Statistical modeling of volume of alcohol exposure for epidemiological studies of population health: the US example
Open accessAbstract
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.
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Modelling of alcohol use on cardiovascular disease outcomes has to take different dimensions of exposure into account.
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Self-citation
- Authors
- Rehm, J., Kehoe, T., Gmel, G., Stinson, F., Grant, B., & Gmel, G.
- Affiliations
- Centre for Addiction and Mental Health (CA)
- National Institutes of Health (US)
- Corresponding author
- Rehm, Jürgen
- Venue
- Population Health Metrics
- Published
- 2010-03-04
- Volume
- 8
- Issue
- 1
- Pages
- 3-3
- ISSN
- 1478-7954 (ISSN-L)
- PMC
- PMC2841092
- OpenAlex
- W2120827434
- Cited by
- 207
- References
- 29
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 11 · 2023: 6 · 2022: 8 · 2021: 25 · 2020: 21 · 2019: 6 · 2018: 13 · 2017: 14 · 2016: 14 · 2015: 18 · 2014: 18 · 2013: 23 · 2012: 10
- FWCI
- 9.55
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Population Health Metrics (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- IRIS (submittedVersion)
- TSpace (University of Toronto) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion, other-oa)
- Funders
- Centre for Addiction and Mental Health
- National Institute on Alcohol Abuse and Alcoholism (HHSN267200700041C)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Keywords
- alcohol consumption, per capita alcohol consumption, NESARC, gamma distribution, lognormal distribution, Weibull distribution, alcohol-attributable mortality, alcohol-attributable fraction, liver cirrhosis, global burden of disease, United States
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