From the Swiss Institute for the Prevention of Alcohol and Drug Problems, Lausanne, Switzerland.
J Addict Med. 2008 Jun;2(2):96-102. doi: 10.1097/ADM.0b013e31815f0ba6.
: Concerns about self-reports have led to calls for objective measures of blood alcohol concentration (BAC). The present study compared objective measures with self-reports.
: BAC from breath or blood samples were obtained from 272 randomly sampled injured patients who were admitted to a Swiss emergency department (ED). Self-reports were compared a) between those providing and refusing a BAC test, and b) to estimated peak BAC (EPBAC) values based on BACs using the Widmark formula.
: Those providing BACs were significantly (P < 0.05) younger, more often male, and less often reported alcohol consumption before injury, but consumed higher quantities when drinking. Eighty-eight percent of those with BAC measures gave consistent reports (positive or negative). Significantly more patients reported consumption with negative BAC measures (N = 29) than vice versa (N = 3). Duration of consumption and times between injury and BAC measurement predicted EPBAC better than did the objective BAC measure.
: There is little evidence that patients who provide objective BAC measures deliberately conceal consumption. ED studies must rely on self-reports, eg, take the time period between injury and ED admission into account. Clearly, objective measures are of clinical relevance, eg, to provide optimal treatment in the ED. However, they may be less relevant to establishing effects in an epidemiologic sense, such as estimating risk relationships. In this respect, efforts to increase the validity and reliability of self-reports should be preferred over the collection of additional objective measures.
由于对自我报告的担忧，人们呼吁采用客观的血液酒精浓度（BAC）测量方法。本研究比较了客观测量与自我报告的结果。
从瑞士急诊部（ED）随机抽取的 272 名受伤患者中采集了呼气或血液样本的 BAC，并对其进行了比较。a）提供和拒绝 BAC 测试的患者之间的比较，b）基于 Widmark 公式的 BAC 计算的估计峰值 BAC（EPBAC）值的比较。
提供 BAC 的患者明显更年轻（P<0.05）、更多为男性，且受伤前饮酒的可能性更小，但饮酒量更大。88%有 BAC 测量值的患者给出了一致的报告（阳性或阴性）。有 BAC 测量值的患者中，报告阴性 BAC 值的患者（N=29）明显多于报告阳性 BAC 值的患者（N=3）。饮酒持续时间和受伤与 BAC 测量之间的时间间隔比客观 BAC 测量更能预测 EPBAC。
没有证据表明提供客观 BAC 测量值的患者故意隐瞒饮酒情况。ED 研究必须依赖于自我报告，例如，考虑受伤与 ED 入院之间的时间间隔。显然，客观测量对于临床治疗很重要，例如在 ED 提供最佳治疗。然而，从流行病学意义上评估风险关系时，它们的相关性可能较低。在这方面，应该优先考虑提高自我报告的有效性和可靠性，而不是收集更多的客观测量值。
