title: Recommendations for the Design and Analysis of Treatment Trials for Alcohol Use Disorders.
abstract: BACKGROUND
  Over the past 60 years, the view that "alcoholism" is a disease for which the only acceptable goal of treatment is abstinence has given way to the recognition that alcohol use disorders (AUDs) occur on a continuum of severity, for which a variety of treatment options are appropriate. However, because the available treatments for AUDs are not effective for everyone, more research is needed to develop novel and more efficacious treatments to address the range of AUD severity in diverse populations. Here we offer recommendations for the design and analysis of alcohol treatment trials, with a specific focus on the careful conduct of randomized clinical trials of medications and nonpharmacological interventions for AUDs.
  
  
  METHODS
  This paper provides a narrative review of the quality of published clinical trials and recommendations for the optimal design and analysis of treatment trials for AUDs.
  
  
  RESULTS
  Despite considerable improvements in the design of alcohol clinical trials over the past 2 decades, many studies of AUD treatments have used faulty design features and statistical methods that are known to produce biased estimates of treatment efficacy.
  
  
  CONCLUSIONS
  The published statistical and methodological literatures provide clear guidance on methods to improve clinical trial design and analysis. Consistent use of state-of-the-art design features and analytic approaches will enhance the internal and external validity of treatment trials for AUDs across the spectrum of severity. The ultimate result of this attention to methodological rigor is that better treatment options will be identified for patients with an AUD.
authors.affiliation: Department of Psychology, University of New Mexico, Albuquerque, New Mexico.|Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, Albuquerque, New Mexico.
authors.forename: Katie
authors.initials: K
authors.lastname: Witkiewitz
authors.affiliation: Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California.
authors.forename: John W
authors.initials: JW
authors.lastname: Finney
authors.affiliation: Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, California.|VA Substance Use Disorder Quality Enhancement Research Initiative, VA Palo Alto Health Care System, Menlo Park, California.
authors.forename: Alex H S
authors.initials: AH
authors.lastname: Harris
authors.affiliation: Veterans Health Administration, Washington, District of Columbia.|Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Kivlahan
authors.affiliation: Center for Studies of Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.|VISN4 MIRECC, Philadelphia VAMC, Philadelphia, Pennsylvania.
authors.forename: Henry R
authors.initials: HR
authors.lastname: Kranzler
mesh_terms: D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D055118:Medication Adherence; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000592:standards*; D012107:Research Design / Q000592:standards*; D013223:Statistics as Topic / Q000379:methods / Q000592:standards*
keywords: Alcohol Randomized Trials; Alcohol Use Disorder; Data Analysis; Eligibility Criteria; Missing Data Approaches; Research Design