Which outcomes matter most in alcohol brief intervention trials? An international consensus study

What is it about?

Alcohol brief interventions (ABIs) are short, evidence-based conversations designed to help people who are drinking at risky levels cut down, delivered in settings such as primary care, emergency departments and workplaces. A major problem with the ABI evidence base is that trials measure many different outcomes in many different ways, making it very difficult to compare findings across studies or pool results in meta-analyses. This international e-Delphi study, part of the ORBITAL (Outcome Reporting in Brief Intervention Trials: Alcohol) project, convened 150 participants from 19 countries, including researchers, policymakers, clinicians, patients and funders, to prioritise outcomes for a core outcome set (COS). Using two rounds of online rating, participants ranked 86 candidate outcomes derived from a companion systematic review and a patient and public involvement panel. The study identified the outcomes considered most important by international stakeholders to form the foundation of a minimum standard for what should be measured in future ABI trials.

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Why is it important?

The companion systematic review in the same journal issue found 2,641 distinct outcomes measured across 401 ABI trials using 1,560 different approaches, a level of variation that severely undermines the field's ability to build a coherent evidence base or conduct meaningful meta-analyses. This e-Delphi study is the critical second step in resolving that problem, producing internationally agreed priorities directly from the stakeholders who design, fund, deliver and receive these interventions. A COS developed through this kind of multi-stakeholder consensus process carries genuine authority across disciplines and jurisdictions, and it directly informs what outcomes future trials must measure to be comparable. The ORBITAL project, ultimately produced the full COS published in the Journal of Studies on Alcohol and Drugs in 2021, which is now widely cited as the standard reference for outcome selection in ABI trial design.