Statistical modeling of volume of alcohol exposure for epidemiological studies of population health: the US example - PubMed (original) (raw)

Statistical modeling of volume of alcohol exposure for epidemiological studies of population health: the US example

Jürgen Rehm et al. Popul Health Metr. 2010.

Abstract

Background: Alcohol consumption is a major risk factor in the global burden of disease, with overall volume of exposure as the principal underlying dimension. Two main sources of data on volume of alcohol exposure are available: surveys and per capita consumption derived from routine statistics such as taxation. As both sources have significant problems, this paper presents an approach that triangulates information from both sources into disaggregated estimates in line with the overall level of per capita consumption.

Methods: A modeling approach was applied to the US using data from a large and representative survey, the National Epidemiologic Survey on Alcohol and Related Conditions. Different distributions (log-normal, gamma, Weibull) were used to model consumption among drinkers in subgroups defined by sex, age, and ethnicity. The gamma distribution was used to shift the fitted distributions in line with the overall volume as derived from per capita estimates. Implications for alcohol-attributable fractions were presented, using liver cirrhosis as an example.

Results: The triangulation of survey data with aggregated per capita consumption data proved feasible and allowed for modeling of alcohol exposure disaggregated by sex, age, and ethnicity. These models can be used in combination with risk relations for burden of disease calculations. Sensitivity analyses showed that the gamma distribution chosen yielded very similar results in terms of fit and alcohol-attributable mortality as the other tested distributions.

Conclusions: Modeling alcohol consumption via the gamma distribution was feasible. To further refine this approach, research should focus on the main assumptions underlying the approach to explore differences between volume estimates derived from surveys and per capita consumption figures.

PubMed Disclaimer

Figures

Figure 1

Figure 1

Histogram of alcohol exposure and fitted distributions for non-Hispanic white men.

Figure 2

Figure 2

Histogram of alcohol exposure and fitted distributions for non-Hispanic white women.

Figure 3

Figure 3

Original and shifted gamma distributions for non-Hispanic white men.

Figure 4

Figure 4

Original and shifted gamma distributions for non-Hispanic white women.

Similar articles

Cited by

References

    1. Rehm J, Room R, Graham K, Monteiro M, Gmel G, Sempos C. The relationship of average volume of alcohol consumption and patterns of drinking to burden of disease - an overview. Addiction. 2003;98:1209–1228. doi: 10.1046/j.1360-0443.2003.00467.x. - DOI - PubMed
    1. Rehm J, Mathers C, Popova S, Thavorncharoensap M, Teerawattananon Y, Patra J. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol use disorders. Lancet. 2009;373:2223–2233. doi: 10.1016/S0140-6736(09)60746-7. - DOI - PubMed
    1. Rehm J, Baliunas D, Borges GLG, Graham K, Irving HM, Kehoe T, Parry CD, Patra J, Popova L, Poznyak V, Roerecke M, Room R, Samokhvalov AV, Taylor B. The relation between different dimensions of alcohol consumption and burden of disease - an overview. Addiction. in press . - PMC - PubMed
    1. Rothman KJ, Greenland S, Lash TL. Modern epidemiology. 3. Lippincott Williams & Wilkins, PA, USA; 2008.
    1. Hanley JA. A heuristic approach to the formulas for population attributable fraction. J Epidemiol Community Health. 2001;55:508–514. doi: 10.1136/jech.55.7.508. - DOI - PMC - PubMed

LinkOut - more resources