US low-risk drinking guidelines: An examination of four alternatives
US low-risk drinking guidelines: An examination of four alternatives
复制标题
DOI：
10.1097/00000374-200012000-00011
复制
发表时间：
2000-12-01
期刊：
影响因子：
--
通讯作者：
Dawson, DA
中科院分区：
文献类型：
--
作者：
Dawson, DA
工作背景：这项研究比较了四套美国低风险饮酒指南（美国饮食指南的两种解释和NIAAA医生指南的两种变化）的依从性和他们如何预测五种不同的酒精相关结果。方法：使用来自全国代表性样本的17，542名21岁及以上的美国成年人的数据，他们在过去一年中喝了12杯或更多的饮料，本研究评估了各种饮酒指南的敏感性、特异性、总体准确性、阳性和阴性预测值以及优势比（特别是，已经超过他们以不同程度的频率）作为酒精依赖，驾驶障碍，肝病，消化性溃疡和高血压的预测因子。过去一年经常饮酒者超过四套指南的比例从20.9%（平均摄入量超过每周限制）到21.0%至42.7%（每周至少一次超过每日指南）不等，以及69.2%至94.2%在访问前一年内曾超过每日限额。灵敏度和比值比最高的是超过膳食指南每日限制的，中等的是超过基于NIAAA医生指南的两个变化的，最低的是远远超过膳食指南解释为每周限制的。特异性和总体预测准确性则相反。当经常超过每日的限制被认为是，他们的灵敏度下降，但他们的特异性和阳性预测值increased.Conclusions：如果灵敏度和特异性被认为是同样重要的，NIAAA医生的指导方针，将每日和每周的限制似乎做最好的工作，平衡这些方面的预测各种酒精相关的结果。
Background: This study compared four sets of US low-risk drinking guidelines (two interpretations of the US Dietary Guidelines and two variations of the NIAAA physicians' guidelines) in terms of adherence and how well they predicted five different alcohol-related outcomes.Methods: Using data from a nationally representative sample of 17,542 US adults 21 years of age and over who drank 12 or more drinks in the past year, this study assessed the sensitivity, specificity, overall accuracy, positive and negative predictive values, and odds ratios of the various drinking guidelines (specifically, of having exceeded them with different degrees of frequency) as predictors of alcohol dependence, impaired driving, liver disease, peptic ulcer, and hypertension.Results: The proportions of past-year regular drinkers exceeding the four sets of guidelines varied from 20.9%, whose average intake exceeded the weekly Limits, to between 21.0% and 42.7% who exceeded the daily guidelines at least once a week, and to between 69.2% and 94.2% who ever exceeded the daily limits in the year preceding the interview. Sensitivity and odds ratios were highest for the ever exceeding the Dietary Guidelines daily limits, intermediate for ever exceeding the two variations based on the NIAAA physicians' guidelines, and lowest far exceeding the Dietary Guidelines interpreted as weekly limits. The opposite pattern was observed for specificity and overall predictive accuracy. When frequently exceeding the daily limits was considered, their sensitivity declined but their specificity and positive predictive value increased.Conclusions: If sensitivity and specificity are deemed equally important, the NIAAA physicians' guidelines incorporating both daily and weekly limits seem to do the best job of balancing these dimensions in the prediction of a variety of alcohol-related outcomes.