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National Clinical Guideline Centre (UK). Alcohol Use Disorders: Diagnosis and Clinical Management of Alcohol-Related Physical Complications [Internet]. London: Royal College of Physicians (UK); 2010. (NICE Clinical Guidelines, No. 100.)

A.2Clinical questions and literature searches

Question IDQuestion wordingStudy Type Filters usedDatabases and Years
BENZO‘What is the safety and efficacy of a benzodiazepine (chlordiazepoxide or diazepam, alprazolam, oxazepam, clobazam, lorazepam) versus a) placebo b) other benzodiazepines benzodiazepine (chlordiazepoxide or diazepam, alprazolam, oxazepam, clobazam, lorazepam) c) other agents (clomethiazole or carbamazepine) d) other agents (clomethiazole or carbamazepine) versus placebo for patients in acute alcohol withdrawal?’Systematic Reviews, RCTs, Comparative and Observational StudiesMedline 1950– 2009

Embase 1980–2009

Cinahl 1982–2009

Cochrane 1800– 2009
NEUROLEP“What is the safety and efficacy of a) neuroleptic agents, promazine hydrochloride, haloperidol, clozapine, risperidone, olanzapine, quetiapine) versus placebo b) other neuroleptic agents c) neuroleptic agents in combination with benzodiazepines (diazepam, chlordiazepoxide, alprazolam, oxazepam, clobazam, lorazepam) for patients with DTs?”Systematic Reviews, RCTs, Comparative and Observational StudiesMedline 1950– 2009

Embase 1980–2009

Cinahl 1982–2009

Cochrane 1800– 2009
DIAZWhat is the safety and efficacy of benzodiazepines versus a) placebo b) other benzodiazepines c) other anticonvulsants for the prevention of recurrent seizures during acute alcohol withdrawal?Systematic Reviews, RCTs, Comparative and Observational StudiesMedline 1950– 2009

Embase 1980–2009

Cinahl 1982–2009

Cochrane 1800–2009
DIAG1‘In adults and young people in acute alcohol withdrawal, what is the clinical efficacy and safety of, and patient satisfaction associated with, a) a symptom-triggered compared with a fixed-schedule benzodiazepine dose regimen b) symptom triggered compared with loading-dose regimen c) loading-dose compared with fixed- schedule regimen?

What assessment tools, including clinical judgement, are associated with improved clinical and patient outcomes when using a symptom- triggered dose regimen in patients with acute alcohol withdrawal?’
Systematic Reviews, RCTs, Comparative, Observational and Diagnostic studiesMedline 1950– 2009

Embase 1980–2009

Cinahl 1982–2009

Cochrane 1800–2009
DETOX‘What are the benefits and risks of unplanned ‘emergency’ withdrawal from alcohol in acute medical settings versus discharge?

What criteria (e.g. previous treatment, homelessness, levels of home support, age group) should be used to admit a patient with acute alcohol withdrawal for unplanned emergency withdrawal from alcohol?’
Systematic Reviews, RCTs, Comparative and Observational StudiesMedline 1950– 2009

Embase 1980–2009

Cinahl 1982–2009

Cochrane 1800–2009
TRANSPWhat length of abstinence is needed to establish non-recovery of liver damage, which thereby necessitates referral for consideration for assessment for liver transplant?Systematic Reviews, RCTs, Comparative, Observational and Diagnostic studiesMedline 1950– 2009

Embase 1980–2009

Cinahl 1982–2009

Cochrane 1800–2009
NURS
  1. What is the accuracy of a tool and/or clinical judgement for the a) assessment b) monitoring of patients at risk of acute alcohol withdrawal?
  2. Does the assessment and monitoring of patients with acute alcohol withdrawal improve patient outcomes?
Systematic Reviews, RCTs, Comparative and Observational StudiesMedline 1950– 2009

Embase 1980–2009

Cinahl 1982–2009

Cochrane 1800–2009
DIAG2‘What is the accuracy of laboratory and clinical markers versus liver biopsy for the diagnosis of alcohol- related liver disease versus other causes of liver injury?’

‘What is the safety and accuracy of laboratory and clinical markers versus liver biopsy for the diagnosis of alcohol related hepatitis versus decompensated cirrhosis?’
Systematic Reviews, RCTs, Comparative, Observational and Diagnostic StudiesMedline 1950– 2009

Embase 1980–2009

Cinahl 1982–2009

Cochrane 1800–2009
SURG
  1. In patients with chronic alcohol- related pancreatitis, does early versus later referral for a) coeliac axis block b) transthoracic splanchnicectomy c) early referral for coeliac axis/plexus block versus transthoracic splanchnicectomy improve patient outcomes?
  2. In patients with chronic alcohol- related pancreatitis, what is the safety and efficacy of a) transthoracic splanchnicectomy compared with coeliac axis/plexus block? b) or either intervention compared to conservative management?
  3. In patients with chronic alcohol- related pancreatitis, does early versus later referral for a) endoscopic interventional procedures b) surgery c) early referral for surgery versus endoscopic interventional procedures improve patient outcomes?
  4. In patients with chronic alcohol- related pancreatitis, what is the safety and efficacy of endoscopic interventional procedures compared with surgery? Or either intervention compared with conservative management?
Systematic Reviews, RCTs, Comparative, Observational and Diagnostic StudiesMedline 1950– 2009

Embase 1980–2009

Cinahl 1982–2009

Cochrane 1800–2009
ENZYMEIn patients with chronic alcohol- related pancreatitis, what is the safety and efficacy of pancreatic enzyme supplementation versus placebo for a) steatorrhoea and weight gain b) abdominal pain, duration of pain episodes, intensity of pain and analgesic use for pancreatic exocrine insufficiency?NoneMedline 1950– 2009

Embase 1980–2009

Cinahl 1982–2009

Cochrane 1800–2009
NUTRI4
  1. For the prevention and treatment of Wernicke’s encephalopathy, what is:
    i) the safety and efficacy ii) optimum dose iii) optimum duration of treatment of a) Pabrinex b) oral b vitamin c) oral thiamine d) multivitamins e) placebo or any combinations or comparison a–e
  2. Which patients are at risk of developing Wernicke’s encephalopathy and therefore require prophylactic treatment?
Systematic Reviews, RCTs, Comparative and Observational StudiesMedline 1950– 2009

Embase 1980–2009

Cinahl 1982–2009

Cochrane 1800–2009
ANTIBIOIn patients with acute alcohol-related pancreatitis, what is the safety and efficacy of prophylactic antibiotics versus placebo?Systematic Reviews, RCTs, Comparative and Observational StudiesMedline 1950– 2009

Embase 1980–2009

Cinahl 1982–2009

Cochrane 1800–2009
NUTRI2In patients with acute alcohol-related pancreatitis, what is the safety and efficacy a) of nutritional supplementation vs no nutritional supplementation b) early (first 48 hrs) vs late supplementation c) NJ vs NG) vs parenteral nutrition?Systematic Reviews, RCTs, Comparative and Observational StudiesMedline 1950– 2009

Embase 1980–2009

Cinahl 1982–2009

Cochrane 1800–2009
DIAG3“What is the diagnostic accuracy of abdominal ultrasound versus computed tomography (CT) for the diagnosis of alcohol-related chronic pancreatitis?”Systematic Reviews, RCTs, Comparative, Observational and Diagnostic StudiesMedline 1950–2009

Embase 1980–2009

Cinahl 1982–2009

Cochrane 1800–2009
NUTRI1In patients with acute alcohol-related hepatitis, what is the safety and efficacy of:
  1. enteral nutrition versus standard diet
  2. enteral nutrition versus corticosteroids
  3. enteral nutrition in combination with corticosteroids versus enteral diet
Systematic Reviews, RCTs, Comparative and Observational StudiesMedline 1950–2009

Embase 1980–2009

Cinahl 1982–2009

Cochrane 1800–2009
CORTICO‘In patients with acute alcohol- related hepatitis, what is the safety and efficacy of corticosteroids versus placebo?’Systematic Reviews, RCTs, Comparative, Observational and Diagnostic StudiesMedline 1950–2009

Embase 1980–2009

Cinahl 1982–2009

Cochrane 1800–2009
Copyright © 2010, National Clinical Guidelines Centre.

Apart from any fair dealing for the purposes of research or private study, criticism or review, as permitted under the Copyright, Designs and Patents Act, 1988, no part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

Cover of Alcohol Use Disorders
Alcohol Use Disorders: Diagnosis and Clinical Management of Alcohol-Related Physical Complications [Internet].
NICE Clinical Guidelines, No. 100.
National Clinical Guideline Centre (UK).

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