Department of Psychology, PATHS Lab, University of Rhode Island, Kingston, Rhode Island, USA.
Alcohol Clin Exp Res. 2022 Jul;46(7):1154-1165. doi: 10.1111/acer.14850. Epub 2022 Jul 29.
Alcohol use disorders (AUDs) are among the most prevalent behavioral and mental health diagnoses. Individuals with an AUD are at increased risk for numerous consequences across their social, health, and psychological functioning. Research suggests that differences may exist in the prevalence and consequences of AUD and in the efficacy of AUD treatment across demographic characteristics (i.e., sex/gender and race/ethnicity). This meta-epidemiologic review examined the inclusion of diverse groups (sex/gender and race/ethnicity) in published randomized controlled trials of nonpharmacological treatments for AUD since 1994, following passage of the National Institutes of Health Revitalization Act of 1993. We systematically searched databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement criteria. The initial search strategy yielded 7931 articles. After excluding ineligible articles, 155 were included in the present review for synthesis. Of the articles included in this review, only 57 (36.8%) fully reported on both their sample's sex/gender and racial/ethnic breakdown. Of the total sample, seven articles specifically examined one racial/ethnic group and 32 specifically examined one sex/gender group. Six articles (3.9%) reported no information regarding the racial/ethnic breakdown of their sample and five articles (3.2%) reported no information regarding the sex/gender breakdown of their participants. Only two articles (1.3%) reported on subgroup analyses that examined differences in treatment outcomes by both sex/gender and race/ethnicity, despite guidelines set forth by NIH. Only 46 articles (29.7%) described the failure to include diverse sex/gender or racial/ethnic groups or concerns about the generalizability of study findings given their sample's sex/gender or racial/ethnic composition as methodological limitations. These results indicate that substantial efforts must be put forth by the scientific community to ensure the inclusion, analysis, and reporting of data focused on women/females and members of minoritized racial/ethnic groups.
酒精使用障碍 (AUDs) 是最常见的行为和精神健康诊断之一。患有 AUD 的个体在其社交、健康和心理功能方面面临着许多后果的风险增加。研究表明，在 AUD 的患病率和后果以及 AUD 治疗的效果方面，可能存在人口统计学特征（即性别和种族/民族）的差异。这项荟萃流行病学综述检查了自 1993 年《国家卫生研究院复兴法案》通过以来，在 1994 年之后发表的非药物治疗 AUD 的随机对照试验中纳入不同群体（性别和种族/民族）的情况。我们按照系统评价和荟萃分析的首选报告项目 (PRISMA) 声明标准系统地搜索了数据库。最初的搜索策略产生了 7931 篇文章。在排除不符合条件的文章后，本综述共纳入 155 篇文章进行综合分析。在本综述中纳入的文章中，只有 57 篇（36.8%）完全报告了其样本的性别和种族/民族细分。在总样本中，有 7 篇文章专门研究了一个种族/民族群体，32 篇文章专门研究了一个性别群体。有 6 篇文章（3.9%）没有报告其样本的种族/民族细分信息，有 5 篇文章（3.2%）没有报告其参与者的性别细分信息。尽管 NIH 制定了指导方针，但只有两篇文章（1.3%）报告了按性别和种族/民族对治疗结果进行亚组分析的结果，仅 46 篇文章（29.7%）描述了未能纳入不同性别/民族或种族/民族群体，或由于样本的性别/民族或种族/民族构成而对研究结果的普遍性存在担忧，这些被视为方法学局限性。这些结果表明，科学界必须做出巨大努力，确保纳入、分析和报告重点关注女性/女性和少数种族/民族群体的数据。
