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October 22, 1997

Pharmacologic Treatment of Alcohol Withdrawal-Reply

Author Affiliations

Department of Veterans Affairs Medical Center Manchester, NH

JAMA. 1997;278(16):1318. doi:10.1001/jama.1997.03550160038028

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In Reply.  —Dr Johnson expresses concern about the level of significance in 1 of the 11 statistical analyses we performed. In approaching our topic, we attempted to follow the basic principles of the scientific method as it applies to meta-analyses. Meta-analysis can be viewed as a research project in which the unit of analysis is the individual study rather than an individual patient. As such, we formed our hypotheses and plan for analysis before searching and reviewing the medical literature. We identified criteria for study inclusion, including standards for study design, inclusion and exclusion criteria, treatment protocol, and measurement of outcomes. We identified 4 studies that met these criteria, analyzed them using a conservative approach recommended by our statistical consultants, and report the results. As such, we feel the recommendations are based on the best available evidence and represent reasonable positions. The lack of well-designed trials addressing the relative efficacy of the