Evidence map›Paper›PMID 36750037›Full record

ArticleEuropean addiction research2023

Using Direct and Indirect Estimates for Alcohol-Attributable Mortality: A Modelling Study Using the Example of Lithuania.

Jürgen Rehm, Huan Jiang, Kawon Victoria Kim, Robin Room, Pol Rovira, Kevin David Shield, Alexander Tran, Shannon Lange, Mindaugas Štelemėkas

Abstract read
In one paragraph

Article in European addiction research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

9 authors.

Jürgen RehmInstitute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Huan JiangInstitute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Kawon Victoria KimInstitute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Robin RoomCentre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria, Australia.
Pol RoviraProgram on Substance Abuse, Public Health Agency of Catalonia, Program on Substance Abuse and Designated WHO CC, Public Health Agency of Catalonia, Barcelona, Spain.
Kevin David ShieldInstitute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Alexander TranInstitute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Shannon LangeInstitute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.
Mindaugas ŠtelemėkasHealth Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.

Funding

Evaluation of the impact of alcohol control policies on morbidity and mortality in Lithuania and other Baltic statesR01AA028224 · NIAAA · CENTRE FOR ADDICTION AND MENTAL HEALTH · PI REHM, JUERGEN T, ŠTELEMĖKAS, MINDAUGAS · 2020 to 2024
$2.2M
NIAAA NIH HHS R01 AA028224
6 · The paper itself

Abstract

introductionComparative risk assessments (CRAs) for alcohol use are based on indirect estimates of attributable harm, and usually combine country-specific exposure estimates and global risk relations derived from meta-analyses. CRAs for Eastern European countries, such as Lithuania, base their risk relations not on global risk relations, but on a large Russian cohort study. The availability of a direct estimate of alcohol-attributable mortality following the 2017 implementation of a large increase in alcohol excise taxes in Lithuania has allowed a comparison of these indirect estimates with a country-specific gold standard.

methodsA statistical modelling study compared direct (predictions based on a time-series methodology) and indirect (predictions based on an attributable-fraction methodology) estimates of alcohol-attributable mortality before and after a large increase in alcohol excise taxes in Lithuania. Specifically, Russia-specific versus global relative risks were compared against the gold standard of time-series based predictions.

resultsCompared to direct estimates, indirect estimates markedly underestimated the reduction of alcohol-attributable mortality 12 months post intervention by at least 63%. While both of the indirect estimates differed markedly from the direct estimates, the Russia-specific estimates were closer to the direct estimates, primarily due to higher estimates for alcohol-attributable cardiovascular mortality. DISCUSSION: As all indirect estimates were markedly lower than direct estimates, current overall relative risks and price elasticities should be re-evaluated. In particular, global estimates should be replaced by new regional estimates based on cohort studies.

Indexed as

Alcohol DrinkingTaxesCohort StudiesHumansLithuaniaRisk AssessmentAlcohol-attributable fractionAlcohol useCauses of deathMortalityRisk relations

Identifiers

PMID36750037
PMCPMC10238643

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LicenceCC BY
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.