NHMRC Career Development Fellowship (Level 2): Revolutionising alcohol dependence treatment: Targeting individual genetic and psychological risk through Clinical Decision Support Systems (2012-2017)

Objectives: o To test a new computer based, Clinical Decision Support System which employs non-linear methods to identify individual patient genetic and psychological factors associated with poor treatment response. o To conduct a randomised controlled trial of the Clinical Decision Support System that systematically targets specific patient psychological and genetic deficits, compared to Treatment as Usual. o Develop, test and publish clinical protocols that improve alcohol dependence treatment outcomes. o Produce software applications that can be universally applied to individual alcohol treatment services. Overview of Project: This randomised control trial (RCT) is the first study to combine state-of-the-art clinical decision making technology with powerful prognostic statistical methods to treatment for patients with alcohol dependence. It specifically investigates whether empirically derived clinical decisions to target patient deficits in alcohol dependence treatment is clinically more effective than treatment as usual. Cost effectiveness and clinical efficiencies will also be examined. Outcomes and Significance: After tobacco, alcohol misuse is the second highest preventable cause of death and hospitalization in Australia. Treatment outcomes remain modest and the majority of patients relapse within 12 months For further progress to occur, the fundamental question of individual patient prognosis has to be investigated. Prognosis guides treatment decision making in other areas of medicine and should have applications in Addiction treatment. The systematic targeting of key modifiable behaviors is under studied and its translation into specific areas of improved function requires confirmation. Outcomes will be readily applicable to alcohol & drug and mental health services.