. 2020 Sep 3;2020(9):CD007668. doi: 10.1002/14651858.CD007668.pub3

Marlowe 2007.

*Study characteristics*
Methods	Design: parallel randomised controlled trial
Participants	Participants: adults charged with a drug‐related offence and admitted to a pre‐adjudication court Sex: (for whole sample^a) 75% males; 25% females Age: (for whole sample^a) mean = 25.1 years (SD = 8.4) Unit of allocation: individual participant Number randomised: 279 (for sample as a whole; no details for AsPD subgroup^a) Number completing: no details for AsPD subgroup^a Setting: outpatient; single site; urban; USA (Wilmington, Delaware) Inclusion criteria: at least 18 years old; admitted to a misdemeanour (pre‐adjudication) drug court located in Wilmington, Delaware, USA; having pleaded guilty to the initial charge (the plea of guilty was held in abeyance pending graduation or termination from the programme); charged with possession or consumption of cannabis, possession of drug paraphernalia, possession of hypodermic syringes, or driving under the influence; resident in New Castle County, Delaware or committed his/her offence there Exclusion criteria: having a history of a violent offence involving serious injury to a victim or use of a deadly weapon Ethnicity: (for whole sample^a) white (60%); African American (35%) Baseline characteristics: (for whole sample^a) unmarried (94%); employed (66%); currently abusing cannabis (68%); currently abusing alcohol to intoxication (47%); currently abusing stimulants or cocaine (14%), opiates (13%) or hallucinogens (3%)
Interventions	Two conditions: optimal (‘matched’) schedule of court hearings; or standard (‘unmatched’) schedule court hearings Experimental group (n = 137 randomised for whole sample; n = not reported for AsPD subgroup^a): optimal (‘matched’) schedule of court hearings Control group (n = 142 randomised for whole sample; n = not reported for AsPD subgroup^a): standard (‘unmatched’) schedule of court hearings Details of conditions: Optimal (‘matched’) schedule of court hearings in which frequency of court attendance was matched with risk, so that high‐risk offenders (those with AsPD and a history of drug treatment) attended with greater frequency. Group sessions were psychoeducational and covered a range of topics including relapse prevention strategies. Minimum requirements for graduation from the programme were attending at least 12 weekly group counselling sessions, providing at least 14 consecutive weekly drug‐negative urine specimens, remaining arrest‐free, obeying programme rules and paying a USD 200 court fee. Standard (‘unmatched’) schedule of court hearings required attendance every 4 to 6 weeks. Duration of intervention: minimum 14 weeks, although clients required on average approximately 9 months to satisfy all the conditions for graduation Duration of trial: 15 months (9 months to graduation plus 6 months post‐discharge) Length of follow‐up: 6 months post‐discharge
Outcomes	Primary outcomes Reconviction: as recorded in Criminal Justice System databases up to 24 months post‐admission to programme Adverse events: "no study‐related adverse event was reported to date" (quote; p 56, column 1) Secondary outcomes Substance misuse (drugs): data from Addiction Severity Interview, including days of drug use, days any drug use, days alcohol intoxication; any criminal activity; drug screen by urinalysis Leaving the study early: proportion of participants discontinuing treatment
Notes	^aInvestigators used diagnosis of AsPD as one criterion in the assessment of risk. Diagnosis of AsPD was via an antisocial personality disorder interview derived from SCID‐II. Characteristics of, and outcomes for, this subgroup have been requested from trial investigators. Study funding: National Institute on Drug Abuse Declaration of interests: none
*Risk of bias*
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Comment: No information given. Insufficient reporting to permit judgement of Yes or No. Clarification has been requested from the trial investigators, but no further information was available at the time this review was prepared.
Allocation concealment (selection bias)	Unclear risk	Comment: No information given. Insufficient reporting to permit judgement of Yes or No. Clarification has been requested from the trial investigators, but no further information was available at the time this review was prepared.
Blinding (performance bias and detection bias) of participants	Unclear risk	Comment: In a study such as this, full blinding is difficult to achieve because participants would be aware whether or not they were participating in a psychological intervention and may also be aware of the nature of this intervention. The review authors judged that it would thus not be possible to fully blind participants in this type of study. We found no indication of any specific additional measures taken to reduce the risk of bias that might result from differential behaviours by participants.
Blinding (performance bias and detection bias) of personnel	Unclear risk	Comment: In a study such as this, full blinding is difficult to achieve because personnel would be aware whether or not they were participating in a psychological intervention and may also be aware of the nature of this intervention. The review authors judged that it would thus not be possible to fully blind personnel in this type of study.
Blinding (performance bias and detection bias) of outcome assessors	Unclear risk	Comment: Insufficient information to allow a judgement to be made. Clarification about blinding of outcome assessors has been requested from the trial investigators, but no further information was available at the time this review was prepared.
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Comment: Unclear whether there were missing outcome data for the AsPD subgroup and, if so, whether the numbers of and reasons for such missing data were balanced across intervention groups. Review authors unable to make a judgement unless data from AsPD subgroup were available
Selective reporting (reporting bias)	Low risk	Comment: Review authors judged that the published report included all expected outcomes, including those that were prespecified.
Other bias	Unclear risk	Comment: Review authors unable to judge unless data from the AsPD subgroup become available. It is important to note, however, that the diagnosis of AsPD was via an 'antisocial personality disorder interview' derived from SCID‐II by the trial investigators, but with no evidence that this has been validated. This may have introduced bias.