Steps towards Constructing a Global Comparative Risk Analysis for Alcohol Consumption: Determining Indicators and Empirical Weights for Patterns of Drinking, Deciding about Theoretical Minimum, and Dealing with Different Consequences

Abstract

In order to conduct a comparative risk analysis for alcohol within the Global Burden of Disease Study (GBD 2000), several questions had to be answered. (1) What are the appropriate dimensions for alcohol consumption and how can they be categorized? The average volume of alcohol and patterns of drinking were selected as dimensions. Both dimensions could be looked upon as continuous but were categorized for practical purposes. The average volume of drinking was categorized into the following categories: abstention; drinking 1 (>0–19.99 g pure alcohol daily for females, >0–39.99 g for males); drinking 2 (20–39.99 g for females, 40–59.99 g for males), and drinking 3 (≧40 g for females, ≧60 g for males). Patterns of drinking were categorized into four levels of detrimental impact based on an optimal scaling analysis of key informant ratings. (2) What is the theoretical minimum for both dimensions? A pattern of regular light drinking (at most 1 drink every day) was selected as theoretical minimum for established market economies for all people above age 45. For all other regions and age groups, the theoretical minimum was set to zero. Potential problems and uncertainties with this selection are discussed. (3) What are the health outcomes for alcohol and how do they relate to the dimensions? Overall, more than 60 disease conditions were identified as being related to alcohol consumption. Most chronic conditions seem to be related to volume only (exceptions are coronary heart disease and ischemic stroke), and most acute conditions seem to be related to volume and patterns. In addition, using methodology based on aggregate data, patterns were relevant for attributing harms for men but not women.

A Predictive Microsimulation Model to Estimate the Clinical Relevance of Reducing Alcohol Consumption in Alcohol Dependence

“…For example, while an extensive list of conditions has been established as alcohol attributable [65], not all could be considered in the model due to the time horizon of the analysis and the availability of data. The alcohol-attributable events selected for inclusion in the model were those with a strong published evidence base demonstrating an association between alcohol consumption and risk, and those shown to have a high incidence of hospitalisation over a 1-year time horizon in the population of alcohol-dependent patients modelled and for which nalmefene is licensed.…”

The relationship between different dimensions of alcohol use and the burden of disease—an update

“…for outcome categories for which alcohol is a component cause. AAFs can be interpreted as the proportion of an outcome in a specific population, which would not occur if there had been no alcohol use 11, 29. In discussing the various conditions, we also refer to the Bradford Hill criteria 30, with most emphasis on pathophysiology.…”

Methodological Approaches to Conducting Pooled Cross-Sectional Time Series Analysis: The Example of the Association between All-Cause Mortality and per capita Alcohol Consumption for Men in 15 European States

“…This analysis is based on the data collected from the WHO key informants survey 2000 [14]. The scoring is based on the fact that optimal scoring of the full survey (including non-European countries) basically lead to the same results as a simple additive scoring.…”