Assessment may conceal therapeutic benefit: findings from a randomized controlled trial for hazardous drinking
Assessment may conceal therapeutic benefit: findings from a randomized controlled trial for hazardous drinking
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DOI：
10.1111/j.1360-0443.2006.01632.x
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发表时间：
2007-01-01
期刊：
影响因子：
6
通讯作者：
Cashell-Smith, Martine L.
中科院分区：
文献类型：
--
作者：
Kypri, Kypros;Langley, John D.;Cashell-Smith, Martine L.
对一个人的健康状况进行评估而不采取后续干预措施，这一概念本身就具有有益的效果，这一概念激发了人们对潜在的心理机制、方法影响及其公共卫生潜力的极大兴趣。然而，关于评估效果的实验研究很少。为了检验评估本身能减少危险饮酒的假设，（A组，仅瓣叶; B组，2003年3月至4月入组的一项四臂随机对照试验，共975名学生参加初级卫生保健诊所的17-29岁的妇女完成了基于网络的酒精使用障碍识别测试（AUDIT）问卷。在599名得分>= 8576的患者中，有293人（153名女性）同意接受随访并被纳入完整的四组试验，其中293人（153名女性）被分配到A组和B组。B组在4周后接受宣传单和10 min的网络评估，评估饮酒频率、典型饮酒量、重度饮酒频率、个人问题和学业问题，A组和B组基线平均AUDIT评分分别为15.0（SD = 5.4）和14.9（SD = 5.0）。基线后12个月，相对于A组，B组报告的总消耗量较低（几何均值比0.82，95% CI：0.68-0.98），酗酒事件减少（0.66，0.47-0.91）、较少的问题（0.81，0.67-0.99）和较低的AUDIT评分（β =-1.63，-0.62至-2.65）。因此，依赖于评估的对照试验可能会低估治疗效果。局限性包括由于社会期望偏差导致的测量伪影的可能性。
The concept that assessment of a person's health status without subsequent intervention has beneficial effects in itself has stimulated much interest in underlying psychological mechanisms, methodological implications and its public health potential. There have, however, been few experimental studies of assessment effects.To test the hypothesis that assessment in itself produces a reduction in hazardous drinking.Two conditions (group A, leaflet only and group B, leaflet and assessment but no intervention) of a four-arm randomized controlled trial with enrolment in March-April 2003.A total of 975 students (17-29 years) attending a primary health-care clinic completed a web-based Alcohol Use Disorders Identification Test (AUDIT) questionnaire. Of 599 who scored >= 8576 consented to follow-up and were included in the full four-arm trial, of whom 293 (153 women) were assigned to groups A and B.Group A received an information leaflet at baseline. Group B received the information leaflet and 10 minutes of web-based assessment 4 weeks later.Drinking frequency, typical quantity, heavy episode frequency, personal problems and academic problems.Baseline mean AUDIT scores were 15.0 (SD = 5.4) and 14.9 (SD = 5.0) in groups A and B, respectively. Twelve months after baseline, relative to group A, group B reported lower overall consumption (geometric means ratio 0.82, 95% CI: 0.68-0.98), fewer heavy drinking episodes (0.66, 0.47-0.91), fewer problems (0.81, 0.67-0.99) and lower AUDIT scores (beta = -1.63, -0.62 to -2.65).Brief assessment appeared to reduce hazardous drinking. Controlled trials that rely on assessment may therefore underestimate treatment effects. Limitations include the possibility of measurement artefact due to social desirability bias.