Reduction of Alcohol Consumption and Subsequent Mortality in Alcohol Use Disorders
Bibliographic record
Abstract
Article AbstractObjective: To determine whether a reduction in drinking in individuals with alcohol use disorders resulted in reduced mortality risk.Data Sources: Electronic searches were performed of MEDLINE, EMBASE, and ISI Web of Science and references of identified articles were searched up to May 2012 using these keywords: (alcohol dependence OR alcohol abuse) AND (mortality) AND (cohort OR follow-up). Only English-language articles were included.Study Selection: Sixteen cohort studies were identified that reported all-cause mortality risk by drinking groups measuring change in alcohol intake among people with alcohol use disorders.Data Extraction: Numbers of participants and deaths in each group; odds ratios (ORs); and demographic, clinical, and methodological variables were extracted.Results: In comparison to continued heavy drinking, a reduction below heavy levels of alcohol use (including abstention) was associated with a substantially reduced risk of mortality (random-effects pooled OR = 0.41; 95% CI, 0.34-0.50; P < .001). The OR was 0.35 (95% CI, 0.20-0.60; P < .001) for those who reached abstention and 0.61 (95% CI, 0.39-0.94; P = .026) for those who did not reach abstention but substantially reduced their consumption. The pooled OR for abstention compared to reduced consumption was 0.42 (95% CI, 0.19-0.92; P = .031). Meta-regression models did not reveal significant influences of study characteristics examined.Conclusions: Reduction of drinking in alcohol use disorders was associated with a marked reduction in mortality risk for those who reached abstinence or reduced drinking compared to continued heavy drinkers. Those who reached abstention showed the smallest mortality risk, lower than the risk for reduced consumption without abstinence.J Clin Psychiatry 2013;74(12):e1181-e1189© Copyright 2013 Physicians Postgraduate Press, Inc.Submitted: January 17, 2013; accepted August 20, 2013 (doi:10.4088/JCP.13r08379).Corresponding author: Michael Roerecke, PhD, Social and Epidemiological Research Department, Centre for Addiction and Mental Health (CAMH), 33 Russell St, Toronto, ON, M5S 2S1, Canada (m.roerecke@web.de).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.024 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".