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Cited by 10Substance Abuse Treatment and OutcomesOpioid Use Disorder TreatmentHIV, Drug Use, Sexual Risk

Efficacy of Brief Intervention for Unhealthy Drug Use in Outpatient Medical Care: a Systematic Review and Meta-analysis

Open access
Sahker, Ethan, Luo, Yan, Sakata, Masatsugu, Toyomoto, Rie, Hwang, Chiyoung, Yoshida, Kazufumi, Watanabe, Norio, Furukawa, Toshi A.·2022·Journal of General Internal Medicine
DOI 10.1007/s11606-022-07543-zPMC PMC9198157
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Abstract

Background The efficacy of brief intervention (BI) for unhealthy drug use in outpatient medical care has not been sufficiently substantiated through meta-analysis despite its ongoing global delivery. This study aims to determine the efficacy of BI for unhealthy drug use and the expected length of effects, and describe subgroup analyses by outpatient setting.Methods Trials comparing BI with usual care controls were retrieved through four databases up to January 13, 2021. Two reviewers independently screened, selected, and extracted data. Primary outcomes included drug use frequency (days used) and severity on validated scales at 4-8 months and were analyzed using random-effects model meta-analysis.Results In total, 20 studies with 9182 randomized patients were included. There was insufficient evidence to support the efficacy of BI for unhealthy drug use among all outpatient medical care settings for use frequency (SMD = -0.07, 95% CI = -0.17, 0.02, p = 0.12, I 2 = 37%, high certainty of evidence) and severity (SMD = -0.27, 95% CI = -0.78, 0.24, p = 0.30, I 2 = 98%, low certainty of evidence). However, post hoc subgroup analyses uncovered significant effects for use frequency by setting (interaction p = 0.02), with significant small effects only in emergency departments (SMD = -0.15, 95% CI = -0.25, -0.04, p < 0.01). Primary care, student health, women's health, and HIV primary care subgroups were nonsignificant. Primary care BI revealed nonsignificant greater average use in the treatment group compared to usual care.Discussion BI for unhealthy drug use lacks evidence of efficacy among all outpatient medical settings. However, small effects found in emergency departments may indicate incremental benefits for some patients. Clinical decisions for SBI or specialty treatment program referrals should be carefully considered accounting for these small effects in emergency departments.Registration PROSPERO (CRD42020157733).

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Registry

Crossref · 10.1007/s11606-022-07543-z

Cites

54 of 54 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 33 cited sources checked · 0 supported · 0 flagged

  • Findingown data
    § Meta-analytic Findings · p. 4

    When studies with more than usual care controls were excluded, evidence remained insufficient for intermediate follow-up drug use severity (SMD = -0.64, 95% CI = -1.65 to 0.37, p = 0.22, I2 = 98%).

    “and severity (SMD = -0.64, 95% CI = -1.65, 0.37, p = 0.22, I 2 = 98%)”
    Quote in the paperNot a substantial claim
  • Findingown data
    § DISCUSSION · p. 6

    In primary care, the brief intervention group had higher average drug use than usual care, by -0.3 to 2.1 days in the past month.

    “In primary care settings, the BI group demonstrated greater average drug use than UC ( -0.3 to 2.1 days used/past month).”
    Quote in the paperNot a substantial claim
  • Findingown data
    § Meta-analytic Findings · p. 4

    When studies using last observation carried forward were excluded, evidence remained insufficient for drug use frequency (SMD = -0.08, 95% CI = -0.18 to 0.02, p = 0.08, I2 = 45%).

    “Excluding studies using last observation carried forward imputation methods for the primary outcomes still found insufficient evidence for both frequency (SMD = -0.08, 95% CI = -0.18, 0.02, p = 0.08, I 2 = 45%)”
    Quote in the paperNot a substantial claim
  • Findingnone given
    § Limitations · p. 7

    Most trials included a minor active element.

    “Most trials included some small active component.”
    Quote in the paperNot a substantial claim
  • Findingown data
    § Meta-analytic Findings · p. 4

    There was insufficient evidence to support brief intervention efficacy for all secondary outcomes at every timepoint.

    “There was insufficient evidence to support efficacy in all secondary outcomes at any timepoint.”
    Quote in the paperSubstantial claim
  • The quote only partly states this claim. 9
  • May combine two claims. 19
  • Classified as probably not a substantial claim. 15

  • The quote only partly states this claim.

    Findingown data
    § Meta-analytic Findings · p. 4

    At 4-8 months, the evidence was insufficient to support brief intervention efficacy for drug use severity in outpatient medical care (SMD = -0.27, 95% CI = -0.78 to 0.24, p = 0.30, I2 = 98%), with low certainty.

    “With 3312 patients from 7 studies, there was insufficient evidence to support efficacy of BI in reduction of drug use severity at intermediate follow-up (SMD = -0.27, 95% CI = -0.78, 0.24, p = 0.30, I 2 = 98%).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data
    § DISCUSSION · p. 5

    The review included 20 studies with 9182 randomized patients.

    “Findings were taken from 20 studies with a total of 9182 randomized patients.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given
    § Limitations · p. 7

    All studies used motivational interviewing-based brief intervention, but for different and mixed substances.

    “All studies used some form of motivational interviewing-based BI, but these were delivered for various and mixed problem substances.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data
    § Meta-analytic Findings · p. 4

    When studies using last observation carried forward were excluded, evidence remained insufficient for drug use severity (SMD = -0.36, 95% CI = -0.98 to 0.26, p = 0.25, I2 = 99%).

    “and severity (SMD = -0.36, 95% CI = -0.98, 0.26, p = 0.25, I 2 = 99%)”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data
    § Meta-analytic Findings · p. 5

    The women's health and HIV primary care subgroups each contained only one study.

    “Additionally, women ' s health and HIV primary care subgroups each consisted of one study and the individual studies failed to show significance.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Efficacy of Brief Intervention for Unhealthy Drug Use in Outpatient Medical Care: a Systematic Review and Meta-analysis · p. 1

    The meta-analysis included 20 randomized studies with 9182 patients across three timepoints.

    “In total, 20 studies with 9182 randomized patients were included.”
    • Also stated in: § Meta-analytic Findings · p. 4 · plain
      “For the meta-analysis, 20 studies with 9182 randomized patients were included at three timepoints.”
    Quote in the paperSubstantial claim

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

    Findingown data
    § DISCUSSION · p. 6

    In the HIV primary care subgroup, the effect of brief intervention on drug use was SMD -0.27 (95% CI -0.56 to 0.01), with P=0.06.

    “8.2% -0.27 [-0.56, 0.01]”
    • Also stated in: § DISCUSSION · p. 6 · plain
      “Test for overall effect: Z = 1.87 (P = 0.06)”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data
    § Meta-analytic Findings · p. 4

    When studies with high risk of bias were excluded, evidence remained insufficient for drug use severity (SMD = -0.35, 95% CI = -0.97 to 0.26, p = 0.26, I2 = 99%).

    “and severity (SMD = -0.35, 95% CI = -0.97, 0.26, p = 0.26, I 2 = 99%)”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data
    § Meta-analytic Findings · p. 5

    At long-term follow-up, brief intervention did not significantly reduce drug use frequency (SMD -0.06, 95% CI -0.19 to 0.8, p=0.4) among 2431 patients from 6 studies, with substantial heterogeneity (I2=57%) and moderate certainty evidence.

    “Long-term follow-up assessment also revealed non-significant findings among 2431 patients in 6 studies with substantial heterogeneity (SMD = -0.06, 95% CI = -0.19, 0.8, p = 0.4, I 2 = 57%, moderate certainty of evidence).”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Findingown data
    § Efficacy of Brief Intervention for Unhealthy Drug Use in Outpatient Medical Care: a Systematic Review and Meta-analysis · p. 1

    At 4-8 months, the evidence was insufficient to support brief intervention efficacy for drug use frequency in outpatient medical care (SMD = -0.07, 95% CI = -0.17 to 0.02, p = 0.12, I2 = 37%), with high certainty.

    “There was insufficient evidence to support the efficacy of BI for unhealthy drug use among all outpatient medical care settings for use frequency (SMD = -0.07, 95% CI = -0.17, 0.02, p = 0.12, I 2 = 37%, high certainty of evidence)”
    • Also stated in: § Meta-analytic Findings · p. 4 · plain
      “With 3378 patients from 9 studies, there was insufficient evidence to support efficacy of BI for drug use frequency at intermediate follow-up (SMD = -0.07, 95% CI = -0.17, 0.02, p = 0.12, I 2 = 37%).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data
    § DISCUSSION · p. 6

    In the present study, across all outpatient settings, brief intervention for unhealthy drug use had SMD = -0.17, nonsignificant.

    “the present study ' s findings in all outpatient settings (SMD = -0.17, nonsignificant)”
    Quote in the paperSubstantial claim

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

    Findingown data
    § RESULTS · p. 2

    The narrative review included 27 primary studies.

    “In all, 27 primary studies were included and described in the narrative review.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § Efficacy of Brief Intervention for Unhealthy Drug Use in Outpatient Medical Care: a Systematic Review and Meta-analysis · p. 1

    Primary care, student health, women's health, and HIV primary care subgroups did not show significant effects.

    “Primary care, student health, women ' s health, and HIV primary care subgroups were nonsignificant.”
    Quote in the paperSubstantial claim

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

    Findingown data
    § Meta-analytic Findings · p. 5

    In the overall analysis of severity on the ASSIST, brief intervention was not significantly associated with drug use severity (SMD -0.27, 95% CI -0.78 to 0.24, p=0.30), with substantial heterogeneity (I2=98%).

    “| Total (95% CI) | | | 1731 |”
    Quote in the paperSubstantial claim

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

    Findingown data
    § DISCUSSION · p. 6

    Overall pooled effect of brief intervention on drug use days in the past month across all included studies was SMD -0.07 (95% CI -0.17 to 0.02), not statistically significant (P=0.12).

    “100.0% -0.07 [-0.17, 0.02]”
    • Also stated in: § DISCUSSION · p. 6 · plain
      “Test for overall effect: Z = 1.55 (P = 0.12)”
    Quote in the paperSubstantial claim

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

    Findingown data
    § Study Populations · p. 3

    Most included studies were conducted in emergency departments (10 studies).

    “Most (10 studies) were conducted in emergency departments”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingnone given
    § DISCUSSION · p. 6

    In hospital and community primary care clinics, the estimated treatment effect on days used in the past month ranged from -0.3 to 2.1 days.

    “Estimated treatment effect in | days | used in the | past month | = -0.3 | to 2.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). The quote only partly states this claim.

    Findingnone given
    § DISCUSSION · p. 6

    In emergency departments, the estimated treatment effect on days used in the past month ranged from -2.9 to -0.5 days.

    “Estimated treatment effect in used in the past month = -2.9 to -0.5 days”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data
    § DISCUSSION · p. 6

    In emergency department subgroups, brief intervention for unhealthy drug use had SMD = -0.15, significant.

    “emergency department subgroups (SMD = -0.15, significant)”
    Quote in the paperSubstantial claim

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

    Findingreasoning
    § Limitations · p. 7

    A usual-care condition with no intervention is more ideal than realistic.

    “The use of UC with zero intervention is more of an ideal than a reality.”
    Quote in the paperNot a substantial claim

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

    Findingnone given
    § Limitations · p. 7

    Interventions were delivered by providers with varied educational backgrounds.

    “Trials were delivered by a variety of providers ranging in education level.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation
    § INTRODUCTION · p. 1

    The US Preventive Services Task Force found some evidence supporting brief intervention for unhealthy drug use in any setting.

    “The US Preventive Services Task Force found some evidence supporting BI for unhealthy drug use in any setting. 17”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [17] Patnode CD, Perdue LA, Rushkin M, et al. Screening for Unhealthy Drug Use: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA - J Am Med Assoc. 2020;323(22):2310-2328. https://doi.org/10.1001/jama.2019.21381 source

      Not checked in the free run.

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

    Premisecitation
    § INTRODUCTION · p. 1

    Many outpatient medical care facilities globally have dedicated resources to implementing screening and brief intervention.

    “Many outpatient medical care facilities across the globe have dedicated resources 7 -9 to implementing SBI for early detection and early intervention. 5,6”
    Quote in the paperNot a substantial claim0 of 5 sources checked
    • cites [7] Cowell AJ, Dowd WN, Mills MJ, Hinde JM, Bray JW. Sustaining SBIRT in the wild: simulating revenues and costs for Screening, Brief Intervention and Referral to Treatment programs. Addiction. 2017;112:101-109. https://doi.org/10.1111/add.13650 source

      Not checked in the free run.

    • cites [8] Substance Abuse and Mental Health Services Administration. Grant Awards Archive FY 2001-2018. Published 2019. Accessed October 9, 2019. https://www.samhsa.gov/grants/archive

      Not checked in the free run.

    • cites [9] Barbosa C, Cowell A, Dowd W, Landwehr J, Aldridge A, Bray J. The cost-effectiveness of brief intervention versus brief treatment of Screening, Brief Intervention and Referral to Treatment (SBIRT) in the United States. Addiction. 2017;112:73-81. https://doi.org/10.1111/add.13658 source

      Not checked in the free run.

    • cites [5] Substance Abuse and Mental Health Services Administration. Systems-Level Implementation of Screening, Brief Intervention, and Referral to Treatment.; 2013. https://store.samhsa.gov/system/files/sma13-4741.pdf

      Not checked in the free run.

    • cites [6] Kaner EFS, Dickinson HO, Beyer F, et al. The effectiveness of brief alcohol interventions in primary care settings: A systematic review. Drug Alcohol Rev. 2009;28(3):301-323. https://doi.org/10.1111/j.1465-3362.2009.00071.x source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation
    § INTRODUCTION · p. 1

    Much of the evidence supporting brief intervention for unhealthy drug use came from treatment-seeking populations, so its efficacy in outpatient medical care settings remains unknown.

    “However, much of the evidence came from treatment-seeking populations, meaning the efficacy of BI in outpatient medical care settings remains unknown. 17”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [17] Patnode CD, Perdue LA, Rushkin M, et al. Screening for Unhealthy Drug Use: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA - J Am Med Assoc. 2020;323(22):2310-2328. https://doi.org/10.1001/jama.2019.21381 source

      Not checked in the free run.

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

    Premisenone given
    § INTRODUCTION · p. 1

    Delivery of screening and brief intervention in outpatient medical care depends on the efficacy of the brief intervention component.

    “However, delivery of SBI in outpatient medical care is predicated on the efficacy of the brief intervention (BI) component.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation
    § INTRODUCTION · p. 1

    Findings from brief intervention trials have been mixed, with supportive findings for unhealthy alcohol use but a lack of evidence for unhealthy drug use.

    “Findings from BI trials have been mixed, with supportive findings for unhealthy alcohol use, 10 -13 but currently lack evidence for unhealthy drug use. 11,14 -16”
    Quote in the paperSubstantial claim0 of 7 sources checked
    • cites [10] Kaner E, Beyer F, Muirhead C, et al. Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev. 2018;(2):1-248. https://doi.org/10.1002/14651858.CD004148.pub4 source

      Not checked in the free run.

    • cites [11] Madras BK, Compton WM, Avula D, Stegbauer T, Stein JB, Clark HW. Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: Comparison at intake and 6 months later. Drug Alcohol Depend. 2009;99(1-3):280-295. https://doi.org/10.1016/j.drugalcdep.2008.08.003 source

      Not checked in the free run.

    • cites [12] Aldridge A, Linford R, Bray J. Substance use outcomes of patients served by a large US implementation of Screening, Brief Intervention and Referral to Treatment (SBIRT). Addiction. 2017;112(459 599):43-53. https://doi.org/10.1111/add.13651 source

      Not checked in the free run.

    • cites [13] Rastegar D, Fingerhood M. The American Society of Addiction Medicine Handbook of Addiction Medicine. New York, NY: Oxford University Press; 2015. source

      Not checked in the free run.

    • cites [14] Saitz R. Alcohol screening and brief intervention in primary care: Absence of evidence for efficacy in people with dependence or very heavy drinking. Drug Alcohol Rev. 2010;29(6):631-640. https://doi.org/10.1111/j.1465-3362.2010.00217.x source

      Not checked in the free run.

    • cites [15] Saitz R. Screening and brief intervention for unhealthy drug use: Little or no efficacy. Front Psychiatry. 2014;5(AUG):1-5. https://doi.org/10.3389/fpsyt.2014.00121 source

      Not checked in the free run.

    • cites [16] Babor TF, Del Boca F, Bray JW. Screening, brief intervention and referral to treatment: implications of SAMHSA’s SBIRT initiative for substance abuse policy and practice. Addiction. 2017;112:110-117. https://doi.org/10.1111/add.13675 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning
    § Limitations · p. 7

    Bias from selective reporting of outcomes and analyses might be greater, which would lower confidence in the evidence.

    “The actual bias associated with selective reporting of outcome measurements and analyses may be higher, making the certainty of evidence lower.”
    Quote in the paperNot a substantial claim

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

    Interpretationnone given
    § DISCUSSION · p. 6

    This study is the most comprehensive assessment to date of brief intervention for unhealthy drug use in outpatient medical care.

    “The present research represents the most comprehensive evaluation of outpatient medical care BI for unhealthy drug use to date.”
    Quote in the paperNot a substantial claim

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

    Premisecitation
    § DISCUSSION · p. 6

    A decade ago, researchers called for additional randomized trials of brief intervention for unhealthy drug use.

    “The call for more RCTs in BI for unhealthy drug use was made a decade ago. 15,20”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [15] Saitz R. Screening and brief intervention for unhealthy drug use: Little or no efficacy. Front Psychiatry. 2014;5(AUG):1-5. https://doi.org/10.3389/fpsyt.2014.00121 source

      Not checked in the free run.

    • cites [20] Saitz R, Alford DP, Bernstein J, Cheng DM, Samet J, Palfai T. Screening and brief intervention for unhealthy drug use in primary care settings: Randomized clinical trials are needed. J Addict Med. 2010;4(3):123-130. https://doi.org/10.1097/ADM.0b013e3181db6b67 source

      Not checked in the free run.

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

    Study design and conductreasoning
    § Limitations · p. 7

    A sensitivity analysis excluding active substance use disorder components was used to address this.

    “However, we did our best to correct for this through a sensitivity analysis that excluded active SUD components.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation
    § Assessment of Risk of Bias in Included Studies · p. 2

    Two review authors independently assessed risk of bias for each study using Cochrane RoB2.

    “Tworeview authors independently assessed the risk of bias for each study using the Cochrane risk of bias tool version 2 (RoB2). 24”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [24] Higgins JPT, Thomas J, Chandler J, et al. Cochrane Handbook for Systematic Reviews of Interventions. Second. Chichester, UK: The Cochrane Collaboration and John Wiley & Sons Ltd.; 2019. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data
    § DISCUSSION · p. 5

    Support was found for brief intervention reducing drug use frequency in emergency department settings, but not in hospital/community primary care, student health, women's health, or HIV primary care settings.

    “However, support was found favoring BI for lower drug use frequency in emergency department settings, but not for hospital/community primary care clinics, student health, women ' s health, or HIV primary care settings.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductnone given
    § Baseline Frequency and Severity · p. 4

    All 27 included studies provided baseline outcome data and reported no differences between treatment and control baseline means.

    “All 27 studies provided baseline data for the outcomes reporting no differences between treatment and control baseline means.”
    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
    § Study Selection and Data Extraction · p. 2

    Two reviewers independently screened, selected, and extracted data and reached consensus, with moderate interrater reliability (κ = 0.66).

    “Two reviewers independently screened, selected (moderate interrater reliability, κ = 0.66), and extracted data from studies and came to a consensus.”
    Quote in the paperNot a substantial claim

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

    Interpretationnone given
    § DISCUSSION · p. 7

    This is the first meta-analysis focused specifically on brief intervention for unhealthy drug use in outpatient medical care.

    “This is the first metaanalysis to specifically investigate BI for unhealthy drug use in outpatient medical care.”
    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 conductcitation
    § METHODS · p. 2

    The review methods align with PRISMA-P and the review is registered in PROSPERO (CRD42020157733).

    “The methods reported in this systematic review and meta-analysis are aligned with the preferred reporting items for systematic reviews and meta-analyses guidelines for systematic review protocols (PRISMA-P) 23 and i s registered i n PROSPERO (CRD42020157733).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [23] Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;(January):1-9. 10.1186/2046-4053-4-1 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data
    § Conclusion · p. 7

    Emergency department effects were small, and their clinical meaningfulness remains undetermined.

    “However, the effects were small and clinical meaningfulness is yet to be determined.”
    Quote in the paperSubstantial claim
37 of 37

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?

  • Sahker et al. in another meta-analysis found that BIs delivered in outpatient medical care had no effect on drug use (other than alcohol).

    “Sahker et al [127] in another meta-analysis found that BIs delivered in outpatient medical care had no effect on drug use (other than alcohol) [127].”

    From A scoping review of substance use brief interventions in Africa (2024) · cites this paper as [127]

    The Discussion (p. 5) reports no significant overall effect on drug-use frequency or severity across outpatient medical settings, consistent with the claim’s broad direction. But it also reports a statistically significant small reduction in drug-use frequency in emergency departments. Saying the interventions ‘had no effect’ across outpatient care overstates the finding. (LLM, conf=0.89)

    Experimental — accuracy not yet measured

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.

  • Student-health p-values differ between text and figure

    Minor

    The subgroup's p-value is 0.07 in the text but 0.17 in Figure 3.

  • Short-term frequency confidence interval is not centered on its estimate

    Minor

    The reported confidence limits have a midpoint of 0.08, not the stated SMD of −0.06. The interval is therefore inconsistent with the reported estimate.

    Reported -0.06 · recomputed 0.08

  • Student-health confidence intervals differ between text and figure

    Minor

    The text gives the student-health subgroup a lower confidence limit of −0.38, whereas Figure 3 gives −0.51.

  • Long-term frequency confidence interval is not centered on its estimate

    Minor

    The reported confidence limits have a midpoint of 0.305, rather than the stated SMD of −0.06.

    Reported -0.06 · recomputed 0.305

4 of 4

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. United Nations Office on Drugs and Crime. World Drug Report 2017: Executive Summary Conclusions and Policy Implications.; 2017. 10.4324/9780429269486-6 · DOI

Cited by

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Related

Authors
Sahker, E., Luo, Y., Sakata, M., Toyomoto, R., Hwang, C., Yoshida, K., Watanabe, N., & Furukawa, T. A.
Affiliations
Kyoto University (JP)
Corresponding author
Sahker, Ethan
ORCID
Venue
Journal of General Internal Medicine
Publisher
Springer Science and Business Media LLC
Published
2022-04-13
Volume
37
Issue
8
Pages
2041-2049
ISSN
  • 0884-8734 (ISSN-L)
  • 1525-1497
DOI
10.1007/s11606-022-07543-z
PMC
PMC9198157
OpenAlex
W4223985864
Cited by
10
References
52
Citations by year
2026: 2 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 1
FWCI
0.32
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of General Internal Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Institutional Repositories DataBase (IRDB) (submittedVersion)
  • Kyoto University Research Information Repository (Kyoto University) (submittedVersion)
Funders
japan society for the promotion of science (P19110 and 19F19110)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
Keywords
brief intervention, outpatient care, emergency department, primary care, drug use frequency, drug use severity, usual care comparison, subgroup analysis
MeSH terms
Ambulatory Care, Crisis Intervention, Female, Humans, Outpatients, Quality of Life, Randomized Controlled Trials as Topic, Substance-Related Disorders

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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.

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Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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