Romano Eduardo, Torres-Saavedra Pedro, Voas Robert B, Lacey John H
Pacific Institute for Research and Evaluation (PIRE), 11720 Beltsville Drive, Suite 900, Calverton, MD, 20705, USA.
Department of Mathematical Sciences, University of Puerto Rico at Mayagüez, Mayagüez, Puerto Rico.
J Prim Prev. 2017 Jun;38(3):315-328. doi: 10.1007/s10935-017-0478-3.
Lab studies have shown that marijuana can severely impair driving skills. Epidemiological studies, however, have been inconclusive regarding the contribution of marijuana use to crash risk. In the United States, case-control studies based on the merging of comparable crash Fatality Analysis Reporting System (FARS) and non-crash National Roadside Survey (NRS) data have been applied to assess the contribution of drugs to crash risk, but these studies have yielded confusing, even contradictory results. We hypothesize that such a divergence of results emanates from limitations in the databases used in these studies, in particular that of the FARS. The goal of this effort is to examine this hypothesis, and in doing so, illuminate the pros and cons of using these databases for drugged-driving research efforts. We took advantage of two relatively recent cannabis crash risk studies that, despite using similar databases (the FARS and the NRS) and following similar overall approaches, yielded opposite results (Li, Brady, & Chen, 2013; Romano, Torres-Saavedra, Voas, & Lacey, 2014). By identifying methodological similarities and differences between these efforts, we assessed how the limitations of the FARS and NRS databases contributed to contradictory and biased results. Because of its limitations, we suggest that the FARS database should neither be used to examine trends in drug use nor to obtain precise risk estimates. However, under certain conditions (e.g., based on data from jurisdictions that routinely test for drugs, with as little variation in testing procedures as possible), the FARS database could be used to assess the contribution of drugs to fatal crash risk relative to other sources of risk such as alcohol.
实验室研究表明，大麻会严重损害驾驶技能。然而，关于使用大麻对撞车风险的影响，流行病学研究尚无定论。在美国，基于可比的撞车事故死亡分析报告系统（FARS）和非撞车事故全国路边调查（NRS）数据合并的病例对照研究已被用于评估药物对撞车风险的影响，但这些研究得出的结果令人困惑，甚至相互矛盾。我们假设，这种结果差异源于这些研究中所使用数据库的局限性，尤其是FARS数据库的局限性。这项工作的目标是检验这一假设，并在此过程中阐明使用这些数据库进行酒驾研究的利弊。我们利用了两项相对较新的大麻撞车风险研究，尽管它们使用了相似的数据库（FARS和NRS）并遵循了相似的总体方法，但得出了相反的结果（Li、Brady和Chen，2013年；Romano、Torres-Saavedra、Voas和Lacey，2014年）。通过识别这些研究在方法上的异同，我们评估了FARS和NRS数据库的局限性是如何导致相互矛盾和有偏差的结果的。由于其局限性，我们建议既不应使用FARS数据库来研究药物使用趋势，也不应使用该数据库来获得精确的风险估计。然而，在某些条件下（例如，基于常规进行药物检测的司法管辖区的数据，且检测程序的差异尽可能小），FARS数据库可用于评估相对于酒精等其他风险来源，药物对致命撞车风险的影响。
