Alcohol treatment outcome evaluation methodology: State of the art 1980–1984 (original) (raw)
Related papers
Alcohol treatment outcome methodology: State of the art 1989–1993
Addictive Behaviors, 1997
This article reviews the 61 alcohol treatment outcome studies published from 1989-1993 with respect to methodology. Although better assessment of subjects' pretreatment characteristics was noted, a minority of studies met even the basic requirements of experimental studies. Further. some reversals of methodological progress were observed in several areas. particularly in collecting outcome data from multiple sources. It is suggested that funding agencies and journal editors require that submissions meet minimum standards for adequate outcome evaluation. We would like to thank Karen Hobdon and Mariella DeFilippo for their assistance with this project. Requests for reprints should be sent to Curtis Breslin.
Addictive Behaviors
Although several critiques of the methodology of alcohol treatment outcome studies have been published, similar reviews of the methodology of drug treatment outcome studies are lacking. This paper reviews the methodology of drug treatment outcome studies published from 1993 through 1997 and draws comparisons with the most recent methodological review of alcohol treatment outcome studies. Each drug study was evaluated as to whether the following types of data were reported: (1) demographic, (2) drug use, (3) study characteristics, and (4) outcome and follow-up information. Although results for drug studies showed some areas of strength compared to alcohol studies, in general, the weaknesses were similar to or worse than in the alcohol field, including inadequate reporting of demographic and drug use variables. Weaknesses in follow-up procedures were particularly notable. Suggestions for improving the reporting of methodological and outcome variables for drug treatment outcome studies...
Issues in the definition and measurement of drinking outcomes in alcoholism treatment research
Journal of Studies on Alcohol, Supplement, 1994
This article reviews methodological and conceptual issues regarding the choice of drinking outcome measures in alcoholism treatment research. The following issues are discussed: Should drinking outcomes be conceptualized in terms of an underlying unitary disorder, or should provision be made for independent outcomes that cover a wide variety of dimensions? Which drinking outcomes are typically measured in treatment evaluation studies and how are they operationalized? What are the empirical associations among drinking outcome measures? If multiple outcomes are measured, which should be given primary importance? Over what period of time should treatment outcome be evaluated? What procedures can be used to detect, correct or prevent the response bias associated with verbal report methods? Because outcome measures need to fit the hypotheses and practical needs of a particular study, it is unlikely that complete standardization can be achieved across all studies. Nevertheless, given the importance of drinking outcomes and the need for economy, two primary dependent measures are recommended: (1) proportion of available drinking days abstinent; and (2) intensity of drinking, as defined by the total amount consumed (in ounces absolute alcohol) during the follow-up period divided by the number of actual drinking days. This article also proposes a strategy that may help to guide the selection of outcome measures in future research. (J. Stud. Alcohol, Supplement No. 12:101-111, 1994) N A 1988 EDITORIAL, Arnold Relman stated, "We can no longer afford to provide health care without knowing more about its successes and faiIures." Applying this admonition to the treatment of alcoholism, the Institute of Medicine (1990, p. 326) recommended that "consensus must be achieved on the need for outcome determination, on the parameters to be used in determining outcome, and on the optimal way(s) to go about making outcome determinations." The goal of this article is to review methodological and conceptual issues regarding the choice of alcohol-related outcome measures in alcoholism treatment research. Alcoholrelated outcomes are the measures of drinking behavior, alcohol dependence symptoms and alcohol-related consequences that are directly attributable to drinking following treatment. A secondary goal of this article is to suggest ways that greater standardization could be introduced to the planning, execution and reporting of treatment research. Because
Methodological and Statistical Considerations in Measuring Alcohol Treatment Effects
Alcoholism: Clinical & Experimental Research, 2003
This article addresses the design and selection of outcome methods for treatment research from a statistical perspective. Two of the major statistical and methodological issues relevant to the selection of dependent variable(s) are statistical power and social utility. Power is the paramount issue in research design. Power can be improved by measures and methods tailored to the predicted effects of treatment. These effects should vary from treatment to treatment, suggesting that no single outcome measure is suitable for all purposes. In estimating power, researchers should also consider the time-varying nature of most types of treatment effects. Given these considerations, timeline procedures have advantages because they allow the derivation of measures linked to specific treatment components. They also permit the study of time-varying effects of variables such as life stress. An analysis on the relationship between drinking and self-reported stress is presented as an illustration of how advanced statistical methods, in conjunction with carefully gathered data, can provide process data on how treatment can affect individual responses to stressors or other events. From a social utility perspective, however, having research focus on narrower and narrower slices of behavior in the search for power raises questions about the value of this research to clients and society. For dealing with this dilemma, it will be necessary to build a series of studies linking improvement in specific aspects of short-term outcome to longer term outcome and ultimately benefit to society.
Addictive Behaviors, 2009
Whilst many instruments have been developed for screening and treatment outcome evaluation studies in the alcohol and other drug treatment (AOD) sector, very few are suitable for routine, ongoing use by clinicians. The aim of the current study was to assess the psychometric properties of the Alcohol Treatment Outcome Measure (ATOM). The ATOM was designed to measure the key outcomes of alcohol treatment whilst remaining a brief and easy to use clinical tool. Participants (N = 134) with a concern for their alcohol use were recruited from AOD treatment agencies and interviewed on two occasions one week apart. Results indicate that the ATOM has overall good to excellent test–retest and inter-rater reliability; and satisfactory concurrent validity and internal reliability. The instrument also demonstrated the ability to measure change in client functioning over time. Results suggest that the ATOM can be used successfully and confidently within alcohol treatment services.
Bridging the gap between alcoholism treatment research and practice: Identifying what works and why
… Psychology: Research and …, 2001
Despite the proliferation of alcoholism treatment research over the past 2 decades, there is a continued gap between what has been shown to be promising in the extant literature and what is commonly practiced by clinicians in the alcohol treatment field. The present article is an effort to bridge this gap by examining findings from the broad body of alcoholism treatment outcome research to determine how these findings may optimally be used by treatment providers. To this end, the authors provide clinicians with a succinct review of the current alcoholism treatment outcome literature and identify hallmarks of the most empirically supported treatments. Clinical implications of this literature for practitioners working with client with alcohol use disorders are discussed, with a focus on factors underlying effective treatments and on how these factors can be transferred from research to practice.
Clinical and Methodological Utility of a Composite Outcome Measure for Alcohol Treatment Research
Alcoholism: Clinical & Experimental Research, 2003
Background: How to capture different response patterns resulting from alcohol treatment has been a troublesome issue for alcohol researchers. A composite measure is one approach to capturing multiple treatment outcomes among diverse client populations. This article provides the rationale, development, and work conducted thus far on the composite outcome index and discusses the clinical utility of the measure.