Brief interventions consistently produced reductions in alcohol consumption. When data were available by gender, the effect was clear in men at one year of follow up, but unproven in women. Longer duration of counselling probably has little additional effect. The lack of differences in outcomes between efficacy and effectiveness trials suggests that the current literature had clear relevance to routine primary care. Future trials should focus on women and on delineating the most effective components of interventions.

We found moderate-quality evidence that brief interventions can reduce alcohol consumption in hazardous and harmful drinkers compared to minimal or no intervention. Longer counselling duration probably has little additional effect. Future studies should focus on identifying the components of interventions which are most closely associated with effectiveness.

Brief interventions can reduce alcohol consumption in men, with benefit at a year after intervention, but they are unproven in women for whom there is insufficient research data. Longer counselling has little additional effect over brief intervention. The lack of differences in outcomes between efficacy and effectiveness trials suggests that the current literature is relevant to routine primary care.

Our review found moderate quality evidence that shifting responsibility from doctors to adequately trained and supported nurses or community health workers for managing HIV patients probably does not decrease the quality of care and, in the case of nurse initiated care, may decrease the numbers of patients lost to follow-up.

Background: Research on identifying trials using geographic filters is limited. Objectives: To test the sensitivity and precision of a filter to identify African randomised controlled trials (RCTs). Methods: We searched MEDLINE and EMBASE for RCTs published in 2004 using a Cochrane filter for RCTs. The search was limited to HIV ⁄AIDS but irrespective of location. Two investigators independently identified African RCTs from the retrieved records forming a reference set. We then repeated the search using an African geographic filter comprising country and regional terms forming the filter set. We compared the sensitivity and precision of the sets. Results: The MEDLINE reference set comprised 1799 records with 23 African RCTs; for EMBASE, the reference set comprised 763 records with 37 African RCTs. The MEDLINE filter set comprised 180 records with 17 African RCTs; the EMBASE filter set comprised 98 records with 27 African RCTs. Sensitivity of the filter was 74% (MEDLINE) and 73% (EMBASE). Addition of the filter improved precision from 1.3% to 9.4% (MEDLINE) and from 5% to 28% (EMBASE). Conclusion: The African filter improved precision with some loss in sensitivity. Incomplete reporting of trial location in electronic bibliographic records restricts efficiency of geographic filters. Prospective trial registration should alleviate this.