Baseline predictors of treatment outcome in Internet-based alcohol interventions: a recursive partitioning analysis alongside a randomized trial
Open accessAbstract
BACKGROUND: Internet-based interventions are seen as attractive for harmful users of alcohol and lead to desirable clinical outcomes. Some participants will however not achieve the desired results. In this study, harmful users of alcohol have been partitioned in subgroups with low, intermediate or high probability of positive treatment outcome, using recursive partitioning classification tree analysis. METHODS: Data were obtained from a randomized controlled trial assessing the effectiveness of two Internet-based alcohol interventions. The main outcome variable was treatment response, a dichotomous outcome measure for treatment success. Candidate predictors for the classification analysis were first selected using univariate regression. Next, a tree decision model to classify participants in categories with a low, medium and high probability of treatment response was constructed using recursive partitioning software. RESULTS: Based on literature review, 46 potentially relevant baseline predictors were identified. Five variables were selected using univariate regression as candidate predictors for the classification analysis. Two variables were found most relevant for classification and selected for the decision tree model: 'living alone', and 'interpersonal sensitivity'. Using sensitivity analysis, the robustness of the decision tree model was supported. CONCLUSIONS: Harmful alcohol users in a shared living situation, with high interpersonal sensitivity, have a significantly higher probability of positive treatment outcome. The resulting decision tree model may be used as part of a decision support system but is on its own insufficient as a screening algorithm with satisfactory clinical utility. TRIAL REGISTRATION: Netherlands Trial Register (Cochrane Collaboration): NTR-TC1155.
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Previous efforts to identify nontechnological factors influencing attrition in online interventions have yielded inconclusive results.
“although previous efforts to identify nontechnological factors influencing attrition in online interventions have yielded inconclusive results [71-75].”
From Short-term effectiveness of web-based guided self-help for phobic outpatients: randomized controlled trial. (2014) · cites this paper as [71]
The Background (page unavailable) says findings on baseline predictors of alcohol-treatment outcome are mixed and have not always been replicated. The Methods and Discussion (pages unavailable) clarify that this study predicts treatment response, not attrition; its discussion of follow-up attrition does not say that efforts to identify nontechnological predictors of attrition were inconclusive. (LLM, conf=0.84)
Experimental — accuracy not yet measuredBecause there was systematic attrition in this trial, the significant differences between completers and dropouts may provide valuable information to identify focal points for targeted attrition reduction.
“Because there was systematic attrition in this trial, the significant differences between completers and dropouts may provide valuable information to identify focal points for targeted attrition reduction, although previous efforts to identify nontechnological factors influencing attrition in online interventions have yielded inconclusive results [71-75].”
From Short-term effectiveness of web-based guided self-help for phobic outpatients: randomized controlled trial. (2014) · cites this paper as [71]
The citation is attached to the statement that previous studies of nontechnological factors influencing attrition in online interventions yielded inconclusive results. The Background and Discussion describe mixed findings about predictors of treatment outcome, not attrition; Methods > Procedure and interventions reports follow-up response rates but does not assess factors influencing dropout. Searches for attrition, dropout, completers, and their predictors found no passage addressing the cited point. Our copy provides no page numbers for these passages. (LLM, conf=0.73)
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Cites
R: A Language and Environment for Statistical Computing
R Core Team (2000) · doi:10.32614/r.manuals · Cited by 355,706 · see citing works
(1990) · Choice Reviews Online · doi:10.5860/choice.27-3338 · Cited by 35,305 · see citing works
Classification and Regression Trees.
Gordon, A. D., Breiman, L., Friedman, J. H., Olshen, R. A., & Stone, C. J. (1984) · Biometrics · doi:10.2307/2530946 · Cited by 23,834 · see citing works
Classification and Regression Trees.
Ryzin, J. V., Breiman, L., Friedman, J. H., Olshen, R. A., & Stone, C. J. (1986) · Journal of the American Statistical Association · doi:10.2307/2288003 · Cited by 21,028 · see citing works
Hosmer, D. W., & Lemeshow, S. (2000) · doi:10.1002/0471722146 · Cited by 20,302 · see citing works
EuroQol: a new facility for the measurement of health-related quality of life
(1990) · Health Policy · doi:10.1016/0168-8510(90)90421-9 · Cited by 15,736 · see citing works
SAUNDERS, J. B., AASLAND, O. G., BABOR, T. F., DE LA FUENTE, J. R., & GRANT, M. (1993) · Addiction · doi:10.1111/j.1360-0443.1993.tb02093.x · Cited by 13,482 · see citing works
The brief symptom inventory: an introductory report.
Derogatis, L. R., & Melisaratos, N. (1983) · Psychological Medicine · doi:10.1017/s0033291700048017 · Cited by 6,650 · see citing works
(1997) · doi:10.1097/00005650-199711000-00002 · Cited by 4,544 · see citing works
Applied Logistic Regression Analysis
Ziegel, E. R., & Menard, S. (1996) · Technometrics · doi:10.1080/00401706.1996.10484485 · Cited by 3,923 · see citing works
Rehm, J., Mathers, C., Popova, S., Thavorncharoensap, M., Teerawattananon, Y., & Patra, J. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60746-7 · Cited by 3,870 · see citing works
Bandura, A. (1997) · American Journal of Health Promotion · doi:10.4278/0890-1171-12.1.8 · Cited by 3,499 · see citing works
Applied Logistic Regression Analysis
Menard, S. (2002) · Sage eBooks · doi:10.4135/9781412983433 · Cited by 3,011 · see citing works
Strobl, C., Malley, J., & Tutz, G. (2009) · Psychological Methods · doi:10.1037/a0016973 · Cited by 2,583 · see citing works
Eysenbach, G. (2005) · Journal of Medical Internet Research · doi:10.2196/jmir.7.1.e11 · Cited by 2,524 · see citing works
(1997) · Journal of Studies on Alcohol · doi:10.15288/jsa.1997.58.7 · Cited by 1,905 · see citing works
Treatment gap in mental health care.
Abramowitz, M. Z., Greenberg, D., & Levav, I. (2008) · PubMed · Cited by 1,482 · see citing works
The treatment gap in mental health care.
(2004) · Europe PMC (PubMed Central) · Cited by 1,419 · see citing works
The alcohol use disorders identification test: an update of research findings
Reinert, D. F., & Allen, J. P. (2007) · Alcoholism: Clinical and Experimental Research · doi:10.1111/j.1530-0277.2006.00295.x · Cited by 1,397 · see citing works
Moyer, A., Finney, J. W., Swearingen, C. E., & Vergun, P. (2002) · Addiction · doi:10.1046/j.1360-0443.2002.00018.x · Cited by 1,092 · cited 1× · see citing works
“A number of studies have found a negative relationship between the severity of drinking problems at baseline and clinical outcome [13-15].”
BackgroundSubstance abuse treatment entry, retention, and outcome in women: a review of the literature
Greenfield, S. F., Brooks, A. J., Gordon, S. M., Green, C. A., Kropp, F., McHugh, R. K., Lincoln, M., Hien, D., & Miele, G. M. (2007) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2006.05.012 · Cited by 1,055 · see citing works
An Introduction to Recursive Partitioning Using the RPART Routines
Therneau, T. M., & Atkinson, E. J. (2015) · Cited by 1,006 · see citing works
Comparison of Stopping Rules in Forward “Stepwise” Regression
Bendel, R. B., & Afifi, A. A. (1977) · Journal of the American Statistical Association · doi:10.1080/01621459.1977.10479905 · Cited by 885 · see citing works
A research approach to improving our quality of life.
Flanagan, J. C. (1978) · American Psychologist · doi:10.1037/0003-066x.33.2.138 · Cited by 755 · see citing works
Ryan, R. M., Plant, R., & O'Malley, S. (1995) · Addictive Behaviours · doi:10.1016/0306-4603(94)00072-7 · Cited by 709 · see citing works
Alcoholism Treatment: Context, Process, and Outcome
Moos, R. H., Finney, J. W., & Cronkite, R. C. (1990) · Medical Entomology and Zoology · Cited by 530 · see citing works
Recursive Partitioning in the Health Sciences
Zhang, H., & Singer, B. H. (1999) · Statistics in the health sciences · doi:10.1007/978-1-4757-3027-2 · Cited by 455 · see citing works
Dobkin, P. L., Civita, M. D., Paraherakis, A., & Gill, K. (2002) · Addiction · doi:10.1046/j.1360-0443.2002.00083.x · Cited by 378 · cited 1× · see citing works
“With regard to psychosocial functioning, several measures have been found to predict intervention outcome: self-efficacy [17,18], motivation to change [18-21], internal locus of control, coping skills, low levels of experienced stress, concern from partners or peers, and a stable social environment [13,16,22-24].”
BackgroundPatient predictors of alcohol treatment outcome: A systematic review
Adamson, S. J., Sellman, J. D., & Frampton, C. M. A. (2009) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2008.05.007 · Cited by 370 · see citing works
Global burden of disease from alcohol, illicit drugs and tobacco
Rehm, J. T., TAYLOR, B., & Room, R. (2006) · Drug and Alcohol Review · doi:10.1080/09595230600944453 · Cited by 366 · see citing works
The Role of Psychiatric Disorders in Predicting Drug Dependence Treatment Outcomes
Compton, W. M., Cottler, L. B., Jacobs, J., Abdallah, A. B., & Spitznagel, E. L. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.5.890 · Cited by 309 · see citing works
Web‐based self‐help for problem drinkers: a pragmatic randomized trial
Riper, H., Kramer, J., Smit, F., Conijn, B., Schippers, G., & Cuijpers, P. (2008) · Addiction · doi:10.1111/j.1360-0443.2007.02063.x · Cited by 267 · see citing works
Self-citationComputer‐delivered interventions for alcohol and tobacco use: a meta‐analysis
Rooke, S., Thorsteinsson, E., Karpin, A., Copeland, J., & Allsop, D. (2010) · Addiction · doi:10.1111/j.1360-0443.2010.02975.x · Cited by 262 · see citing works
Psychometric properties of Work Ability Index in the light of comparative survey study
Radkiewicz, P., & Widerszal‐Bazyl, M. (2005) · International Congress Series · doi:10.1016/j.ics.2005.02.089 · Cited by 209 · see citing works
Blankers, M., Koeter, M. W. J., & Schippers, G. M. (2010) · Journal of Medical Internet Research · doi:10.2196/jmir.1448 · Cited by 194 · see citing works
Self-citationMyers, M. G., Stewart, D. G., & Brown, S. A. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.4.479 · Cited by 185 · see citing works
A randomized controlled trial of an internet‐based intervention for alcohol abusers
Cunningham, J. A., Wild, T. C., Cordingley, J., Van Mierlo, T., & Humphreys, K. (2009) · Addiction · doi:10.1111/j.1360-0443.2009.02726.x · Cited by 182 · see citing works
McKay, J. R., & Weiss, R. V. (2001) · Evaluation Review · doi:10.1177/0193841x0102500202 · Cited by 175 · see citing works
Blankers, M., Koeter, M. W. J., & Schippers, G. M. (2011) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0023498 · Cited by 146 · see citing works
Self-citationThe Flanagan Quality Of Life Scale: evidence of construct validity.
Burckhardt, C. S., Anderson, K. L., Archenholtz, B., & Hägg, O. (2003) · Health and Quality of Life Outcomes · doi:10.1186/1477-7525-1-59 · Cited by 133 · see citing works
Outcome predictors in substance use disorders
Ciraulo, D. A., Piechniczek‐Buczek, J., & Iscan, E. N. (2003) · Psychiatric Clinics of North America · doi:10.1016/s0193-953x(02)00106-5 · Cited by 118 · see citing works
Postel, M. G., de Haan, H. A., ter Huurne, E. D., Becker, E. S., & de Jong, C. A. (2010) · Journal of Medical Internet Research · doi:10.2196/jmir.1642 · Cited by 117 · see citing works
Cognitive-motivational predictors of excessive drinkers’ success in changing
Cox, W. M., Pothos, E. M., & Hosier, S. G. (2007) · Psychopharmacology · doi:10.1007/s00213-007-0736-9 · Cited by 103 · see citing works
Screening for Prenatal Substance Use
Yonkers, K. A., Gotman, N., Kershaw, T., Forray, A., Howell, H. B., & Rounsaville, B. J. (2010) · Obstetrics and Gynecology · doi:10.1097/aog.0b013e3181ed8290 · Cited by 90 · see citing works
Vielva, I., & Castillo, I. I. (2001) · Addiction · doi:10.1046/j.1360-0443.2001.96229713.x · Cited by 82 · see citing works
Matching patients with alcohol disorders to treatments: Clinical implications from Project MATCH
Project MATCH Research Group (1998) · Journal of Mental Health · doi:10.1080/09638239817743 · Cited by 80 · see citing works
Rounsaville, B. J., Tierney, T., Crits-Christoph, K., Weissman, M. M., & Kleber, H. D. (1982) · Comprehensive Psychiatry · doi:10.1016/0010-440x(82)90160-2 · Cited by 78 · see citing works
Binary recursive partitioning: Background, methods, and application to psychology
Merkle, E. C., & Shaffer, V. A. (2010) · British Journal of Mathematical and Statistical Psychology · doi:10.1348/000711010x503129 · Cited by 63 · see citing works
Günther, O., Roick, C., Angermeyer, M. C., & König, H. (2006) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2006.07.001 · Cited by 61 · see citing works
Heterogeneity in 12‐month outcome among female and male smokers
Swan, G. E., Javitz, H. S., Jack, L. M., Curry, S. J., & McAfee, T. A. (2004) · Addiction · doi:10.1111/j.1360-0443.2003.00629.x · Cited by 56 · see citing works
Does E-Therapy for Problem Drinking Reach Hidden Populations?
Postel, M. G., de Jong, C. A. J., & de Haan, H. A. (2005) · American Journal of Psychiatry · doi:10.1176/appi.ajp.162.12.2393 · Cited by 53 · see citing works
Riper, H., Kramer, J., Keuken, M., Smit, F., Schippers, G., & Cuijpers, P. (2008) · Journal of Medical Internet Research · doi:10.2196/jmir.1102 · Cited by 52 · see citing works
Predictors Of Drinking Outcomes Among Alcoholics
Staines, G., Magura, S., Rosenblum, A., Fong, C., Kosanke, N., Foote, J. P., & Deluca, A. (2003) · The American Journal of Drug and Alcohol Abuse · doi:10.1081/ada-120018847 · Cited by 47 · see citing works
FIRM: Formal Inference-Based Recursive Modeling
Hawkins, D. M. (1991) · The American Statistician · doi:10.2307/2684385 · Cited by 31 · see citing works
Hellemann, G., Conner, B. T., Anglin, M. D., & Longshore, D. L. (2008) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2008.03.005 · Cited by 28 · see citing works
Blankers, M., Koeter, M. W. J., & Schippers, G. M. (2009) · BMC Public Health · doi:10.1186/1471-2458-9-16 · Cited by 14 · see citing works
Self-citationPredictors of 2-Year Drinking Outcomes in a Swedish Treatment Sample
Bodin, M. C., & Romelsjö, A. (2007) · European Addiction Research · doi:10.1159/000101549 · Cited by 12 · see citing works
[Staging and profiling in addication].
van den Brink, W., & Schippers, G. M. (2012) · PubMed · Cited by 7 · see citing works
Internetprogramm Selbsthilfe Alkohol: Erste Ergebnisse
Blankers, M., Nabitz, U. W., Kerssemakers, R., Schramade, M., & Schippers, G. M. (2008) · SUCHT - Zeitschrift für Wissenschaft und Praxis / Journal of Addiction Research and Practice · doi:10.1024/2008.05.03 · Cited by 3 · see citing works
Self-citationCurbing Problem Drinking in the Digital Galaxy
Riper, H. M. (2008) · Data Archiving and Networked Services (DANS) · Cited by 2 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Riper, H. M., Hoogendoorn, A. W., Cuijpers, P. J., Karyotaki, E., Boumparis, N., Mira, A., Andersson, G., Berman, A. H., Bertholet, N., Bischof, G., et al. (2018) · PLoS Medicine · doi:10.1371/journal.pmed.1002714 · Cited by 283 · see citing works
Self-citationDonkin, L., Hickie, I. B., Christensen, H., Naismith, S. L., Neal, B., Cockayne, N. L., & Glozier, N. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2771 · Cited by 193 · see citing works
Shingleton, R., & Palfai, T. (2015) · Patient Education and Counseling · doi:10.1016/j.pec.2015.08.005 · Cited by 175 · see citing works
Kok, R. N., van Straten, A., Beekman, A. T. F., & Cuijpers, P. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.3429 · Cited by 50 · see citing works
“…significant differences between completers and dropouts may provide valuable information to identify focal points for targeted attrition reduction, although previous efforts to identify nontechnological factors influencing attrition in online interventions have yielded inconclusive results [71-75].”
Symons, M., Feeney, G. F. X., Gallagher, M. R., Young, R. M., & Connor, J. P. (2020) · Addiction · doi:10.1111/add.15038 · Cited by 28 · see citing works
Blankers, M., Frijns, T., Běláčková, V., Rossi, C. R., Svensson, B., Trautmann, F., & van Laar, M. (2014) · PLoS ONE · doi:10.1371/journal.pone.0108298 · Cited by 19 · see citing works
Self-citationDavis, A. K., Arterberry, B. J., Bonar, E. E., Chermack, S. T., Blow, F. C., Cunningham, R. M., & Walton, M. A. (2018) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2018.03.044 · Cited by 15 · see citing works
Predictors of treatment response in a web-based intervention for cannabis users
Jonas, B., Tensil, M.-D., Leuschner, F., Strüber, E., & Tossmann, P. (2019) · Internet Interventions · doi:10.1016/j.invent.2019.100261 · Cited by 12 · see citing works
Rodrigo, H., Beukes, E. W., Andersson, G., & Manchaiah, V. K. C. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-049384 · Cited by 11 · see citing works
Web-based alcohol intervention for veterans: PTSD, combat exposure, and alcohol outcomes.
Brief, D. J., Solhan, M. B., Rybin, D. V., Enggasser, J. L., Rubin, A., Roy, M., Helmuth, E., Schreiner, A. M., Heilman, M. E., Vittorio, L. N., et al. (2017) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/tra0000281 · Cited by 9 · see citing works
Schettini, G., Johansson, M., Andersson, S., Romero, D., Berman, A. H., & Lindner, P. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1486278 · Cited by 2 · see citing works
Sundström, C., Eék, N., Kraepelien, M., Kaldo, V., & Berman, A. H. (2022) · European Addiction Research · doi:10.1159/000527868 · Cited by 2 · see citing works
Olthof, M. I. A., Ramos, L. A., van Laar, M., Goudriaan, A. E., & Blankers, M. (2024) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2024.112431 · Cited by 1 · see citing works
Self-citationAsiakkaan kokemus alkoholin käytön mini-interventiosta
Honkalampi, S. (2015) · Jyväskylä University Digital Archive (University of Jyväskylä)
- Authors
- Blankers, M., Koeter, M. W., & Schippers, G. M.
- Affiliations
- Jellinek (NL)
- Amsterdam Institute for Addiction Research (NL)
- Corresponding author
- Blankers, Matthijs
- Venue
- BMC Public Health
- Published
- 2013-05-07
- Volume
- 13
- Issue
- 1
- Pages
- 455-455
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC3662562
- OpenAlex
- W2171757795
- Cited by
- 14
- References
- 60
- Citations by year
- 2024: 2 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 1 · 2018: 2 · 2017: 1 · 2015: 2 · 2014: 2 · 2013: 1
- FWCI
- 1.21
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Funders
- ZonMw (31160006)
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (036.002.345)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- hazardous drinking, treatment outcome prediction, baseline predictors, recursive partitioning, classification trees, living alone, interpersonal sensitivity, decision support system, screening algorithm, co-living
- MeSH terms
- Adult, Alcoholism, Decision Trees, Female, Humans, Male, Middle Aged, Netherlands, Prognosis, Regression Analysis, Self Care, Cognitive Behavioral Therapy, Treatment Outcome, Internet, Motivational Interviewing
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