Evidence map›Paper›PMID 10101999›Full record

SynthesisCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne1999

Meta-analysis of benzodiazepine use in the treatment of acute alcohol withdrawal.

A M Holbrook, R Crowther, A Lotter, C Cheng, D King

Abstract readMeta-Analysis
PubMed Full text at PMC
In one paragraph

Synthesis in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 1999. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 5 pooled it
2.2field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 5 syntheses or guidelines pooled it, 127 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Benzodiazepines for alcohol withdrawal.The Cochrane database of systematic reviews · 2010
    Pooled it
  5. Meta-analysis of benzodiazepine use in the treatment of insomnia.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2000
    Pooled it
  6. Trial
  7. Article
  8. Evaluation of Gabapentin and Baclofen Combination for Inpatient Management of Alcohol Withdrawal Syndrome.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2023
    Article
  9. Review
  10. Article
  11. Review
  12. Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond.Journal of clinical and diagnostic research : JCDR · 2015
    Review
  13. Review
  14. Review
  15. Article
  16. Article
  17. Article
  18. Review
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

A M HolbrookCentre for Evaluation of Medicines, St. Joseph's Hospital, Hamilton, Ont.
R Crowther
A Lotter
C Cheng
D King
St. Joseph Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo analyse the evidence for the efficacy and potential harmful effects of benzodiazepines compared with other therapies in the treatment of acute alcohol withdrawal. DATA SOURCES: MEDLINE and the Cochrane Controlled Trials Registry were searched for English-language articles published from 1966 to December 1997 that described randomized controlled trials (RCTs) of benzodiazepines in the treatment of acute alcohol withdrawal. Key words included "benzodiazepines" (exploded) and "randomized controlled trial." Bibliographies of relevant articles were reviewed for additional RCTs, and manufacturers of benzodiazepines were asked to submit additional RCT reports not in the literature. STUDY SELECTION: Articles were considered for the meta-analysis if they were RCTs involving patients experiencing acute alcohol withdrawal and comparing a benzodiazepine available in Canada with placebo or an active control drug. Of the original 23 trials identified, 11 met these criteria, representing a total of 1286 patients. DATA EXTRACTION: Data were extracted regarding the participants, the setting, details of the intervention, the outcomes (including adverse effects) and the methodologic quality of the studies. DATA SYNTHESIS: The meta-analysis of benefit (therapeutic success within 2 days) showed that benzodiazepines were superior to placebo (common odds ratio [OR] 3.28, 95% confidence interval [CI] 1.30-8.28). Data on comparisons between benzodiazepines and other drugs, including beta-blockers, carbamazepine and clonidine, could not be pooled, but none of the alternative drugs was found to be clearly more beneficial than the benzodiazepines. The meta-analysis of harm revealed no significant difference between benzodiazepines and alternative drugs in terms of adverse events (common OR 0.67, 95% CI 0.34-1.32) or dropout rates (common OR 0.68, 95% CI 0.47-0.97).

interpretationBenzodiazepines should remain the drugs of choice for the treatment of acute alcohol withdrawal.

Indexed as

Acute DiseaseAdultAnti-Anxiety AgentsBenzodiazepinesEthanolHumansMiddle AgedRandomized Controlled Trials as TopicSubstance Withdrawal SyndromeAnti-Anxiety AgentsBenzodiazepinesEthanol

Identifiers

PMID10101999
PMCPMC1230110
OpenAlexW2165605153

What OpenQuestion holds

Texttitle and abstract
measurements read3
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.