Dinh-Zarr T, DiGuiseppi C, Heitman E, Roberts I
Management and Policy Sciences (MAPS), University of Texas School of Public Health, 1200 Herman Pressler, RAS-901, Houston, Texas 77030, USA.
Cochrane Database Syst Rev. 2000(2):CD001857. doi: 10.1002/14651858.CD001857.
To assess the effect of interventions for problem drinking on subsequent injury risk.
Data Sources.- Twelve computerized databases: MEDLINE (1966-8/96), EMBASE (1982-1/97), Cochrane Controlled Trials Register (1997, issue #1), PSYCHINFO (1967-1/97), CINAHL (1982-10/96), ERIC (1966-12/96), Dissertation Abstracts International (1861-11/96), IBSS (1961-1/97), ISTP (1982-1/97) and three specialized transportation databases, using terms for problem drinking combined with terms for controlled trials; bibliographies of relevant trials; and contact with authors and government agencies.
Data Selection.- Randomized controlled trials of interventions among particiapnts with problem drinking, which are intended to reduce alcohol consumption or to prevent injuries or their antecedents, and which measured injury-related outcomes. Of 7014 studies identified, 19 (0. 3%) met the inclusion criteria.
Data Extraction.- Two authors extracted data on participants, interventions, follow-up, allocation concealment, and outcomes, and independently rated allocation concealment quality.
Data Synthesis.- In completed trials, interventions for problem drinking were associated with reduced suicide attempts, domestic violence, falls, drinking-related injuries, and injury hospitalizations and deaths, with reductions ranging from 27-65%. Several interventions among convicted drunk drivers reduced motor vehicle crashes and injuries. Because few trials were sufficiently large to assess effects on injuries, individual effect estimates were imprecise. We did not combine the results quantitatively because the interventions, patient populations, and outcomes were so diverse.
REVIEWER'S CONCLUSIONS: Conclusion.- Interventions for problem drinking may reduce injuries and their antecedents. Because injuries account for much of the morbidity and mortality from problem drinking, further studies are warranted to evaluate the effect of treating problem drinking on injuries.
评估针对问题饮酒的干预措施对后续受伤风险的影响。
数据来源。——十二个计算机化数据库：MEDLINE（1966 - 1996年8月）、EMBASE（1982 - 1997年1月）、Cochrane对照试验注册库（1997年，第1期）、PSYCHINFO（1967 - 1997年1月）、CINAHL（1982 - 1996年10月）、ERIC（1966 - 1996年12月）、国际学位论文摘要（1861 - 1996年11月）、IBSS（1961 - 1997年1月）、ISTP（1982 - 1997年1月）以及三个专门的交通数据库，使用与问题饮酒相关的术语结合对照试验的术语；相关试验的参考文献；并与作者和政府机构进行联系。
数据选择。——针对有问题饮酒的参与者进行干预的随机对照试验，旨在减少酒精消费或预防伤害及其先兆，并测量与伤害相关的结果。在识别出的7014项研究中，19项（0.3%）符合纳入标准。
数据提取。——两位作者提取了关于参与者、干预措施、随访、分配隐藏和结果的数据，并独立对分配隐藏质量进行评分。
数据综合。——在已完成的试验中，针对问题饮酒的干预措施与自杀未遂、家庭暴力、跌倒、与饮酒相关的伤害以及伤害住院和死亡的减少相关，减少幅度在27%至65%之间。对醉酒驾驶定罪者的几种干预措施减少了机动车碰撞和伤害。由于很少有试验规模足够大以评估对伤害的影响，个体效应估计不精确。我们没有对结果进行定量合并，因为干预措施、患者群体和结果差异很大。
结论。——针对问题饮酒的干预措施可能会减少伤害及其先兆。由于伤害占问题饮酒导致的大部分发病率和死亡率，有必要进一步研究以评估治疗问题饮酒对伤害的影响。
