In this regard, a recent U.S. study in primary care used the Composite International Diagnostic Interview Alcohol Module to identify adults with alcohol problems in 3 randomized controlled trials comparing BMI with no BMI. These were conducted in the USA in order to identify key intervention components. This study examined 3 sets of audio-recorded BMIs (2 from null studies - no difference in drinking between BMI and no BMI groups; and 1 from a positive study - less drinking in BMI group compared with no BMI group). The drinking decreased among participants in all 3 studies. Intervention characteristics that are considered as central to efficacious BMIs (such as changes in self- or other reports of drinking quantity and/or frequency, drinking intensity and drinking within recommended limits) were not strong predictors of drinking outcome. The quality of the BMI processes was not predictive in these studies and may require attention to factors beyond constructs typically examined. Therefore, more detailed analysis and prospective studies are necessary. For example, the varying efficacy of BMI may depend on different factors such as drinking motives, impulsivity, depression, anxiety, sleep disorders, and aggression.