TAILIEUCHUNG - The management of harmful drinking and alcohol dependence in primary care

These figures derive from population studies showing the relationship of self reported levels of drinking to risk of harm. It is arbitrary which point on the risk curve is deemed to merit a Other authorities have quoted weekly recommended upper limits for alcohol consumption of 21 units per week for men and 14 units per week for Consuming over 40 g/day alcohol on average doubles a man s risk for liver disease, raised blood pressure, some cancers (for which smoking is a confounding factor) and violent death (because some people who have this average alcohol consumption drink heavily on some days). For women, over 24 g/day. | Scottish Intercollegiate Guidelines Network The management of harmful drinking and alcohol dependence in primary care A national clinical guideline 1 2 3 4 5 6 7 8 9 Introduction 1 Detection and assessment 4 Brief interventions for hazardous and harmful drinking 7 Detoxification 11 Referral and follow up 16 Advising families 20 Information for discussion with patients and carers 21 Implementation audit and further research 24 Development of the guideline 25 Annexes 28 Abbreviations 36 References 37 September 2003 COPIES OF ALL SIGN GUIDELINES ARE AVAILABLE BY CALLING 0131 247 3664 OR ONLINE AT KEY TO EVIDENCE STATEMENTS AND GRADES OF RECOMMENDATIONS LEVELS OF EVIDENCE 1 High quality meta-analyses systematic reviews of randomised controlled trials RCTs or RCTs with a very low risk of bias 1 Well conducted meta-analyses systematic reviews of RCTs or RCTs with a low risk of bias 1 - Meta-analyses systematic reviews of RCTs or RCTs with a high risk of bias 2 2 2 - 3 High quality systematic reviews of case control or cohort studies High quality case control or cohort studies with a very low risk of confounding or bias and a high probability that the relationship is causal Well conducted case control or cohort studies with a low risk of confounding or bias and a moderate probability that the relationship is causal Case control or cohort studies with a high risk of confounding or bias and a significant risk that the relationship is not causal Non-analytic studies . case reports case series 4 Expert opinion GRADES OF RECOMMENDATION Note The grade of recommendation relates to the strength of the evidence on which the recommendation is based. It does not reflect the clinical importance of the recommendation. A B C D At least one meta-analysis systematic review of RCTs or RCT rated as 1 and directly applicable to the target population or A body of evidence consisting principally of studies rated as 1 directly applicable to the target population and .

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