The ORBITAL core outcome set

Abstract

Assessment of alcohol use is central to our field. For example, in research, we consider effects, costs, and mechanisms; in clinical or intervention practice, we assess, treat, and evaluate; and in public health and policy, we monitor consumption and patterns. Like de Bejczy et al. (2022, this issue), we recognize that self-report measures may under-represent the true amount of alcohol consumed and are grateful for illustrative examples from Sweden. We note that for alcohol brief intervention (ABI) research, self-reported consumption is vulnerable to social desirability bias; participants are advised to drink less and are later asked to confirm this (McCambridge & Saitz, 2017; Shorter et al., 2019a, 2021). Other problems include memory, arithmetic (e.g., summation, averaging), psychological state, and time of assessment (McClatchley et al., 2014). Because ABI studies often aim to reduce consumption to within recommended guidelines rather than to eliminate it entirely, the drinkers' estimation of their use patterns is a key intervention outcome. Self-report was a concern for consensus meeting delegates voting on the final Core Outcome Set (COS; Shorter et al., 2021). Although blinding of outcome assessors, confidentiality assurances, and agnostic views on amount of alcohol consumed partially overcome self-report biases, decisions on the COS items included multiple time points of recent and average consumption to capture variability. The phenomenology of outcomes expected to change following ABI includes consumption measures, alongside the impact of alcohol use, and quality of life.