Table 2.
SOE, by Outcome Domains*
| Outcome | SOE Domains
|
6-mo Effect Estimate (95% CI); Trial Composition | SOE | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Studies, n | Patients, n | Study Design | Risk of Bias | Consistency | Directness | Precision | Publication Bias | |||
| E-intervention vs. control in persons who screened positive for alcohol misuse | ||||||||||
|
| ||||||||||
| Alcohol consumption (g/wk) | 18 | 7484 | RCT | Moderate | Consistent | Direct | Precise | None detected | MD, −16.7 g/wk (−27.6 to −5.8 g/wk)†; 5 trials of adults | Moderate |
| MD, −11.7 g/wk (−19.3 to −4.1 g/wk); 11 trials of students | Moderate | |||||||||
|
| ||||||||||
| Alcohol consumption (met limits) | 5 | 4313 | RCT | Low | Some inconsistency | Direct | Imprecise | None detected | RR, 1.22 (0.79 to 1.89); 4 trials of adults | Low |
| OR, 1.53 (1.09 to 2.17); 1 trial of students | Low | |||||||||
|
| ||||||||||
| Alcohol consumption (binge drinking) | 7 | 5043 | RCT | Low | Some inconsistency | Some indirectness | Precise | None detected | Difference, −1.9% (−10.4% to 6.6%) (49) β, 0; SE, 0.01 (48); 2 trials of adults |
Moderate |
| MD, −0.1 episodes (−0.6 to 0.4 episodes); 5 trials of students | Moderate | |||||||||
|
| ||||||||||
| Alcohol social problems | 11 | 5234 | RCT | Low | Some inconsistency | Some indirectness | Precise | None detected | β, 0.24; SE, 0.41; 1 trial of adults | Low |
| SMD, 0 (−0.10 to 0.10); 10 trials of students | Moderate | |||||||||
| E-intervention vs. control in persons with an AUD | ||||||||||
|
| ||||||||||
| Alcohol consumption | 3 | 533 | RCT | Moderate | Consistent | Direct | Imprecise | None detected | Increase in abstinence for adults with smartphone e-intervention: OR, 1.94 (1.14 to 3.31) | Low |
| No difference with IVR or computerized feedback | Insufficient | |||||||||
|
| ||||||||||
| Alcohol social problems | 2 | 409 | RCT | Moderate | NA | Direct | Imprecise | None detected | No difference in adults | Low |
AUD = alcohol use disorder; e-intervention = electronic intervention; IVR = interactive voice response; MD = mean difference; NA = not applicable; OR = odds ratio; RCT = randomized, controlled trial; RR = relative risk; SMD = standardized mean difference; SOE = strength of evidence.
*
When evaluating the overall strength of evidence, we considered a difference of 3 standard U.S. drinks/wk or an SMD ≥0.4 as clinically significant and defined precise effects as those with 95% CIs that excluded smaller effects.
†
Results are from a sensitivity analysis that included only trials rated as low to moderate risk of bias because this analysis produced a more precise estimate.