “Blinding of participants High risk No reported attempt to blind participants.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Beckham 2007 source

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

    Study design and conductnone given

    Bischof 2008 had low risk of bias for random sequence generation.

    “Random sequence generation (selection bias) Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bischof 2008 source

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

    Study design and conductcitation

    Bischof 2008 used intention-to-treat analysis.

    “ITT: yes.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bischof 2008 source

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

    Study design and conductown data

    Bischof 2008 had low risk of bias for incomplete outcome data.

    “Incomplete outcome data (attrition bias) All outcomes Low risk Loss to follow-up reported with reasons.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bischof 2008 source

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

    Study design and conductown data

    Blow 2006 had unclear risk of bias for blinding of outcome assessment.

    “Blinding of outcome assessment (detection bias) All outcomes Unclear risk Not reported.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Blow 2006 source

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

    Study design and conductown data

    Bischof 2008 had high risk of bias for blinding of participants.

    “Blinding of participants High risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bischof 2008 source

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

    Study design and conductnone given

    Blow 2006 had low risk of bias for random sequence generation.

    “Random sequence generation (selection bias) Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Blow 2006 source

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

    Study design and conductcitation

    Blow 2006 used intention-to-treat analysis.

    “ITT: yes.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Blow 2006 source

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

    Study design and conductnone given

    Bischof 2008 had high risk of bias for blinding of treatment providers.

    “Blinding of treatment providers High risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bischof 2008 source

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

    Study design and conductown data

    Cherpitel 2009 had unclear risk of bias for random sequence generation.

    “Random sequence generation (selection bias) Unclear risk Randomisation process not described.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cherpitel 2009 source

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

    Study design and conductown data

    Blow 2006 had unclear risk of bias for allocation concealment.

    “Allocation concealment (selection bias) Unclear risk Not reported.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Blow 2006 source

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

    Study design and conductown data

    Blow 2006 had high risk of bias for blinding of participants.

    “Blinding of participants High risk No reported attempt to blind participants.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Blow 2006 source

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

    Study design and conductcitation

    Bischof 2008 had low risk of bias for allocation concealment.

    “Allocation concealment (selection bias) Low risk Final study participants were randomly allocated, using coloured cards in sealed, non-transparent envelopes (drawn envelopes were not put back), to either the control group or to one of two intervention groups (p.245)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bischof 2008 source

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

    Study design and conductcitation

    In Cherpitel 2009, blinding of outcome assessment was judged to be at low risk of detection bias for all outcomes.

    “Blinding of outcome assessment (detection bias) All outcomes Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cherpitel 2009 source

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductcitation

    In Crawford 2010, blinding of participants was judged to be at high risk of bias.

    “Blinding of participants High risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Crawford 2010 source

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based).

    Study design and conductcitation

    In Crawford 2010, the study used intention-to-treat analysis.

    “ITT: yes.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Crawford 2010 source

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

    Study design and conductcitation

    In Curry 2003, blinding of treatment providers was judged to be at low risk of bias.

    “Blinding of treatment providers Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Curry 2003 source

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

    Study design and conductcitation

    In Cherpitel 2009, blinding of treatment providers was judged to be at low risk of bias.

    “Blinding of treatment providers Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cherpitel 2009 source

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductcitation

    In Crawford 2010, blinding of outcome assessment was judged to be at low risk of detection bias for all outcomes.

    “Blinding of outcome assessment (detection bias) All outcomes Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Crawford 2010 source

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based).

    Study design and conductcitation

    In Crawford 2010, blinding of treatment providers was judged to be at low risk of bias.

    “Blinding of treatment providers Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Crawford 2010 source

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

    Study design and conductcitation

    In Crawford 2010, selective reporting was judged to be at low risk of reporting bias.

    “Selective reporting (reporting bias) Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Crawford 2010 source

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

    Study design and conductcitation

    Cherpitel 2009 used intention-to-treat analysis.

    “ITT: yes.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cherpitel 2009 source

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

    Study design and conductcitation

    In Crawford 2010, incomplete outcome data was judged to be at low risk of attrition bias for all outcomes.

    “Incomplete outcome data (attrition bias) All outcomes Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Crawford 2010 source

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

    Study design and conductcitation

    In Curry 2003, random sequence generation was judged to be at unclear risk of selection bias.

    “Random sequence generation (selection bias) Unclear risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Curry 2003 source

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

    Study design and conductown data

    In Cherpitel 2009, incomplete outcome data was judged to be at high risk of attrition bias for all outcomes.

    “Incomplete outcome data (attrition bias) All outcomes High risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cherpitel 2009 source

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

    Study design and conductcitation

    In Cherpitel 2009, allocation concealment was judged to be at unclear risk of selection bias.

    “Allocation concealment (selection bias) Unclear risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cherpitel 2009 source

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

    Study design and conductcitation

    In Crawford 2010, random sequence generation was judged to be at low risk of selection bias.

    “Random sequence generation (selection bias) Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Crawford 2010 source

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

    Study design and conductcitation

    In Cherpitel 2009, blinding of participants was judged to be at high risk of bias.

    “Blinding of participants High risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cherpitel 2009 source

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

    Study design and conductcitation

    In Crawford 2010, allocation concealment was judged to be at unclear risk of selection bias.

    “Allocation concealment (selection bias) Unclear risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Crawford 2010 source

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

    Study design and conductreasoning

    In Cherpitel 2009, selective reporting was judged to be at low risk of reporting bias.

    “Selective reporting (reporting bias) Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cherpitel 2009 source

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

    Study design and conductcitation

    In Curry 2003, allocation concealment was judged to be at unclear risk of selection bias.

    “Allocation concealment (selection bias) Unclear risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Curry 2003 source

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

    Study design and conductcitation

    In D'Onofrio 2008, selective reporting was judged to be at low risk of reporting bias.

    “Selective reporting (reporting bias) Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites D'Onofrio 2008 source

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductcitation

    In D'Onofrio 2008, blinding of outcome assessment was judged to be at low risk of detection bias for all outcomes.

    “Blinding of outcome assessment (detection bias) All outcomes Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites D'Onofrio 2008 source

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

    Study design and conductcitation

    In Córdoba 1998, selective reporting was judged to be at low risk of reporting bias.

    “Selective reporting (reporting bias) Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Córdoba 1998 source

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

    Study design and conductcitation

    In Córdoba 1998, blinding of outcome assessment was judged to be at unclear risk of detection bias for all outcomes.

    “Blinding of outcome assessment (detection bias) All outcomes Unclear risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Córdoba 1998 source

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

    Study design and conductreasoning

    In D'Onofrio 2008, blinding of participants was judged to be at low risk of bias.

    “Blinding of participants Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites D'Onofrio 2008 source

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

    Study design and conductcitation

    In Curry 2003, blinding of outcome assessment was judged to be at unclear risk of detection bias for all outcomes.

    “Blinding of outcome assessment (detection bias) All outcomes Unclear risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Curry 2003 source

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

    Study design and conductcitation

    In D'Amico 2008, blinding of outcome assessment was judged to be at unclear risk of detection bias for all outcomes.

    “Blinding of outcome assessment (detection bias) All outcomes Unclear risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites D'Amico 2008 source

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

    Study design and conductreasoning

    In D'Amico 2008, incomplete outcome data was judged to be at unclear risk of attrition bias for all outcomes.

    “Incomplete outcome data (attrition bias) All outcomes Unclear risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites D'Amico 2008 source

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

    Study design and conductcitation

    In Córdoba 1998, random sequence generation was judged to be at unclear risk of selection bias.

    “Random sequence generation (selection bias) Unclear risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Córdoba 1998 source

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

    Study design and conductcitation

    In D'Amico 2008, selective reporting was judged to be at low risk of reporting bias.

    “Selective reporting (reporting bias) Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites D'Amico 2008 source

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductcitation

    In Córdoba 1998, blinding of participants was judged to be at high risk of bias.

    “Blinding of participants High risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Córdoba 1998 source

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

    Study design and conductcitation

    In Córdoba 1998, blinding of treatment providers was judged to be at low risk of bias.

    “Blinding of treatment providers Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Córdoba 1998 source

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

    Study design and conductreasoning

    In Curry 2003, blinding of participants was judged to be at low risk of bias.

    “Blinding of participants Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Curry 2003 source

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

    Study design and conductreasoning

    In D'Onofrio 2008, allocation concealment was judged to be at low risk of selection bias.

    “Allocation concealment (selection bias) Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites D'Onofrio 2008 source

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

    Study design and conductcitation

    In Córdoba 1998, intention-to-treat analysis was unclear.

    “ITT: unclear.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Córdoba 1998 source

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

    Study design and conductcitation

    In D'Onofrio 2008, incomplete outcome data was judged to be at unclear risk of attrition bias for all outcomes.

    “Incomplete outcome data (attrition bias) All outcomes Unclear risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites D'Onofrio 2008 source

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

    Study design and conductown data

    In Curry 2003, selective reporting was judged to be at low risk of reporting bias.

    “Selective reporting (reporting bias) Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Curry 2003 source

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

    Study design and conductcitation

    In D'Onofrio 2008, blinding of treatment providers was judged to be at unclear risk of bias.

    “Blinding of treatment providers Unclear risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites D'Onofrio 2008 source

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

    Study design and conductcitation

    In Córdoba 1998, allocation concealment was judged to be at low risk of selection bias.

    “Allocation concealment (selection bias) Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Córdoba 1998 source

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

    Study design and conductcitation

    In Córdoba 1998, incomplete outcome data was judged to be at high risk of attrition bias for all outcomes.

    “Incomplete outcome data (attrition bias) All outcomes High risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Córdoba 1998 source

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

    Study design and conductcitation

    In D'Amico 2008, the study did not use intention-to-treat analysis.

    “ITT: no.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites D'Amico 2008 source

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

    Study design and conductreasoning

    In D'Amico 2008, blinding of treatment providers was judged to be at unclear risk of bias.

    “Blinding of treatment providers Unclear risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites D'Amico 2008 source

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

    Study design and conductcitation

    In D'Onofrio 2008, the study used intention-to-treat analysis.

    “ITT: yes.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites D'Onofrio 2008 source

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

    Study design and conductcitation

    In D'Amico 2008, random sequence generation was judged to be at high risk of selection bias.

    “Random sequence generation (selection bias) High risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites D'Amico 2008 source

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

    Study design and conductcitation

    In D'Amico 2008, blinding of participants was judged to be at low risk of bias.

    “Blinding of participants Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites D'Amico 2008 source

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

    Study design and conductreasoning

    In Curry 2003, incomplete outcome data was judged to be at unclear risk of attrition bias for all outcomes.

    “Incomplete outcome data (attrition bias) All outcomes Unclear risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Curry 2003 source

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

    Study design and conductcitation

    In D'Onofrio 2008, random sequence generation was judged to be at unclear risk of selection bias.

    “Random sequence generation (selection bias) Unclear risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites D'Onofrio 2008 source

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

    Study design and conductcitation

    In Curry 2003, the study used intention-to-treat analysis with multiple imputation for non-respondents.

    “ITT: paper reported multiple imputation to impute outcome data for non-respondents; unpublished data supplied to the reviewers was based on 222/333 (67%) of those randomised”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Curry 2003 source

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

    Study design and conductown data

    In Drummond 2014, allocation concealment was at low risk of selection bias.

    “Allocation concealment (selection bias) Low risk Cluster randomised trial.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    Drummond 2009 used intention-to-treat analysis.

    “ITT: yes.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Drummond 2009, random sequence generation was at low risk of selection bias.

    “Random sequence generation (selection bias) Low risk”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Dent 2008, random sequence generation was at low risk of selection bias.

    “Random sequence generation (selection bias) Low risk Computer generated block-randomisation process (p.122).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    In Dent 2008, only the brief intervention and standard care groups were used because the motivational interview was not comparable to other trials and very few participants received the intervention.

    “only brief intervention and standard care groups used because the motivational interview was not comparable to other trials, and very few participants received the intervention”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Dent 2008 source

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based).

    Study design and conductown data

    Drummond 2014 used intention-to-treat analysis.

    “ITT: yes.”
    Quote in the paperNot a substantial claim

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

    Study design and conductcitation

    In Daeppen 2007, blinding of treatment providers was judged to be at high risk of bias.

    “Blinding of treatment providers High risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Daeppen 2007

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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

    Study design and conductcitation

    In Daeppen 2007, blinding of outcome assessment was judged to be at low risk of detection bias for all outcomes.

    “Blinding of outcome assessment (detection bias) All outcomes Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Daeppen 2007

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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

    Study design and conductown data

    In Dent 2008, selective reporting was at low risk of reporting bias.

    “Selective reporting (reporting bias) Low risk Outcomes specified in methods are reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Drummond 2014, random sequence generation was at low risk of selection bias.

    “Random sequence generation (selection bias) Low risk”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Drummond 2009, blinding of outcome assessment was at low risk of detection bias.

    “Blinding of outcome assessment (detection bias) All outcomes Low risk”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductown data

    In Dent 2008, incomplete outcome data was at high risk of attrition bias.

    “Incomplete outcome data (attrition bias) All outcomes High risk Loss to follow-up > 30%.”
    Quote in the paperNot a substantial claim

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

    Study design and conductcitation

    In Daeppen 2007, incomplete outcome data was judged to be at unclear risk of attrition bias for all outcomes.

    “Incomplete outcome data (attrition bias) All outcomes Unclear risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Daeppen 2007

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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

    Study design and conductown data

    In Dent 2008, allocation concealment was at low risk of selection bias.

    “Allocation concealment (selection bias) Low risk Sequentially-numbered, opaque, sealed envelope (p.122).”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Drummond 2009, incomplete outcome data was at unclear risk of attrition bias.

    “Incomplete outcome data (attrition bias) All outcomes Unclear risk”
    Quote in the paperNot a substantial claim

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

    Study design and conductcitation

    In Daeppen 2007, allocation concealment was judged to be at unclear risk of selection bias.

    “Allocation concealment (selection bias) Unclear risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Daeppen 2007

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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

    Study design and conductown data

    In Dent 2008, blinding of participants was at high risk of bias.

    “Blinding of participants High risk”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Drummond 2009, blinding of participants was at low risk of bias.

    “Blinding of participants Low risk”
    Quote in the paperNot a substantial claim

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

    Study design and conductnone given

    In Daeppen 2007, selective reporting was judged to be at low risk of reporting bias.

    “Selective reporting (reporting bias) Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Daeppen 2007

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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

    Study design and conductown data

    In Drummond 2009, selective reporting was at low risk of reporting bias.

    “Selective reporting (reporting bias) Low risk Outcomes specified in methods are reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductreasoning

    In Daeppen 2007, blinding of participants was judged to be at low risk of bias.

    “Blinding of participants Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Daeppen 2007

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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

    Study design and conductcitation

    In Daeppen 2007, random sequence generation was judged to be at low risk of selection bias.

    “Random sequence generation (selection bias) Low risk”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Daeppen 2007

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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

    Study design and conductown data

    In Drummond 2009, loss to follow-up was 15/54 (28%) in the stepped care group and 6/58 (10%) in the minimal intervention group.

    “Loss to follow-up: Stepped Care: 15/54 (28%) (52 received step 1, 17 received step 2, 1 received step 3) Minimal intervention: 6/58 (10%) (all received intervention)”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Drummond 2009, allocation concealment was at unclear risk of selection bias.

    “Allocation concealment (selection bias) Unclear risk”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Dent 2008, the study used intention-to-treat analysis.

    “ITT: yes.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Dent 2008 source

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

    Study design and conductcitation

    In Daeppen 2007, intention-to-treat analysis was unclear.

    “ITT: unclear.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Daeppen 2007

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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

    Study design and conductown data

    In Dent 2008, loss to follow-up was 83/159 (52%) in the BI group and 95/161 (59%) in the SC group.

    “Loss to follow-up: BI group: 83/159 (52%).SC group: 95/161 (59%).”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Díez 2002, selective reporting was at low risk of reporting bias.

    “Selective reporting (reporting bias) Low risk Outcomes specified in methods are reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Désy 2010, selective reporting was at low risk of reporting bias.

    “Selective reporting (reporting bias) Low risk Outcomes specified in methods were reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Désy 2010, blinding of participants was at high risk of bias.

    “Blinding of participants High risk Participants were not blinded, screening questions concern alcohol consumption (National Institute on Alcohol Abuse and Alcoholism quantity and frequency questions and the CAGE questionnaire)”
    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 conductown data

    In Field 2010, loss to follow-up was 317/737 (43.0%) in the BMI group and 309/756 (40.9%) in the TAU+ group.

    “Loss to follow-up: BMI: 317/737 (43.0%).TAU+: 309/756 (40.9%).”
    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 conductown data

    In Díez 2002, loss to follow-up was 111/592 (19%) in the intervention group and 84/430 (20%) in the control group; for the C Urbano and C Rural groups, it was 49/255 (19%) and 43/229 (19%) respectively.

    “Loss to follow-up: Intervention group: 111/592 (19%).Control group: 84/430 (20%).Extracted data for C Urbano and C Rural groups only, others were not based in primary health care.Loss to follow-up for these two groups: Intervention group: 49/255 (19%).Control group: 43/229 (19%).”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fernández 1997, blinding of participants was at high risk of bias.

    “Blinding of participants High risk No reported attempt to blind participants.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Field 2010, random sequence generation was at low risk of selection bias.

    “Random sequence generation (selection bias) Low risk”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Ettner 2014, blinding of outcome assessment was at low risk of detection bias.

    “Blinding of outcome assessment (detection bias) All outcomes Low risk”
    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 conductown data

    In Désy 2010, loss to follow-up was 23/49 (47%) in the SBIRT group and 22/42 (52%) in the control group.

    “Loss to follow-up: SBIRT group: 23/49 (47%).Control group: 22/42 (52%).”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fernández 1997, blinding of outcome assessment was at low risk of detection bias.

    “Blinding of outcome assessment (detection bias) All outcomes Low risk The nurse who performed the assessment was unaware of allocation (p.129)”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fernández 1997, blinding of treatment providers was at unclear risk of bias.

    “Blinding of treatment providers Unclear risk Not clear whether the same provider delivers both intervention and control arms”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductown data

    In Field 2010, incomplete outcome data was at high risk of attrition bias.

    “Incomplete outcome data (attrition bias) All outcomes High risk Loss to follow-up > 30%.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    Díez 2002 had unclear intention-to-treat analysis.

    “ITT: unclear.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Ettner 2014, random sequence generation was at low risk of selection bias.

    “Random sequence generation (selection bias) Low risk”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Díez 2002, incomplete outcome data was at low risk of attrition bias.

    “Incomplete outcome data (attrition bias) All outcomes Low risk Loss to follow-up is reported with reasons.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    Field 2010 had unclear intention-to-treat analysis.

    “ITT: unclear.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Ettner 2014, blinding of participants was at high risk of bias.

    “Blinding of participants High risk Not blinded; no reported attempt to reduce bias.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Ettner 2014, incomplete outcome data was at unclear risk of attrition bias.

    “Incomplete outcome data (attrition bias) All outcomes Unclear risk Loss to follow-up is reported with reasons, but big differential between arms”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Díez 2002, blinding of outcome assessment was at unclear risk of detection bias.

    “Blinding of outcome assessment (detection bias) All outcomes Unclear risk Not reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fernández 1997, random sequence generation was at low risk of selection bias.

    “Random sequence generation (selection bias) Low risk Block randomisation (p.128).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductown data

    In Fernández 1997, incomplete outcome data was at high risk of attrition bias.

    “Incomplete outcome data (attrition bias) All outcomes High risk Loss to follow-up > 30%.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Field 2010, allocation concealment was at low risk of selection bias.

    “Allocation concealment (selection bias) Low risk”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Field 2010, blinding of participants was at high risk of bias.

    “Blinding of participants High risk No reported attempt to blind participants.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductown data

    In Désy 2010, random sequence generation was at low risk of selection bias.

    “Random sequence generation (selection bias) Low risk”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Drummond 2014, blinding of outcome assessment was at low risk of detection bias.

    “Blinding of outcome assessment (detection bias) All outcomes Low risk”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Díez 2002, blinding of treatment providers was at high risk of bias.

    “Blinding of treatment providers High risk Not blinded; no reported attempt to reduce bias.”
    Quote in the paperNot a substantial claim

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

    Study design and conductreasoning

    In Ettner 2014, blinding of treatment providers was at low risk of bias.

    “Blinding of treatment providers Low risk”
    Quote in the paperNot a substantial claim

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

    Study design and conductreasoning

    In Drummond 2014, blinding of treatment providers was at low risk of bias.

    “Blinding of treatment providers Low risk Treatment providers not blinded but cluster randomisation means little chance of contamination”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    Fernández 1997 had unclear intention-to-treat analysis.

    “ITT: unclear.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductown data

    Ettner 2014 used intention-to-treat analysis.

    “ITT: yes.”
    Quote in the paperNot a substantial claim

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

    Study design and conductreasoning

    In Ettner 2014, allocation concealment was at low risk of selection bias.

    “Allocation concealment (selection bias) Low risk Cluster randomised.”
    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 conductown data

    In Drummond 2014, loss to follow-up at 6 months was 114/406 (28%) for PIL, 99/403 (25%) for BA, and 128/395 (32%) for BLC; at 12 months it was 142/406 (35%), 108/403 (27%), and 144/395 (36%) respectively.

    “Loss to follow-up at 6 months: Patient information leaflet: 114/406 (28%).Brief advice: 99/403 (25%).Brief lifestyle counselling: 128/395 (32%).Loss to follow-up at 12 months: Patient information leaflet: 142/406 (35%).Brief advice: 108/403 (27%).Brief lifestyle counselling: 144/395 (36%).”
    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 conductown data

    In Fernández 1997, loss to follow-up was 29/67 (43%) in the intervention group and 35/85 (41%) in the control group.

    “Loss to follow-up: Intervention group: 29/67 (43%).Control group: 35/85 (41%).”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Drummond 2014, selective reporting was at low risk of reporting bias.

    “Selective reporting (reporting bias) Low risk Outcomes specified in methods were reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Désy 2010, allocation concealment was at unclear risk of selection bias.

    “Allocation concealment (selection bias) Unclear risk”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fleming 1997, random sequence generation was at low risk of selection bias.

    “Random sequence generation (selection bias) Low risk Computer generated random sequence (p.1040).”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fernández 1997, selective reporting was at low risk of reporting bias.

    “Selective reporting (reporting bias) Low risk Outcomes specified in methods are reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Désy 2010, blinding of outcome assessment was at unclear risk of detection bias.

    “Blinding of outcome assessment (detection bias) All outcomes Unclear risk Not reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Díez 2002, random sequence generation was at unclear risk of selection bias.

    “Random sequence generation (selection bias) Unclear risk”
    Quote in the paperNot a substantial claim

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

    Study design and conductreasoning

    In Désy 2010, blinding of treatment providers was at low risk of bias.

    “Blinding of treatment providers Low risk”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Díez 2002, allocation concealment was at unclear risk of selection bias.

    “Allocation concealment (selection bias) Unclear risk Not reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Ettner 2014, selective reporting was at low risk of reporting bias.

    “Selective reporting (reporting bias) Low risk Outcomes specified in methods were reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductnone given

    Fleming 1997 used intention-to-treat analysis only in one sub-analysis paper.

    “ITT: only in 1 sub analysis paper.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Field 2010, blinding of outcome assessment was at low risk of detection bias.

    “Blinding of outcome assessment (detection bias) All outcomes Low risk”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Ettner 2014, loss to follow-up at 12 months was 107/546 (20%) in the intervention group and 30/640 (5%) in the control group.

    “Loss to follow-up at 12 months: Intervention group: 107/546 (20%).Control group: 30/640 (5%).”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    Désy 2010 did not use intention-to-treat analysis.

    “ITT: no.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Drummond 2014, incomplete outcome data was at high risk of attrition bias.

    “Incomplete outcome data (attrition bias) All outcomes High risk Loss to follow-up > 30%.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Díez 2002, blinding of participants was at high risk of bias.

    “Blinding of participants High risk Not blinded; no reported attempt to reduce bias.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fleming 1999, allocation concealment was at low risk of selection bias because physicians were not told which of their patients were in the control group.

    “Allocation concealment (selection bias) Low risk Physicians were not told which of their patients were in control group (p.379)”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductown data

    In Helstrom 2014, selective reporting was at low risk.

    “Selective reporting (reporting bias) Low risk Outcomes specified in methods are reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Heather 1987, blinding of outcome assessment for all outcomes was at low risk.

    “Blinding of outcome assessment (detection bias) All outcomes Low risk The follow-up interviewers were blind to patients' study groups (p.359)”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Heather 1987, blinding of participants was at high risk.

    “Blinding of participants High risk Patients were screened with a general health questionnaire but were told that the study was about the way people's drinking changes over time (p.359)”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Huas 2002, random sequence generation was at unclear risk of selection bias because it was not reported.

    “Random sequence generation (selection bias) Unclear risk Not reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fleming 2010, random sequence generation was at low risk of selection bias because randomisation used a computer-generated allocation method separately for men and women.

    “Random sequence generation (selection bias) Low risk Randomised using a computer-generated allocation method (separately for men and women) (p.26)”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fleming 2010, blinding of participants was at low risk.

    “Blinding of participants Low risk”
    Quote in the paperNot a substantial claim

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

    Study design and conductreasoning

    In Fleming 1999, blinding of treatment providers was at low risk.

    “Blinding of treatment providers Low risk Researchers carried out baseline assessment; physicians (treatment providers) only saw the intervention participants and were not told which patients were in the control group, therefore little chance of contamination”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fleming 1999, blinding of participants was at low risk.

    “Blinding of participants Low risk Patients completed a modified Health Screening Survey with alcohol questions embedded”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In the study with risk-of-bias support citing p.1040, blinding of outcome assessment for all outcomes was at low risk.

    “Blinding of outcome assessment (detection bias) All outcomes Low risk Follow-up included telephone interview by researcher not assigned to subject's clinic (p.1040)”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fleming 2004, intention-to-treat analysis was used.

    “ITT: yes.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductown data

    In Fleming 2010, selective reporting was at low risk.

    “Selective reporting (reporting bias) Low risk Outcomes specified in methods are reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Helstrom 2014, blinding of participants was at high risk.

    “Blinding of participants High risk Not blinded; no reported attempt to reduce bias.”
    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 conductown data

    In Fleming 1997, loss to follow-up was 39/392 (10%) in the intervention group and 12/382 (3%) in the control group.

    “Loss to follow-up: Intervention group = 39/392 (10%).Control group = 12/382 (3%).”
    Quote in the paperNot a substantial claim

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

    Study design and conductreasoning

    In the study with risk-of-bias support citing p.1040, allocation concealment was at low risk of selection bias.

    “concealment (selection bias) Low risk Physicians were not told which of their patients were in control group”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fleming 1999, intention-to-treat analysis was used.

    “ITT: yes.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing).

    Study design and conductreasoning

    In Fleming 1997, blinding of treatment providers was at low risk of bias.

    “Blinding of treatment providers Low risk”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Huas 2002, intention-to-treat analysis was unclear.

    “ITT: unclear.”
    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 conductown data

    In Fleming 2010, 96% completed either six month or 12 month follow-up and 88% completed both.

    “Loss to follow-up: 96% completed either six month or 12 month follow-up; 88% completed both”
    Quote in the paperNot a substantial claim

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

    Study design and conductreasoning

    In Huas 2002, allocation concealment was at low risk of selection bias because the trial was cluster randomised.

    “Allocation concealment (selection bias) Low risk Cluster randomised.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Helstrom 2014, intention-to-treat analysis was not used.

    “ITT: no.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Helstrom 2014, random sequence generation was at unclear risk of selection bias because the method of sequence generation was not reported.

    “Random sequence generation (selection bias) Unclear risk Method of sequence generation not reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Heather 1987, blinding of treatment providers was at high risk.

    “Blinding of treatment providers High risk Treatment providers not blinded (p.359).”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Heather 1987, incomplete outcome data for all outcomes was at low risk of attrition bias because loss to follow-up was completely recorded with reasons.

    “Incomplete outcome data (attrition bias) All outcomes Low risk Loss to follow-up completely recorded with reasons.”
    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 conductown data

    In Helstrom 2014, loss to follow-up was not reported by arm, and seven could not be contacted following baseline or withdrew from the study.

    “Loss to follow up not reported by arm.Seven could not be contacted following baseline or withdrew from the study”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Helstrom 2014, blinding of outcome assessment for all outcomes was at unclear risk.

    “Blinding of outcome assessment (detection bias) All outcomes Unclear risk Not blinded; no reported attempt to reduce bias.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fleming 1999, blinding of outcome assessment for all outcomes was at low risk.

    “Blinding of outcome assessment (detection bias) All outcomes Low risk Follow-up telephone interviews done by physician not linked to patient's clinic (p.379)”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductown data

    In Fleming 2010, incomplete outcome data for all outcomes was at low risk of attrition bias because loss to follow-up was reported with reasons.

    “Incomplete outcome data (attrition bias) All outcomes Low risk Loss to follow-up is reported with reasons.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fleming 2010, intention-to-treat analysis was used.

    “ITT: yes.”
    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 conductown data

    In Heather 1987, loss to follow-up was 5/34 (15%) in the DRAMS group, 2/32 (6%) in the advice group, and 6/38 (16%) in the control group.

    “Loss to follow-up: DRAMS group: 5/34 (15%).Advice group: 2/32 (6%).Control group: 6/38 (16%).”
    Quote in the paperNot a substantial claim

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

    Study design and conductcitation

    In the study with risk-of-bias support citing p.1040, blinding of participants was at low risk.

    “Blinding of participants Low risk”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fleming 1999, selective reporting was at low risk.

    “Selective reporting (reporting bias) Low risk Outcomes specified in methods are reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fleming 2004, incomplete outcome data for all outcomes was at unclear risk of attrition bias because loss to follow-up was reported but not reasons.

    “Incomplete outcome data (attrition bias) All outcomes Unclear risk Loss to follow-up is reported but not reasons.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fleming 2004, blinding of participants was at high risk.

    “Blinding of participants High risk Participants not blinded (p.632).”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fleming 1997, allocation concealment was at low risk of selection bias.

    “Allocation concealment (selection bias) Low risk Physicians were not told which of their patients were in control group”
    Quote in the paperNot a substantial claim

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

    Study design and conductreasoning

    In Fleming 2010, blinding of treatment providers was at low risk.

    “Blinding of treatment providers Low risk Researchers carried out baseline assessment; physicians (treatment providers) only saw the intervention participants and were not told which patients were in the control group, therefore little chance of contamination”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Helstrom 2014, allocation concealment was at unclear risk of selection bias because it was not described.

    “Allocation concealment (selection bias) Unclear risk Not described.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fleming 2004, blinding of outcome assessment for all outcomes was at low risk.

    “Blinding of outcome assessment (detection bias) All outcomes Low risk Data were collected by a researcher blind to group assignment (p.632)”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fleming 1999, random sequence generation was at unclear risk of selection bias because it was not reported.

    “Random sequence generation (selection bias) Unclear risk Not reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Helstrom 2014, incomplete outcome data for all outcomes was at unclear risk of attrition bias because loss to follow-up was not described by arm and only reasons given were unable to follow-up or withdrew.

    “Incomplete outcome data (attrition bias) All outcomes Unclear risk Loss to follow-up not described by arm and only reasons given were”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fleming 2004, random sequence generation was at unclear risk of selection bias because the method of sequence generation was not reported.

    “Random sequence generation (selection bias) Unclear risk Method of sequence generation not reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In the study with risk-of-bias support citing p.1040, selective reporting was at low risk.

    “Selective reporting (reporting bias) Low risk Outcomes specified in methods were reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductreasoning

    In Fleming 2004, blinding of treatment providers was at low risk.

    “Blinding of treatment providers Low risk Nurse practitioners or physician assistants carried out the brief intervention but had no contact with control patients, so little chance of contamination”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Heather 1987, intention-to-treat analysis was unclear.

    “ITT: unclear.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based).

    Study design and conductown data

    In Heather 1987, selective reporting was at low risk.

    “Selective reporting (reporting bias) Low risk Outcomes specified in methods are reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fleming 1999, incomplete outcome data for all outcomes was at low risk of attrition bias because loss to follow-up was reported with reasons.

    “Incomplete outcome data (attrition bias) All outcomes Low risk Loss to follow-up is reported with reasons.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Heather 1987, random sequence generation was at unclear risk of selection bias because it was unclear how the randomisation sequence was generated.

    “Random sequence generation (selection bias) Unclear risk Unclear how randomisation sequence was generated.”
    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 conductown data

    In Fleming 2004, loss to follow-up at 12 months was 11/92 (12%) in the intervention group and 5/75 (7%) in the control group.

    “Loss to follow-up at 12 months: Intervention group: 11/92 (12%).Control group: 5/75 (7%).”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Huas 2002, blinding of treatment providers was at unclear risk.

    “Blinding of treatment providers Unclear risk Not blinded; no reported attempt to reduce bias.”
    Quote in the paperNot a substantial claim

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

    Study design and conductreasoning

    In Helstrom 2014, blinding of treatment providers was at low risk.

    “Blinding of treatment providers Low risk Interventionist only had contact with intervention group, so low chance of contamination between groups.The primary care doctor had contact with both groups but was supposed to give the same advice to both, so this did not affect risk of bias”
    Quote in the paperNot a substantial claim

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

    Study design and conductreasoning

    In the study with risk-of-bias support citing p.1040, blinding of treatment providers was at low risk.

    “Blinding of treatment providers Low risk Researchers carried out baseline assessment; physicians (treatment providers) only saw the intervention participants and were not told which patients were in the control group, therefore little chance of contamination”
    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 conductown data

    In Fleming 1999, loss to follow-up was 9/87 (9%) in the intervention group and 4/71 (6%) in the control group.

    “Loss to follow-up: Intervention group: 9/87 (9%).Control group: 4/71 (6%).”
    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 conductown data

    In the study with risk-of-bias support citing p.1040, incomplete outcome data for all outcomes was at unclear risk of attrition bias, with loss to follow-up 10% in the intervention group and 3% in the control group.

    “Incomplete outcome data (attrition bias) All outcomes Unclear risk Loss to follow-up 10% in intervention group and 3% in control group”
    Quote in the paperNot a substantial claim

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

    Study design and conductnone given

    In Heather 1987, allocation concealment was at low risk of selection bias.

    “Allocation concealment (selection bias) Low risk Unclear how allocation was concealed.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fleming 2004, selective reporting was at low risk.

    “Selective reporting (reporting bias) Low risk Outcomes specified in methods are reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Fleming 2004, allocation concealment was at unclear risk of selection bias because allocation concealment was not reported.

    “Allocation concealment (selection bias) Unclear risk Allocation concealment not reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Huas 2002, blinding of participants was at high risk.

    “Blinding of participants High risk Not blinded; no reported attempt to reduce bias.”
    Quote in the paperNot a substantial claim

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

    Study design and conductreasoning

    In Israel 1996, blinding of participants was at low risk.

    “Blinding of participants Low risk Screening and baseline questionnaires were broad and not focused on alcohol (p.1445)”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Israel 1996, random sequence generation was at low risk of selection bias because an independent process was used.

    “Random sequence generation (selection bias) Low risk Independent process.”
    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 conductreasoning

    Maisto 2001 had high risk of bias for blinding of participants because participants were not blinded and completed AUDIT for screening, making the alcohol focus clear.

    “Not blinded.Completed AUDIT for screening therefore alcohol focus clear”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Maisto 2001 source

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

    Study design and conductown data

    In Israel 1996, missing data included gender, number randomised to each arm, and baseline data for all randomised participants, which were requested but not available.

    “Missing data: gender, number randomised to each arm, baseline data for all randomised participants: requested, not available”
    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 conductreasoning

    McIntosh 1997 had unclear risk of bias for blinding of treatment providers because treatment providers were not blinded but each delivered only one kind of intervention, limiting chance of contamination.

    “Not blinded but each treatment provider delivered only one kind of intervention therefore limited chance of contamination”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites McIntosh 1997

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Study design and conductown data

    In Israel 1996, loss to follow-up was not recorded by treatment arm and was 30% overall.

    “Loss to follow-up not recorded by treatment arm, 30% overall.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based).

    Study design and conductown data

    In Israel 1996, intention-to-treat analysis was not used.

    “ITT: no.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Israel 1996, incomplete outcome data for all outcomes was at unclear risk of attrition bias because loss to follow-up was not reported by treatment arm and was over 30% overall.

    “Incomplete outcome data (attrition bias) All outcomes Unclear risk Loss to follow-up not reported by treatment arm > 30% overall”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Israel 1996, blinding of outcome assessment for all outcomes was at low risk.

    “Blinding of outcome assessment (detection bias) All outcomes Low risk Follow-up questionnaires were administered”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Huas 2002, incomplete outcome data for all outcomes was at low risk of attrition bias because loss to follow-up was reported with reasons.

    “Incomplete outcome data (attrition bias) All outcomes Low risk Loss to follow-up reported with reasons.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Kaner 2013, intention-to-treat analysis was used.

    “ITT: yes.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing), S4 (based).

    Study design and conductown data

    In Israel 1996, selective reporting was at low risk.

    “Selective reporting (reporting bias) Low risk Outcomes specified in methods are reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductcitation

    Mello 2008 had low risk of bias for blinding of outcome assessment because all data were collected by a research assistant blinded to treatment condition.

    “All data was collected by a research assistant blinded to treatment condition (p.45)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Mello 2008 source

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductown data

    In Huas 2002, selective reporting was at low risk.

    “Selective reporting (reporting bias) Low risk Outcomes specified in methods are reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    In Huas 2002, blinding of outcome assessment for all outcomes was at unclear risk.

    “Blinding of outcome assessment (detection bias) All outcomes Unclear risk Not reported.”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    The initial review analysis was completed in November 2006.

    “Indeed the initial review analysis was completed in November 2006 (the group was awarded a small grant by the Cochrane Collaboration to complete the review by this time).”
    Quote in the paperNot a substantial claim

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

    Study design and conductnone given

    Two of these individuals were involved in conducting three of the null-effect trials that contributed to the review (Heather et al. 1987, Richmond et al. 1995 and Lock et al. 2006).

    “Indeed, two of these individuals were involved in conducting three of the null-effect trials that contributed to the review (Heather et al. 1987, Richmond et al. 1995and Lock et al. 2006).”
    Quote in the paperNot a substantial claim

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

    Interpretationcitation

    Involvement in implementation research is not in itself favourable towards brief intervention.

    “In addition, we do not agree with the proposition that involvement in implementation research is in of itself favourable towards brief intervention (for an example see reference 5) and the findings of null-effect outcome evaluation research highlighted above substantiates this view.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites reference 5

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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

    Premisecitation

    The published version of reference 7 states that it was published in July 2007.

    “The published version of reference 7 states that it was published (following amendment made after peer-review) in July 2007.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites reference 7

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Study design and conductreasoning

    Self-reported drinking was employed in both control and treatment arms of the trials, so this issue would not essentially alter the outcome findings of the review.

    “In addition, whilst self-reported drinking may not be a gold-standard measure of alcohol consumption, this approach was employed in both the control and treatment arms of the trials and so this issue would not essentially alter the outcome findings of the review.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationreasoning

    Since allocation at enrolment was randomly determined, post-screening attrition would be equally experienced in both control and brief intervention conditions.

    “Since allocation at enrolment was randomly determined, it is clear that post-screening attrition would be equally experienced in both control and brief intervention conditions.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given

    All the meta-analysis conducted in the Cochrane review was conducted by two research scientists who have never previously worked in the brief intervention field.

    “Finally, all the meta-analysis conducted in the Cochrane review was conducted by two research scientists who have never previously worked in the brief intervention field the respective contribution of all the review co-authors to each aspect of the review process is clearly outlined on the published review (page 44).”
    Quote in the paperNot a substantial claim

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

    Study design and conductreasoning

    The current review's search strategy extended to 2006.

    “The current review clearly reported that its search strategy extended to 2006.”
    Quote in the paperNot a substantial claim

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

    Study design and conductnone given

    Of the nine co-authors of the current review, three have been involved in both implementation research and outcome evaluation trials in the field of brief alcohol interventions.

    “Of the nine co-authors of the current review, three have been involved in both implementation research and outcome evaluation trials in the field of brief alcohol interventions.”
    Quote in the paperNot a substantial claim

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

    Interpretationreasoning

    The current review would not have included reference 7 which was published in 2007.

    “Thus it obviously would not have included reference 7 which was published in 2007.”
    Quote in the paperNot a substantial claim

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

    Study design and conductreasoning

    The statement that implementation of brief intervention technologies has been the main employment for years of any of the review authors is inaccurate.

    “The statement that implementation of brief intervention technologies has been the main employment for years of any of the review authors is inaccurate.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Chang 1997 compared brief intervention to alcohol treatment referral.

    “Chang 1997 compared brief intervention to alcohol treatment referral”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Chang 1997

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

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

    Interpretationreasoning

    The peer-reviewed version of reference 7 was not available for this review.

    “Thus the peer-reviewed version of this work was not available for this review.”
    Quote in the paperNot a substantial claim

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

    Study design and conductreasoning

    We re-ran our analysis in February 2007 after correspondence from a trial author (Curry 2003) whose work had been excluded from the review in error.

    “However, we re-ran our analysis in February 2007 after correspondence from a trial author (Curry 2003) whose work had been excluded from the review in error.”
    Quote in the paperNot a substantial claim

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

    Study design and conductreasoning

    The current review did not selectively include only work with positive outcomes.

    “it is clear that we have not selectively included only work with positive outcomes.”
    Quote in the paperNot a substantial claim
460 of 460

  • The paper relies on this without support.

    Little is known about how subgroups of hazardous and harmful drinkers (e.g. young people, older people, ethnic minorities) respond to brief intervention in primary care.

    “Little is known about how these subgroups respond to brief intervention in primary care.”

  • The paper relies on this without support.

    The types of participants who were lost from early brief intervention trials remain unclear.

    “but types of participants who were lost remains unclear.”

  • The paper relies on this without support.

    Excessive drinking can be identified routinely in general practice and emergency care.

    “Excessive drinking can be identified routinely in general practice and emergency care.”

  • The paper relies on this without support.

    Screening and brief alcohol intervention in routine primary care typically occurs opportunistically.

    “Screening and brief alcohol intervention in routine primary care typically occurs opportunistically -when the main purpose of the appointment is something other than help with drinking.”

  • The paper relies on this without support.

    Brief interventions in primary care have focused less frequently on dependent drinkers because these people often need more intensive treatment than is available routinely and are likely to require a goal of total abstinence.

    “Brief interventions in primary care have focused less frequently on dependent drinkers because these people often need more intensive treatment than is available routinely and are likely to require a goal of total abstinence.”

  • The paper relies on this without support.

    The brief intervention must be delivered within the limited time frame of a standard consultation.

    “The brief intervention must be delivered within the limited time frame of a standard consultation (typically 5 to 15 minutes for general practitioners (GPs), or up to 30 minutes for nurses).”

  • The paper relies on this without support.

    Recent literature contains a bigger subgroup of trials that focus on emergency care rather than general practice-based primary care, whereas previously the vast majority of the trials took place in primary care.

    “Furthermore, recent literature contains a bigger subgroup of trials that focus on emergency care rather than general practice-based primary care, whereas previously the vast majority of the trials took place in primary care.”

  • The paper relies on this without support.

    Interventions in more recent trials are often based on counselling techniques such as motivational interviewing rather than simpler advice-based input.

    “Finally, interventions in more recent trials are often based on counselling techniques such as motivational interviewing rather than simpler advice-based input.”

  • The authors state this as an assumption.

    Usual care in control conditions was assumed to be care for the presenting condition or usual advice about alcohol consumption.

    “usual care -this was usually not described further but was assumed to be care for the presenting condition or usual advice about alcohol consumption”

  • The authors state this as an assumption.

    Brief interventions not reporting a theoretical basis were assumed to be based on FRAMES.

    “described as brief Intervention (and assumed to be based on FRAMES where not reported)”

  • The authors state this as an assumption.

    The effect of treatment is different in different populations.

    “the random-effects model which we used assumes that the effect of treatment is different in different populations”

  • The authors state this as an assumption.

    The estimated reduction in alcohol consumption of 20 g/week is the mean treatment effect, averaged over all populations.

    “and that the estimated reduction in alcohol consumption of 20 g/week is the mean treatment effect, averaged over all populations”

  • The paper relies on this without support.

    A high proportion of the population attends primary care.

    “because of the high proportion of the population who attends primary care”

  • The paper relies on this without support.

    Since publication of the previous version of this review, the effectiveness of brief interventions has been tested more commonly in emergency departments.

    “Since publication of the previous version of this review, the effectiveness of brief interventions has been tested more commonly in emergency departments.”

  • The authors state this as an assumption.

    Patients in emergency departments may have a different response to a brief intervention, particularly if alcohol consumption has contributed to their visit.

    “It is plausible that patients in emergency departments may have a different response to a brief intervention, particularly if alcohol consumption has contributed to their visit.”

  • The paper relies on this without support.

    More brief interventions have incorporated counselling or motivational interviewing techniques.

    “Another change over time is that more brief interventions have incorporated counselling or motivational interviewing techniques.”

  • The authors state this as an assumption.

    Incorporating counselling or motivational interviewing techniques would have an impact on the effectiveness of the intervention.

    “Again, it is plausible this would have an impact on the effectiveness of the intervention.”

  • The paper relies on this without support.

    More recent studies exploring the screening and assessment reactivity effect have been published since our 2007 review appeared.

    “As described in the Discussion, more recent studies exploring the screening and assessment reactivity effect have been published since our 2007 review appeared.”
18 of 18

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?

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.

  • Fleming 2004 follow-up denominators exceed its stated group sizes

    Minor

    The intervention group is given as 81 participants, but the loss-to-follow-up calculation uses 92 as its denominator. The corresponding control figures are 70 and 75.

  • Córdoba 1998 has two different practice counts

    Minor

    The overview says Córdoba 1998 randomised 33 practices, while its study-characteristics entry says it randomised 74.

  • A trial is both included in and excluded from the primary meta-analysis

    Minor

    Crawford 2010, Díez 2002 and Drummond 2009 are named as primary-meta-analysis trials, but the review also lists them among studies that could not enter its meta-analyses.

  • Trial described as women-only had predominantly male participants

    Minor

    The primary-analysis description calls McDevitt-Murphy 2014 a women-only trial, whereas its study characteristics report 91.2% male participants.

  • Discussion gives an inconsistent overall baseline consumption

    Minor

    The discussion describes mean baseline consumption as about 310 g/week, but the results and clinical-importance sections give the overall mean as 244 g/week. The figure near 310 g/week is identified elsewhere as applying to older studies.

  • Crawford 2010 is incorrectly described as men-only

    Minor

    The primary-analysis description places Crawford 2010 among men-only trials, but its study characteristics report that 51% of participants were male.

  • Patient-satisfaction study is identified by conflicting years

    Minor

    Two sections identify different Drummond trials as one of the two studies reporting patient satisfaction: 2009 in one section and 2014 in the other.

  • D'Amico follow-up fractions use completer counts as losses

    Minor

    The stated loss of 22 out of 38 is 57.9%, not 42%. The adjacent control-group figure has the same problem: 20 out of 26 is 76.9%, not 23%.

    Reported 42 · recomputed 57.894737

8 of 8

Cites

Flagged first, then by citations

14 of the 339 references couldn’t be matched to a known paper.

Research works printed but not linked: 15

  1. Díez, 2002, Brief intervention in Cantabria (Spain) in alcohol related problems, Adicciones, 14, 13
  2. Mundt, 2008, College Alcohol Abuse and Alcohol Related Harms [PhD dissertation]
  3. Huas, 2002, Efficacy of a brief intervention for problematic alcohol users, Revue du Praticien Medecine Generale, 586, 1343
  4. Dauer, 2003, Early identification and brief intervention in alcohol-related traffic casualties: preliminary results, Adicciones, 15, 191
  5. Tait R Including your trial in our Cochrane review...? [personal communication] Email to: FR Beyer
  6. Lang, 2007, Project HaLT, Viennese Journal of Addiction Research, 30, 27
  7. Massey, 2015, Computer and therapist delivered brief alcohol interventions for adult risky drinkers in the emergency department: health explorer study post-test, Alcoholism, Clinical and Experimental Research, 39, 22A
  8. Sterling, 2017, Outcomes from a trial of screening, brief intervention and referral to treatment for adolescents in pediatric primary care: implications for adolescent girls, Alcoholism: Clinical and Experimental Research, 41, 336A
  9. Worden, 2011, Effectiveness of a feedback-based brief intervention for alcohol use disorders in community care [PhD thesis]
  10. Monti, 2015, Effects of a brief intervention in the emergency department for alcohol and HIV/sexual risk, Alcoholism, Clinical and Experimental Research, 39, 305A
  11. Walton, 2015, Project U Connect: a randomized controlled trial testing alcohol interventions among underage drinkers in the emergency department, Alcoholism, Clinical and Experimental Research, 39, 22A
  12. Heather, 2006, WHO collaborative project on identification & management of alcohol-related problems in primary health care. Report on Phase IV: development of country-wide strategies for implementing early identification and brief intervention in primary health care
  13. Higgins JPT Deeks JJ Altman DG (editors) Chapter 16: Special topics in statistics. Approximate analyses of cluster-randomized trials for a meta-analysis: Inflating standard errors. In: Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011 Available from handbook.cochrane.org
  14. Higgins JPT Deeks JJ Altman DG Chapter 16: Special topics in statistics. Intention-to-treat issues. In: Higgins JP, Green S, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011 Available from handbook.cochrane.org
  15. Nordic Cochrane Centre, The Cochrane Collaboration Review Manager (RevMan) 2014

Cited by

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Authors
Kaner, E. F., Beyer, F. R., Muirhead, C., Campbell, F., Pienaar, E. D., Bertholet, N., Daeppen, J. B., Saunders, J. B., & Burnand, B.
Affiliations
  • Newcastle University (GB)
  • University of Sheffield (GB)
  • South African Medical Research Council (ZA)
  • Centre Hospitalier Universitaire Vaudois (CH)
  • The University of Queensland (AU)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2018-02-24
Volume
2018
Issue
6
Pages
CD004148-CD004148
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd004148.pub4
PMC
PMC6491186
OpenAlex
W2136175013
Cited by
1,665
References
339
Citations by year
2026: 29 · 2025: 75 · 2024: 108 · 2023: 94 · 2022: 113 · 2021: 116 · 2020: 156 · 2019: 108 · 2018: 88 · 2017: 78 · 2016: 74 · 2015: 97 · 2014: 90 · 2013: 90 · 2012: 107
FWCI
16.75
Type
journal article
Language
en
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • IRIS (submittedVersion)
  • SERVAL (Université de Lausanne) (submittedVersion)
  • Newcastle University ePrints (Newcastle Univesity)
Funders
  • United States Agency for International Development
  • U.S. Department of Veterans Affairs
  • Hartford Foundation for Public Giving
  • University of Pennsylvania
  • U.S. President’s Emergency Plan for AIDS Relief
  • Imperial College London
  • King's College London
  • Universität zu Lübeck
  • Centro de Investigación Biomédica en Red de Salud Mental
  • National Institutes of Health (5-R01-)
  • University of Illinois at Urbana-Champaign
  • Instituto de Salud Carlos III
  • National Institute on Aging (P30AG028748, P30AG021684)
  • National Institute of Mental Health (P30MH082760)
  • NIH Clinical Center
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
  • Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Keywords
screening and brief intervention, brief alcohol intervention, excessive alcohol consumption, hazardous drinking, alcohol screening, brief advice, general practice, emergency care, primary care, alcohol consumption reduction, behavior change counseling, alcohol harm prevention, cost-effectiveness
MeSH terms
Age Factors, Alcohol Drinking, Alcoholism, Emergencies, Family Practice, Female, Humans, Male, Randomized Controlled Trials as Topic

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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 2026-10-11.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-11.

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Statistics and arithmetic are recomputed, not judged.

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