***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A study was performed to evaluate the extent to which the medical literature may be misleading as a result of selective publication of r and omized clinical trials ( RCTs ) with results showing a statistically significant treatment effect . Three hundred eighteen authors of published trials were asked whether they had participated in any unpublished RCTs .  The 156 respondents reported 271 unpublished and 1041 published trials . Of the 178 completed unpublished RCTs with a trend specified , 26 ( 14 % ) favored the new therapy compared to 423 of 767 ( 55 % ) published reports ( p less than 0.001 ) . For trials that were completed but not published , the major reasons for nonpublication were " negative " results and lack of interest . From the data provided , it appears that nonpublication was primarily a result of failure to write up and su bmi t the trial results rather than rejection of su bmi tted manuscripts . The results of this study imply the existence of a publication bias of importance both to meta- analysis and the interpretation of statistically significant positive trials AIM To evaluate three different intervention programmes for spouses of alcoholics . METHODS 39 spouses of alcoholics ( 36 women and 3 men ) with an average age of 47 years ( ranging from 23 to 60 years ) were r and omly assigned to one of the three interventions : Coping Skills Training , Group Support , and Information . Follow-up interviews were conducted 12 and 24 months after completing the programme . Coping Behaviour Scale , Symptom Checklist 90 ( SCL-90 ) , Hardship Scale and AUDIT at admission and at follow-up were compared . 38 of the 39 spouses completed the 24-month follow-up examination . RESULTS Improvements of coping behaviour , psychiatric symptoms and hardship noted at the 12-month follow-up examination were still evident in all groups at the 24-month follow-up examination . The three groups scored similarly at 24 months on the four scales . CONCLUSIONS A post hoc examination of subjects with SCL-90 scores above general population means , showed less improvement in the Information group than the two therapy groups combined ( P < 0.05 ) Background : Alcohol abuse serves as a chronic stressor between partners and has a deleterious effect on relationship functioning . Behavioral Couples Therapy ( BCT ) for alcohol dependence , studied as an adjunct to individual outpatient counseling , has shown to be effective in decreasing alcohol consumption and enhancing marital functioning , but no study has directly tested the comparative effectiveness of st and -alone BCT versus an individually focused cognitive-behavioral therapy ( CBT ) in a clinical community sample . Methods : The present study is a r and omized clinical trial evaluating the effectiveness of st and -alone BCT ( n = 30 ) compared to individual CBT ( n = 34 ) in the treatment of alcohol use disorders in community treatment centers in Dutch male and female alcoholics and their partners . Results : Results show both BCT and CBT to be effective in changing drinking behavior after treatment . BCT was not found to be superior to CBT .  Marital satisfaction of the spouse increased significantly in the BCT condition but not in the CBT condition , the differences being significant at the post-test . Patients ’ self-efficacy to withst and alcohol-related high-risk situations increased significantly in both treatment conditions , but more so in CBT than in BCT after treatment . Treatment involvement of the spouse did not increase retention . Conclusion : Regular practitioners in community treatment centers can effectively deliver both treatments . St and -alone BCT is as effective as CBT in terms of reduced drinking and to some extent more effective in terms of enhancing relationship satisfaction .  However , BCT is a more costly intervention , given that treatment sessions lasted almost twice as long as individual CBT sessions OBJECTIVE The aims of this study were to test if outcomes would be different when family members of alcohol-dependent individuals were included in intervention and to examine the factors associated with relapse during a 6-month follow-up period . METHOD Ninety male participants admitted for 3 weeks at an inpatient facility in India were r and omly assigned to individual relapse prevention ( IRP ) , dyadic relapse prevention ( DRP ) , and treatment as usual ( TAU ) , with 30 participants in each group . In IRP , intervention was administered to the individual participant . In DRP , both the participant and a family member were included in intervention . In all three conditions , family members stayed in the facility with participants . Participants were followed up for 6 months after discharge from the treatment center . RESULTS DRP consistently performed better than TAU on all of the outcomes ( reduction in quantity of alcohol , drinking days , and number of days with dysfunction in family , occupational , and financial dimensions ) . DRP participants also reported a significant reduction in the quantity of alcohol , drinking days , and family problems , compared with IRP . Results of Cox regression showed that being in IRP/TAU groups , early-onset dependence ( < 25 years ) , and paternal history of alcohol dependence were associated with relapse after adjusting for baseline alcohol use and other covariates . CONCLUSIONS Findings provide evidence for the effectiveness of Western-based family-oriented intervention for alcohol-dependent patients in India ; also , findings might help to alert treatment providers that some subsets of alcohol users might need more tailored interventions and rigorous monitoring during follow-up The purpose of this study was to examine the clinical efficacy and cost effectiveness of brief relationship therapy ( BRT ) , a shortened version of st and ard behavioral couples therapy ( S-BCT ) , with alcoholic male patients ( N = 100 ) and their nonsubstance-abusing female partners . Participants were r and omly assigned to 1 of 4 treatment conditions : ( a ) BRT , ( b ) S-BCT , ( c ) individual-based treatment ( IBT ) , or ( d ) psychoeducational attention control treatment ( PACT ) . Equivalency testing revealed that , compared with those assigned to S-BCT , participants who were r and omly assigned to BRT had equivalent posttreatment and 12-month follow-up heavy drinking outcomes . Moreover , at 12-month follow-up , heavy drinking and dyadic adjustment outcomes for patients who received BRT were superior to those of patients who received IBT or PACT . BRT was significantly more cost effective than the S-BCT , IBT , or PACT This study evaluated the effects of alcohol-focused spouse involvement and behavioral couples therapy ( BCT ) in group drinking reduction treatment for male problem drinkers . Sixty-four male clients and their female partners were r and omly assigned to 1 of 3 conditions : treatment for problem drinkers only ( PDO ) , couples alcohol-focused treatment , or the latter combined with BCT . Clients whose partners were included in treatment evidence d fewer heavy drinking days and more abstinent/light drinking days in the year following treatment , relative to PDO clients . The combination of alcohol-focused spouse involvement and BCT yielded no better outcomes than alcohol-focused spouse involvement alone . Drinking consequences , spouse behavioral support for drinking reduction , and relationship satisfaction showed no effects of treatment condition Our goal was to explore , through a Stage I NIH clinical study , the effectiveness of a manual‐driven , timely response method for helping the “ concerned other ” get resistant substance abusers into treatment/self‐help with minimum professional time/effort . A manual‐driven protocol , “ A Relational Sequence for Engagement ( ARISE ) , ” was applied with 110 consecutive , initial calls/contacts from concerned others ; no cases excluded for research , refusal , or other reasons . The research was conducted at two upstate New York outpatient drug/alcohol clinics . Participants were concerned others who called regarding a cocaine , alcohol , or “ other drug ” abuser ( N = 110 ) ; participating family/friends : 11 ARISE clinicians ; and 110 substance abusers . ARISE is a graduated continuum starting with the least dem and ing option/stage , increasing effort as needed to engage substance abusers in treatment/self‐help . Stage I : Coaching the concerned other to arrange a meeting of significant others , inviting the substance abuser ; Stage II : 1 to 5 additional meetings ( median = 2 ) ; Stage III : A modified Johnson “ Intervention . ” Primary outcome variables were substance abuser engagement ( or not ) in treatment/self‐help ; days between first call and engagement ; clinician time/effort . Predictors were concerned other , substance abuser , and clinician demographics ; number of participants per case ; and Collateral Addiction Severity Index . ARISE result ed in an 83 % success rate ( 55 % at Stage I ) . Median days to engagement was 7 ( IQR = 2 to 14 ) . Average total time ( telephone , sessions ) per case was 1.5 hours . Treatment/self‐help chosen was 95 % treatment and 5 % self‐help . Number of family/friends involved correlated 0.69 with a success/efficiency index . Conclusions . A call from a family member or concerned other for help in getting a loved one into treatment is a rich opportunity for treatment professionals and agencies to engage substance abusers in treatment . These initial calls are similar to referral calls from EAPs or probation officers looking to get an individual started in treatment . ARISE provides an effective , swift , and cost‐efficient option for engaging substance abusers in treatment or self‐help . The more significant others involved , the greater the success of treatment engagement OBJECTIVES A r and omized trial to compare two levels of an intervention ( full versus brief ) for use by primary health-care professionals with family members affected by the problematic drug or alcohol use of a close relative . DESIGN A prospect i ve cluster r and omized comparative trial of the two interventions . SETTING A total of 136 primary care practice s in two study areas within the West Midl and s and the South West regions of Engl and . PARTICIPANTS A total of 143 family members affected by the alcohol or drug problem of a relative were recruited into the study by primary health-care professionals . All recruited family members were seen on at least one occasion by the professional delivering the intervention and 129 ( 90 % ) were followed-up at 12 weeks . MAIN OUTCOME MEASURES Two vali date d and st and ardized self-completion question naires measuring physical and psychological symptoms of stress ( Symptom Rating Test ) and behavioural coping ( Coping Question naire ) experienced by the family members . It was predicted that the full intervention would show increased reduction in both symptoms and coping when compared to the brief intervention . RESULTS The primary analysis adjusted for clustering , baseline symptoms and stratifying variables ( location and professional group ) showed that there were no significant differences between the two trial arms . The symptom score at follow-up was 0.23 [ 95 % confidence interval ( CI ) : -3.65 , + 4.06 ] higher in the full intervention arm than in the brief intervention arm , and the coping score at follow-up was 0.12 ( 95 % CI : -5.12 , + 5.36 ) higher in the full intervention arm than in the brief intervention arm . CONCLUSIONS A well-constructed self-help manual delivered by a primary care professional may be as effective for family members as several face-to-face sessions with the professional Alcohol-dependent patients in inpatient detoxification were r and omized to treatment-as-usual ( TAU ) intervention or brief family treatment ( BFT ) intervention to promote continuing care postdetoxification . BFT consisted of meeting with the patient and an adult family member ( in person or over the phone ) with whom the patient lived to review and recommend potential continuing care plans for the patient . Results showed that BFT patients ( n = 24 ) were significantly more likely than TAU patients ( n = 21 ) to enter a continuing care program after detoxification . This was a medium to large effect size . In the 3 months after detoxification , days using alcohol or drugs ( a ) trended lower for treatment-exposed BFT patients who had an in-person family meeting than for TAU counterparts ( medium effect ) , and ( b ) were significantly lower for patients who entered continuing care regardless of treatment condition ( large effect ) Women ( N=171 ) , distressed from their partners ' untreated alcoholism , received either coping skills training ( CST ) , 12-step facilitation ( TSF ) , or delayed treatment ( DTC ) . CST and TSF result ed in lower depression levels than DTC but did not differ from one another . Skill acquisition mediated the treatment effects of CST ; Al-Anon attendance did not mediate the TSF effect . Lower depression levels were maintained at 12 months with no differences between groups .  Partner drinking decreased from pretreatment to follow-up in the CST and TSF conditions . However , for partners with a history of relationship violence , drinking improved across follow-up in the CST condition but worsened in the TSF condition . Partner relationship violence was less in the CST condition . CST may be particularly useful for women experiencing physical violence from a partner with alcoholism This study evaluated the efficacy of Integrated Family and Cognitive-Behavioral Therapy ( IFCBT ) , a multisystems treatment for adolescent drug abuse , versus a Drugs Harm Psychoeducation curriculum ( DHPE ) . A r and omized controlled trial assessed youth and parents at baseline and at 1 , 3 and 6-month posttreatment points . Youth participants ( N=43 ) met diagnostic criteria for one or more psychoactive substance use disorders with most youth meeting criteria for alcohol and marijuana use disorders .  IFCBT produced significant reductions in posttreatment substance use when compared against DHPE . Throughout the 6-month posttreatment period , youth receiving IFCBT  used alcohol an average of 2.03 days each month , which was significantly lower than the average number of 6.06 days that DHPE youth used alcohol during the same period . Similarly , youth receiving IFCBT  used marijuana an average of 5.67 days each month during the initial 6 posttreatment months which was also significantly lower than the average number of 
    Output:
    
The evidence for the effectiveness of  family-based alcohol interventions is less than optimal , although the review ed studies did show improved outcomes .