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）：这一竞争性续作的工作建立在先前开展的工作的基础上，该工作汇编和分析了来自12个地点的世卫组织酒精与伤害合作研究的数据，以及来自8个国家的33个急诊室地点的数据，包括急诊室协作酒精分析项目（ERCAAP），所有这些都使用了类似的方法和仪器对急诊室患者的概率样本。研究目的包括：1)研究酒精与损伤的关联程度以及酒精相关损伤的风险与饮酒模式、损伤类型和原因、剂量反应关系、损伤的严重程度和致残性、损伤的背景和药物使用有关；2)比较和调整病例交叉分析中不同对照期酒精损伤的相对风险估计值；3)改进对酒精归因分数（AAF）和损伤的估计；4)探讨BAC与中毒总体临床评价、中毒个体临床体征之间的关系。这篇竞争的续篇将更深入地探讨酒精和损伤与更广泛的背景变量之间的关系，以及在2005年10月由NIAAA主办并由世卫组织和疾病预防控制中心共同主办的酒精和损伤国际会议（Cherpitel，首席研究员）上确定的这项研究中的差距，并遵循2006年10月NIAAA关于改善AAF损伤发病率的校外咨询委员会提出的建议。为流行病学和预防研究司确定了一个关键优先事项。拟议的研究将增加世卫组织/ERCAAP数据集，包括11536名受伤患者和10036名非受伤患者，来自13个国家的36个ER站点（总共25个国家），包括11个美国站点，以及组成泛美卫生组织合作研究的3个站点，使受伤病例数量增加一倍以上（超过34000例），非受伤病例增加到14500例以上。这些站点的增加将产生一个关于国际上所有已知急诊室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，而且还提供了WHO/ERCAAP目前无法获得的数据，并提供了国际和国内更广泛的急诊室代表，扩大了代表对上下文分析很重要。还将增加社区和区域一般人口数据，这些数据来自81个ER站点中的76个，包括GENACIS的数据，这将使我们能够开展关于AAF和伤害的重要工作，包括改进背景变量及其相对风险估计的预测价值，并为无法获得ER数据的国家分配AAF提供背景概况。层次线性建模、病例交叉和元分析将用于检查上下文变量与个体和事件级变量的独立和交互影响。这些跨国分析将解决全球和美国在酒精伤害关系方面的重要差距，因为美国是由许多微观文化组成的，这些微观文化反映了这些数据收集的许多国家的背景环境。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概况的国家的酒精归因分数估计值应用于具有类似背景概况的其他国家，这些国家没有ER数据，但有一般人口数据。这项研究对于2005年世界卫生大会关于酒精问题的决议在确定与酒精有关的全球疾病负担方面产生的比较风险评估工作非常重要。