Alcohol and mortality:: methodological and analytical issues in aggregate analyses
Alcohol and mortality:: methodological and analytical issues in aggregate analyses
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DOI：
10.1080/09652140020021143
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发表时间：
2001-02-01
期刊：
影响因子：
6
通讯作者：
Skog, OJ
中科院分区：
文献类型：
--
作者：
Norström, T;Skog, OJ
本增刊包括一组论文，旨在估计人均酒精消费量与各种形式的死亡率之间的一般关系，包括肝硬化、事故、自杀、杀人、缺血性心脏病和总死亡率。这些论文采用了统一的方法协议，它们都基于涵盖战后欧盟国家和挪威的时间序列数据。在本文中，我们讨论了这些论文中常见的各种方法和分析问题。我们认为，时间序列数据分析是评估人口饮酒变化的总体健康后果的最可行方法。我们进一步讨论了汇总数据如何在判断个人层面关系的合理性方面也很有用，特别是那些容易被选择效应混淆的关系。讨论了线性和曲线风险曲线的集合以及处理时滞问题的各种方法。关于估计技术，我们发现具体国家的分析优于汇集的横截面/时间序列模型，因为后者包含了地理共变的一些可疑因素，并掩盖了酒精效应中潜在的有趣变化。手头文件中采用的方法是将具体国家的结果汇总为代表不同饮酒文化的三组国家；南欧的传统葡萄酒国家，中欧和不列颠群岛的啤酒国家，以及北欧的烈酒国家。这些论文的发现强化了公共卫生观点的核心原则，即总体消费是酒精相关伤害率的重要决定因素。然而，不同国家群体对酒精的影响，特别是对暴力死亡的影响存在差异，这表明饮酒模式的潜在重要性。在人口水平上，没有证据支持人均消费量增加对心脏有任何保护作用的观点。
This supplement includes a collection of papers that aim at estimating rite relationship between per capita alcohol consumption and various forms of mortality, including mortality front liver cirrhosis, accidents, suicide, homicide, ischaemic heart disease, and total mortality. The papers apply a uniform methodological protocol, and they are all based on rime series data covering the post-war period in the present EU countries and Norway. bz this paper we discuss various methodological and analytical issues that are common to these papers. We argue that analysis of time series data is the most feasible approach for assessing the aggregate health consequences of changes in population drinking. We further discuss how aggregate data may also be useful for judging the plausibility of individual-level relationships, particularly those prone to be confounded by, selection effects. The aggregation of linear and curvilinear risk curves is treated as well as various methods for dealing with the time-lag problem. with regard to estimation techniques we find country specific analyses preferable to pooled cross-sectional/time series models since the latter incorporate rite dubious element of geographical co-variation, and conceal potentially interesting variations in alcohol effects. The approach taken in the papers at hand if instead to pool the country specific results into three groups of countries that represent different drinking cultures; traditional wine countries of southern Europe, beer countries of central Europe and the British Isles and spirits countries of northern Europe. The findings of the papers reinforce the central tenet of the public health perspective that overall consumption is an important determinant of alcohol-related harm rates. However, there is a variation across country groups in alcohol effects, particularly those on violent deaths, that indicates the potential importance of drinking patterns. There is no support for the notion that increases in per capita consumption have any cardioprotective effects at the population level.