Cross-National Analysis of Alcohol & Injury

酒精的跨国分析

• 批准号: 7692287
• 负责人: CHERYL J CHERPITEL
• 金额: $ 45.34万
• 依托单位: PUBLIC HEALTH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-07-01 至 2012-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7692287
• 关键词: Accident and Emergency department; Address; Adoption; Affect; Age; Agreement; Alcohol consumption; Alcohol dependence; Alcohols; Ambulances; Automobile Driving; Automobiles; Blood alcohol level measurement; Books; Categories; Centers for Disease Control and Prevention (U.S.); Classification; Clinical; Clinical assessments; Code; Communities; Country; Coupled; Data; Data Aggregation; Data Analyses; Data Files; Data Set; Dose; Drug usage; Environment; Epidemiology; Event; Extramural Activities; Frequencies; Future; Gap Junctions; Gender; General Population; Grant; Hand; Heavy Drinking; Heterogeneity; Hospitalization; Hour; Individual; Injury; International; International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10); Intoxication; Knowledge; Legal; Licensing; Linear Models; Measurement; Measures; Meta-Analysis; Methodology; Methods; Morbidity - disease rate; National Institute on Alcohol Abuse and Alcoholism; Pan American Health Organization; Participant; Patients; Pattern; Pharmaceutical Preparations; Population; Population Attributable Risks; Population Control; Predictive Value; Prevention Research; Principal Investigator; Probability; Probability Samples; Progress Reports; Public Health; Publishing; Recommendation; Relative Risks; Reporting; Research; Resolution; Respondent; Risk; Risk Assessment; Risk Estimate; Role; Sampling; Sampling Studies; Screening procedure; Severities; Site; Societies; Stigmatization; Surveys; Techniques; Testing; Validity of Self Report; Variant; Violence; Work; World Health; World Health Organization; alcohol availability; alcohol exposure; alcohol research; alcohol risk; base; burden of illness; clinically significant; comparative; density; density of AOD outlets; disability; drinking; falls; high risk; improved; injured; instrument; instrumentation; interest; minimum drinking age; motor vehicle injury; public health relevance; response; service utilization; symposium; trauma centers

DESCRIPTION (provided by applicant): Work in this competing continuation builds on that previously undertaken which compiled and analyzed data from the 12-site WHO Collaborative Study on Alcohol and Injuries with that from 33 ER sites in 8 countries comprising the Emergency Room Collaborative Alcohol Analysis Project (ERCAAP), all of which used similar methodology and instrumentation on probability samples of ER patients. Study aims include: 1) examine the magnitude of the association of alcohol and injury and risk of alcohol- related injury in relation to drinking pattern, type and cause of injury, dose-response relationship, severity and disability of injury, context of injury, and drug use; 2) compare and adjust estimates of relative risk of injury from alcohol across various control periods used in case-crossover analysis; 3) improve estimates of alcohol attributable fraction (AAF) and injury; 4) investigate the relationship between BAC, overall clinical assessment of intoxication, and individual clinical signs of intoxication. This competing continuation will explore in more depth the association of alcohol and injury with a broader array of contextual variables, and gaps in this research which were identified at an international conference on alcohol and injury, (Cherpitel, Principal Investigator) sponsored by NIAAA and co-sponsored by WHO and CDC in October 2005, and follows recommendations presented at the October 2006 NIAAA Extramural Advisory Board on improving AAF for injury morbidity, a key priority identified for the Division of Epidemiology and Prevention Research. The proposed research will add to the WHO/ERCAAP dataset of 11,536 injured and 10,036 non-injured patients, 36 ER sites from 13 countries (for a total of 25 countries), including 11 U.S. sites, and 3 sites comprising the PAHO Collaborative Study, more than doubling the number of injury cases (to over 34,000) and increasing the non-injured cases to over 14,500. Addition of these sites will result in a data file on variables of interest on all known probability samples of ER patients, internationally, not only increasing the number of patients required for addressing study aims, but also providing data not presently available in the WHO/ERCAAP, and providing a broader representation of ERs, internationally and domestically, with expanded representation important for contextual analysis. Community and regional general population data will also be added, available from 76 of the 81 ER sites, including data from GENACIS, which will allow us to carry out important work on AAF and injury, including refining contextual variables and their predictive value for relative risk estimates and providing contextual profiles for assigning AAFs for countries for which ER data are not available. Hierarchical linear modeling, case-crossover and meta- analysis will be used to examine the independent and interactive effects of contextual variables with individual- and event-level variables. These cross-national analyses will address important gaps in the alcohol-injury nexus worldwide and in the US, since the US is composed of many micro-cultures which reflect the contextual environment dominating many of the countries in which these data were collected. PUBLIC HEALTH RELEVANCE: This work is especially relevant to public health issues in relation to allowing us to apply estimates of alcohol attributable fraction from countries which reflect a specific contextual profile to other countries with similar contextual profiles for which ER data are not available but for which general population data are. This research is important for the ongoing work on Comparative Risk Assessment, resulting from the World Health Assembly 2005 Resolution on Alcohol in determining the Global Burden of Disease related to alcohol.

描述（由申请人提供）：这一竞争性延续项目的工作建立在之前开展的工作的基础上，该工作汇编和分析了世界卫生组织酒精和伤害问题合作研究的 12 个站点以及急诊室协作酒精分析项目 (ERCAAP) 等 8 个国家 33 个急诊室的数据，所有这些都对急诊室患者的概率样本使用了类似的方法和仪器。研究目的包括： 1) 检查酒精与伤害关联的程度以及与饮酒方式、伤害类型和原因、剂量反应关系、伤害严重程度和残疾、伤害背景和药物使用相关的酒精相关伤害的风险； 2) 比较和调整病例交叉分析中使用的不同控制期的酒精伤害相对风险的估计； 3) 改进酒精归因分数 (AAF) 和伤害的估计； 4) 研究BAC、中毒的总体临床评估和个体中毒临床症状之间的关系。这一竞争性的延续将更深入地探讨酒精和伤害与更广泛的背景变量之间的关联，以及在酒精和伤害国际会议（Cerpitel，首席研究员）上确定的本研究中的差距，该会议由 NIAAA 主办，世界卫生组织和 CDC 于 2005 年 10 月共同主办，并遵循 2006 年 10 月 NIAAA 校外咨询委员会提出的关于改善 AAF 伤害发病率的建议， 流行病学和预防研究司确定的一个关键优先事项。拟议的研究将添加到 WHO/ERCAAP 数据集中，该数据集包含 11,536 名受伤患者和 10,036 名未受伤患者、来自 13 个国家（总共 25 个国家）的 36 个急诊室（包括 11 个美国站点）以及包含 PAHO 合作研究的 3 个站点，使受伤病例数增加一倍以上（超过 34,000 例），并将非受伤病例数增加到超过14,500。添加这些站点将产生一个关于国际上所有已知的 ER 患者概率样本的感兴趣变量的数据文件，不仅增加了解决研究目标所需的患者数量，而且提供了 WHO/ERCAAP 目前未提供的数据，并提供了国际和国内 ER 的更广泛的代表性，扩大了代表性对于背景分析很重要。还将添加社区和区域一般人口数据，这些数据可从 81 个 ER 站点中的 76 个获取，包括来自 GENACIS 的数据，这将使我们能够开展有关 AAF 和伤害的重要工作，包括细化背景变量及其对相对风险估计的预测价值，并提供背景概况，以便为无法获得 ER 数据的国家分配 AAF。分层线性模型、案例交叉和荟萃分析将用于检查上下文变量与个体和事件级别变量的独立和交互影响。这些跨国分析将解决全球和美国酒精伤害关系中的重要差距，因为美国由许多微观文化组成，这些文化反映了收集这些数据的许多国家的主导环境。公共卫生相关性：这项工作与公共卫生问题特别相关，因为它允许我们将反映特定背景情况的国家的酒精归因分数估计应用于具有类似背景情况的其他国家，这些国家没有 ER 数据，但有一般人口数据。这项研究对于正在进行的比较风险评估工作非常重要，该工作是世界卫生大会 2005 年酒精决议的结果，旨在确定与酒精相关的全球疾病负担。