Cross-National Analysis of Alcohol & Injury

酒精的跨国分析

• 批准号: 7883184
• 负责人: CHERYL J CHERPITEL
• 金额: $ 42.41万
• 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/7883184
• 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）：在此类竞争延续中的工作是基于先前进行的，该研究汇编和分析了来自12个站点的数据，该数据与8个国家 /地区的33个ER站点合作研究，其中包括急诊室协作酒精分析项目（ERCAAP），所有这些都使用了ER ER患者的可能性和仪器。研究目的包括：1）检查酒精与损伤的关联以及与饮酒模式，损伤类型和原因有关，剂量反应关系，严重程度和伤害，伤害背景和吸毒的残疾的幅度； 2）比较和调整在案例分解分析中使用的各个控制期内酒精受伤相对风险的估计； 3）提高对酒精归因（AAF）和损伤的估计； 4）研究BAC，中毒的总体临床评估与中毒的个人临床迹象之间的关系。这种竞争延续将在更深入的探索酒精和伤害与更广泛的上下文变量之间进行探索，以及这项研究的差距，在国际酒精和伤害会议上（Cherpitel，NIAAA）发起的国际会议（Cherpitel，首席研究员）在2005年10月在2005年10月提高了2005年10月的建议，并在2006年10月提出的建议中提出了一定的建议。流行病学和预防研究的分区确定的关键优先级。拟议的研究将增加WHO/ERCAAP数据集，其中11,536名受伤和10,036名未受伤的患者，来自13个国家的36个急诊室（总计25个国家/地区）（包括11个美国网站），以及3个站点，包括PAHO协作研究的3个站点，增加了受伤案件的数量，超过了34,000例（超过34,000），超过14.500份了14.500份。这些站点的添加将导致有关急诊室患者的所有已知概率样本（在国际上，不仅增加解决研究目标所需的患者数量的已知概率样本）的数据文件，而且还提供了当前在WHO/ERCAAP中尚未提供的数据，并且在国际上和家庭中提供了更广泛的代表性，具有扩展的代表性，具有扩展的代表性分析。还将添加社区和地区一般人口数据，可从81个ER站点中的76个获得，包括来自Genacis的数据，这将使我们能够在AAF和受伤上进行重要的工作，包括提炼上下文变量及其相对风险估计的预测价值，并为无法提供ER数据分配AAF的上下文概况。分层线性建模，案例分解和元分析将用于检查具有个人和事件级变量的上下文变量的独立和交互作用。这些跨国分析将解决全球及美国酒精伤害Nexus Nexus Nexus的重要差距，因为美国由许多微文化组成，这些微文化反映了占主导地位的许多收集这些数据国家的上下文环境。公共卫生相关性：这项工作与公共卫生问题尤其相关，这与我们允许我们对酒精的估计值估计，这些国家反映了针对其他具有类似上下文概况的特定上下文概况，而具有类似的上下文概况，而ER数据可用，但总人口数据的数据是。这项研究对于正在进行的比较风险评估的工作很重要，这是由于2005年世界卫生大会在确定与酒精有关的全球疾病负担方面的饮酒决议而产生的。