Cross-National Analysis of Alcohol & Injury

酒精的跨国分析

• 批准号: 7814440
• 负责人: CHERYL J CHERPITEL
• 金额: $ 2.78万
• 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/7814440
• 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）：本竞争性延续研究的工作建立在先前开展的工作基础上，该工作汇编和分析了来自12个地点的WHO酒精和损伤合作研究的数据，以及来自8个国家33个ER地点的数据，这些地点包括急诊室酒精合作分析项目（ERCAAP），所有这些都使用了类似的方法和仪器对ER患者的概率样本进行分析。研究目的包括：1）检查酒精与损伤的关联程度以及与饮酒模式、损伤类型和原因、剂量-反应关系、损伤的严重程度和残疾、损伤背景和药物使用有关的酒精相关损伤风险; 2）比较和调整病例交叉分析中使用的不同对照期酒精损伤相对风险的估计值; 3）提高酒精归因分数（AAF）和损伤的估计值; 4）研究BAC、中毒的总体临床评估和中毒的个体临床体征之间的关系。这种相互竞争的继续将更深入地探讨酒精和伤害与更广泛的背景变量的关联，以及在酒精和伤害国际会议上确定的这项研究中的差距，（Cherpitel，主要研究者）2005年10月由NIAAA赞助并由WHO和CDC共同赞助，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，这是流行病学和预防研究部门确定的一个关键优先事项。拟议的研究将增加WHO/ERCAAP数据集的11，536名受伤和10，036名非受伤患者，来自13个国家的36个ER站点（共25个国家），包括11个美国研究中心和3个泛美卫生组织合作研究中心，伤害病例数量增加了一倍多（超过34，000起），非受伤案件增加到超过14，500起。这些研究中心的增加将产生一个关于国际上所有已知ER患者概率样本的关注变量的数据文件，不仅增加了解决研究目的所需的患者数量，而且还提供了WHO/ERCAAP中目前不可用的数据，并提供了国际和国内ER的更广泛代表性，扩大代表性对于背景分析很重要。还将增加社区和区域一般人群数据，可从81个ER站点中的76个获得，包括来自GENACIS的数据，这将使我们能够开展关于AAF和损伤的重要工作，包括改进背景变量及其相对风险估计的预测值，并为ER数据不可用的国家分配AAF提供背景概况。分层线性模型，病例交叉和Meta分析将被用来检查独立和交互作用的影响，上下文变量与个人和事件水平的变量。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主要背景环境。公共卫生相关性：这项工作是特别相关的公共卫生问题，使我们能够适用于估计酒精归因分数的国家，反映了一个特定的背景配置文件，其他国家具有类似的背景配置文件，ER数据不可用，但一般人口的数据。这项研究对于目前根据世界卫生大会2005年关于酒精问题的决议进行的比较风险评估工作十分重要，以确定全球与酒精有关的疾病负担。