Should radiologists and pathologists talk to patients?
THE RESEARCH ENTERPRISE RANDOMISED CONTROLLED TRIALS (RCTs) are seen as the evidence “gold standard” for the effectiveness of clinical interventions. However, as a method of evaluating complex interventions in community-based settings they have significant limitations. Because of the poor uptake in Australia of secondary prevention for alcohol misuse among Indigenous people,1 we set out to trial a brief intervention (involving motivational interviewing of individuals not presenting primarily with an alcohol problem2) in this population. This intervention has been subjected to a rigorous multinational trial under the auspices of the World Health Organization (WHO)3 and found to help patients reduce their risk of alcohol-related harm.4,5 However, there were too few Indigenous people in the Australian arm of the WHO trial to provide evidence of the effectiveness of the intervention in this population. Here we report on an attempt to address this gap through implementation of a trial in an urban Aboriginal Medical Service.