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.

说明(申请人提供)：这项竞争性延续的工作建立在先前开展的工作的基础上，先前开展的工作汇编和分析了来自12个地点的世卫组织酒精和伤害合作研究的数据，以及来自8个国家33个急诊室地点的数据，其中包括急诊室酒精分析项目(ERCAAP)，所有这些项目都使用了类似的方法和仪器，对急诊室患者的概率样本进行了分析。研究的目的包括：1)检查酒精与伤害的关联程度以及与饮酒模式、伤害的类型和原因、剂量-反应关系、伤害的严重程度和残疾、伤害的背景和药物使用有关的酒精相关伤害的风险；2)比较和调整在病例交叉分析中使用的不同控制期内酒精造成的伤害的相对风险的估计；3)改进酒精归因分数(AAF)和损伤的估计；4)调查BAC、中毒的总体临床评估和个别临床中毒体征之间的关系。这一竞争性的继续研究将更深入地探讨酒精和伤害与更广泛的背景变量之间的联系，以及这项研究中的差距，这些差距是在2005年10月由NIAAA主办、世卫组织和疾控中心共同赞助的酒精与伤害国际会议(首席调查员切尔皮特尔)上确定的，并遵循了2006年10月NIAAA关于改善AAF以减少伤害发病率的校外咨询委员会提出的建议，这是流行病学和预防研究司确定的一个关键优先事项。这项拟议的研究将增加WHO/ERCAAP的数据集，包括11,536名受伤患者和10,036名非受伤患者，来自13个国家的36个急诊室地点(总共25个国家)，包括11个美国地点，以及3个组成泛美卫生组织合作研究的地点，使受伤病例的数量增加一倍以上(超过34,000例)，非受伤病例增加到14,500多例。这些站点的加入将产生一个关于国际上所有已知的急诊室患者概率样本的感兴趣变量的数据文件，不仅增加了达到研究目标所需的患者数量，而且还提供了世卫组织/ERCAAP目前没有的数据，并提供了国际和国内更广泛的急诊室代表性，扩大了代表性，对背景分析很重要。还将增加从81个急诊室站点中的76个地点获得的社区和区域一般人口数据，包括来自GENACIS的数据，这将使我们能够开展关于AAF和伤害的重要工作，包括提炼背景变量及其相对风险估计的预测值，并为没有ER数据的国家分配AAFs提供背景概况。将使用分层线性建模、病例交叉和元分析来检验背景变量与个体和事件水平变量之间的独立和交互影响。这些跨国分析将解决全球和美国酒精损伤关系中的重要差距，因为美国由许多微观文化组成，这些文化反映了主导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，因为这项工作允许我们将反映特定背景情况的国家对酒精可归因性的估计应用于其他具有类似背景情况的国家，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，这项工作源于2005年世界卫生大会关于酒精在确定与酒精有关的全球疾病负担方面的决议。