PubMed Health⌕ Search

Biomedical subjects

B McRee

Publications and source records attributed to B McRee.

6 recordsLinked to original sources
PubMed1998

Compliance with treatment and follow-up protocols in project MATCH: predictors and relationship to outcome.

Treatment and follow-up session attendance data from Project MATCH, a multisite clinical trial investigating patient-treatment matching, were analyzed to study compliance. High rates of compliance to both therapy and research protocols were achieved, enhancing treatment integrity and data quality. Strong baseline predictors of compliance did not emerge, and the small relationships found were consistent with reports from previous studies. Attendance at therapy sessions was moderately correlated with research follow-up participation. Treatment compliance predicted drinking outcome, underscoring the importance of retaining patients in treatment. Future studies should examine the associations between compliance and structural features of the treatment environment, treatment delivery, and context-features that are often under the control of the clinician/investigator.

Adult↗
PubMed1997

Estimating measurement error in alcohol dependence symptomatology: findings from a multisite study.

Inter-rater test-retest reliability of alcohol diagnoses and symptom ratings, made by means of a modified version of the Structured Clinical Interview for DSM-III-R (SCID), were evaluated in the context of a multisite clinical trial of alcoholism treatment. Reliability coefficients for the subject's 'worst period' and the 'current period' were compared. The results show that with proper training, reliable diagnostic classification can be achieved across multiple sites. Symptom reliabilities for the current period were higher than the worst period. Respondents with higher discrepancies between test and retest tended to drink more on each drinking occasion, reported more medical detoxifications, changed residence more often, had lower occupational status and were rated by the interviewer as less attentive, motivated and intelligent. Methods to monitor and improve the reliability of diagnostic interviews in addiction research, particularly in multisite studies, are discussed in relation to the findings.

Adult↗
PubMed1997

Alcohol screening and brief intervention: where research meets practice.

Numerous studies have consistently shown that quick screening instruments can identify people whose drinking is likely to present health risks and that low-cost, brief interventions are effective in reducing drinking among many such at-risk drinkers. This article describes the results of a one-year policy analysis that explored how alcohol screening and brief intervention (SBI) can be moved to widespread clinical applications in the United States. It introduces the concept of risky drinking and considers the potential of this new technology to reduce it. The research evidence behind this approach is reviewed, and a description of current programs in this and other countries beginning to apply SBI is provided. Economic issues attendant to applications are identified and discussed. The potential for applications in health care is analyzed and summary conclusions from market research are set forth. Recommendations are offered for immediate action.

Alcoholism↗
PubMed1994

Reliability enhancement and estimation in multisite clinical trials.

Clinical trials, particularly those in addictions research, often rely on self-report data for primary dependent variables, and it is imperative to evaluate and to minimize both random and systematic error. This article describes methods for enhancing and assessing reliability of measurement in multisite clinical research. It begins with an overview of the two major approaches to evaluating the reliability of psychiatric diagnosis and verbal self-reports. A model of the interview process is then described, and the major sources of inconsistency that arise in the data collection process are identified. Based on the model, staff selection criteria, training techniques and quality assurance procedures are recommended for enhancing the reliability of interview assessments, and a research design appropriate for evaluating reliability in multisite clinical investigations is proposed.

Alcoholism↗
PubMed1994

Issues in the development of subject recruitment strategies and eligibility criteria in multisite trials of matching.

Decision-making in selecting and recruiting subjects for treatment matching research is a complex process involving conceptual, methodological and practical considerations. In selecting clients, concerns arise about whether the criteria will produce a subject population that is (1) relevant to the dimensions associated with the treatment matching, (2) representative of persons typically seen in alcohol treatment settings and, for practical purposes, (3) able or willing to comply with the requirements of the study protocol. Also, in order to fulfill sampling requirements, it may be necessary to employ a variety of creative outreach methods. However, these recruitment mechanisms can pose additional logistical and methodological problems for the research. This article focuses on various issues arising in the selection and recruitment of subjects in matching research. Project MATCH serves to highlight issues related to client eligibility and recruitment and to discuss effective strategies for resolving these matters.

Adult↗