Retire the Concept of “Relapse”

Stigmatizing Terminology for Outcomes and Processes (STOP) in Alcohol Research: A Meta-epidemiologic Assessment of Language Used in Clinical Trial Publications

“…As Miller points out in a 2015 article, all-or-none progress is antithetical to AUD treatment. 21 To portray this fact, Miller relates using the term “relapse” to describe a person with diabetes presenting to the emergency room in a glycemic crisis. An individual with diabetes in the aforementioned setting is not told they have “relapsed”—nor should they be told they have “failed” in their treatment.…”

“…To explore our primary research question, we systematically searched each article for the presence of the following terms related to trial outcomes which were developed a priori to the study being conducted: “Clean,” “Dirty,” “Resistant,” (as in “treatment-resistant”), “Compliant*” (as in compliant, compliance, or non-), “Adherent*” (as in adherent, adherence, or non-), “Dropout,” “Fail” (as in failed, failure: related to treatment or testing), “Relapse,” “Wagon,” “Recovered.” These terms have been shown to carry negative connotations within patient populations 3 or have been identified by experienced alcohol and addiction researchers as having negative bias. 17 , 21 , 22 The terms “medication-assisted treatment” or “-therapy,” “recurrence,” and “recovery” were not included, as Ashford et al found differing associations among patient populations when compared to terms such as “relapse,” which was frequently associated with negative connotations. 3 We evaluated the full text of each article for any occurrence of the STOP listed previously using the Find feature in Adobe Acrobat Reader DC (Acrobat.adobe.com).…”

Comparative efficacy and safety of pharmacotherapies for alcohol withdrawal: a systematic review and network meta‐analysis

“…For continuous outcomes [3,8,9], we calculated the summary mean difference (MD) or standardized mean difference (SMD), with the uncertainty in each treatment comparison (against placebo) expressed by its 95% CI. In cases of missing standard deviations from baseline to the end of treatment, we imputed the standard deviation at the end of treatment for each group, per previous Cochrane methods [34].…”

“…However, these do not treat AW per se. Pharmacotherapies play a crucial role in relieving immediate AW symptoms, preventing complications (such as seizures and DTs) [8], and may help prevent the return to alcohol use. Choosing a pharmacological treatment for AW is a complex decision that must factor in medication efficacy and safety.…”

“…However, these do not treat AW per se. Pharmacotherapies play a crucial role in relieving immediate AW symptoms, preventing complications (such as seizures and DTs) [8],…”