Talk:Alcoholics Anonymous

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Intro[edit]

Why on earth should evidence from a cochrane review be excluded from the intro? 79.97.226.247 (talk) 02:43, 24 January 2015 (UTC)

So I have read the summary, and what I have done is worded it so that it would reference and summarize the effectiveness section while at the same time maintain faithfully to the article itself. This study was actually already in the body of the article so I used the shortened reference. Cheers! Coffeepusher (talk) 05:03, 24 January 2015 (UTC)

The Cochrane review on alcoholism and addiction treatments comes from 2006 and is outdated. We are about to have a new Cochrane review publised this year that will be more positive towards 12 step programs. The author of the last Cochrane review blogged pretty positive things about AA last year.

That in mind, placing this outdated information in the lead is undue weight. I have removed it. Defendingaa (talk) 03:01, 28 March 2015 (UTC)

I don't agree. Once the "new" Cochrane review is out, then we can replace the old one. An Atlantic article about what is "going to happen" is pretty weak.Desoto10 (talk) 05:42, 10 May 2015 (UTC)
I will concede that the relevant guideline does specifically name Cochrane reviews and not being outdated within five years, but I disagree with the summary of the Cochraine review as posted here. The previous consensus last time this was discussed was to use this wording: "A Cochrane Review of eight studies, published in between 1967 and 2005, measuring the effectiveness of AA found no significant difference between the results of AA and twelve-step participation compared to other treatments. To determine the effectiveness of AA, the authors suggested more studies comparing treatment outcomes with control groups were necessary." This wording is consistent with how the popular press has summarized the Cochraine study, for example, in one reliable blog source, they summarize the Cochraine study thusly:
She quotes Cochrane’s conclusion that “no experimental studies unequivocally demonstrated the effectiveness of AA or [12-step] approaches for reducing alcohol dependence or problems.” She neglects to mention that the 2006 report also examined studies comparing twelve-step programs to other treatment methods. The result? “Severity of addiction and drinking consequence did not seem to be differentially influenced by [twelve-step programs] versus comparison treatment interventions,” Cochrane states, “and no conclusive differences in treatment drop out rates were reported.”
When the New York Times summarized the Cochraine review back when it was published, they said that "no data showed that 12-step interventions were any more — or any less — successful in increasing the number of people who stayed in treatment or reducing the number who relapsed after being sober."
That in mind, I have changing how the Cochrane study is summarized here. Defendingaa (talk) 18:56, 11 May 2015 (UTC)
Thinking about it some more, I agree with Sunrise that the bit about needing more controlled studies is not really relevant for the lead. Defendingaa (talk) 13:56, 18 June 2015 (UTC)

Retention in Lead[edit]

The retention figures from the AA survey and those from other sources should not be confused with efficacy. That someone is or is not attending AA after arbitrary amounts of time says nothing about whether or not the program is effective in dealing with alcoholism. I suggest that we remove the retention figures from the introduction but leave the highest quality efficacy review (the Cochrane study). In any case, the concept from Macintire (sp?) where the argument is presented that only those who have attended for 90 days should be counted in retention counts has been discussed and rejected before, I think. Retention statistics must include those who walk in the door, turn around, and walk out.Desoto10 (talk) 02:06, 16 March 2015 (UTC)

My issue with having this 26% retention number in the lede is that it is original research. The actual survey does not give us a solid number like 26%. The number is probably a reasonable conclusion based on the graph on page 12 of that survey, as explained by unreliable sources, but we really need to have a medically reliable source before having that, or any other retention number, in the lede. That in mind, I have removed it. Defendingaa (talk) 19:14, 11 May 2015 (UTC)
I have reverted this edit because:
1) The revert was not discussed here on the talk page to try and find consensus
2) The edit was done without referring to a medically reliable citation with the 26% number in it.
3) Again, to take a hand drawn graph without 26% anywhere on it and conclude that it states a 26% retention is original research.
4) If this was really AAWO's statement on the matter, I would think it would be put on their web page and not relegated to some document someone posted to Scribd which may or may not be authentic.
Please discuss these changes here on the talk page before reinstating this information in to the lede again. Defendingaa (talk) 13:00, 29 May 2015 (UTC)
AA itself does not have published retention figures, and there are no reliable sources which state "these are AA's own retention numbers" (a Scribd document from over two decades ago which was never published is not a reliable source, much less a currently relevant medically reliable source), but do have number of years sober broken down as follows: According to AA's most recent membership survey, from 2011, 27% of members are sober under a year, 24% are sober 1-5 years, 12% 5-10 years, and 36% of members have over ten years sober. Source: Alcoholics Anonymous 2011 Membership survey I have added this information to the lede. Defendingaa (talk) 13:16, 29 May 2015 (UTC)

To bring the point home again, that 26% number was derived using statistical methods. The stated Wikipedia policy on the matter is that "Summarizations based on statistical methods, however, are original research by synthesis, as they involve the reinterpretation of data". Defendingaa (talk) 16:55, 30 May 2015 (UTC)

To be fair, Lance Dodes, in The Sober Truth, looks at the same source we have been looking at and came up with the same 26% number. Now, I don't think Lance Dodes's "26%" quote based on this document we've all been looking at is a medically reliable source (as long as things like articles in New York Magazine are not considered reliable sources for medical information about AA, we can't consider a book published by the Beacon Press medically reliable either) Defendingaa (talk) 03:33, 23 June 2015 (UTC)

NLAES and NESARC[edit]

We have had the following for a while:

Two surveys that sampled the general population produced independent results on AA continuance rates. The 1990 National Longitudinal Alcohol Epidemiologic Survey (NLAES) found that Alcoholics Anonymous has a 31% continuance rate.[74] The 2001-2002 National Epidemiological Survey on Alcoholism and Related Conditions (NESARC) indicates a slightly higher rate, at 35.2%.[75]

Neither reference provides sufficient information to determine exactly what was found. What I mean is, we need page numbers and, if possible, a link to this information. These are massive studies with hundreds of pages of tables. I am not contesting this information, just want to verify it. Thanks.Desoto10 (talk) 02:05, 16 March 2015 (UTC)

Reference 75 is behind a paywall at http://link.springer.com/chapter/10.1007/978-0-387-77725-2_15. Does the number "35.2%" appear anywhere in that 21-page article, or is this another case of a random Wikipedia editor performing statistical analysis? Defendingaa (talk) 14:27, 18 June 2015 (UTC)

I have added two citations from reliable sources but not medically reliable sources.[edit]

I have added a couple of bits of information about how effective Alcoholics Anonymous is from reliable sources but not medically reliable sources:

  • The 2015 Cochrane review concerning how effective AA is has not been published yet, but one if its authors has commented in New York Magazine that he thinks it will be more positive towards 12-step approaches than the 2006 survey was. It's generally considered a reliable source, and it's the comments of an author of the upcoming review.
  • Lance Dodes's 2014 book "The Sober Truth" actually has that 26% number based on the 1990 Triennial AA survey in it.

One potential problem with these two sources is WP:MEDPOP: "The popular press is generally not a reliable source for scientific and medical information in articles." Would it be better to remove both the 26% number as well as the note from one of the authors of the next Cochrane Review on 12-step programs, since neither comes from a scientific journal? Defendingaa (talk) 15:00, 23 June 2015 (UTC)