Finney J W
Center for Health Care Evaluation, VA Palo Alto Health Care System, Menlo Park, CA 94025, USA.
Addiction. 2000 Oct;95(10):1491-500. doi: 10.1046/j.1360-0443.2000.951014914.x.
In recent years, substantial efforts have been made to identify "best practices" and develop comprehensive practice guidelines for the treatment of various psychiatric disorders and medical conditions, based on systematic, often quantitative reviews of the existing intervention research. There probably are more than 300 comparative treatment trials that have been conducted in the alcohol field. With this large body of research, one might think the development of alcohol treatment guidelines would be a straightforward task. Unfortunately, that is not the case. Four problems are discussed with the "box-score" reviews that have been conducted thus far to identify effective alcohol treatment modalities. At least two of these problems are fundamental barriers to determining the relative efficacy or effectiveness of alcohol treatment modalities even in "meta-analyses" with "effect sizes". These impediments are discussed, as is how future alcohol treatment trials could be conducted so that their findings would more readily inform practice guidelines.
近年来，人们付出了巨大努力来确定“最佳实践”，并基于对现有干预研究的系统（通常是定量）综述，制定针对各种精神疾病和医疗状况的综合实践指南。在酒精领域可能已经进行了300多项比较治疗试验。有了如此大量的研究，人们可能会认为制定酒精治疗指南是一项简单的任务。不幸的是，情况并非如此。本文讨论了迄今为止为确定有效的酒精治疗方式而进行的“计分”综述存在的四个问题。其中至少有两个问题是确定酒精治疗方式相对疗效或有效性的基本障碍，即使在有“效应量”的“荟萃分析”中也是如此。本文将讨论这些障碍，以及未来的酒精治疗试验应如何进行，以便其研究结果能更直接地为实践指南提供信息。
