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Alcohol impacts health: A rapid review of the evidence

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Alcohol impacts health: A rapid review of the evidence Simone Kaptein, PhD Peel Public Health May 28th, 2013 – PowerPoint PPT presentation

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Title: Alcohol impacts health: A rapid review of the evidence


1
Alcohol impacts health A rapid review of the
evidence
  • Simone Kaptein, PhD
  • Peel Public Health
  • May 28th, 2013

2
Evidence Informed Decision Making Peel context
  • Teams would need to conduct a full rapid review
    of the literature when
  • adding a program
  • discontinuing a program
  • refocusing/changing a program
  • reviewing new guidelines/protocols

Source NCCMT
3
Peels Rapid Review Methodology
Source NCCMT
  • Our approach uses
  • Synthesized research
  • Narrow search strategy
  • Limit number of resources
  • Critical appraisal

Tools for rapid reviews http//www.peelregion.ca/
health/library/tools-for-rapid-reviews.asp
4
Issue alcohol impacts health
  • New Canadian LRADG released in 2011
  • Higher limits than old ON guidelines
  • Critically appraised
  • Difficulty accessing methodology

Source CCSA
5
Rapid review question
  • What is the impact of different levels of alcohol
    consumption on mental and physical health?
  • PECO
  • Population Healthy, non-pregnant adults
  • Exposure Various levels of alcohol consumption
  • Comparison None, abstainers
  • Outcome Beneficial or harmful impacts of alcohol

6
Literature search Article selection
  • Search strategy
  • Limited to studies published in English
  • Ovid Medline, PsycInfo (2008-2012)
  • TRIP (2000-2012)
  • Grey literature (e.g., CDC, WHO, NIAAA)
  • 885 potentially relevant articles
  • 72 papers after relevance assessment
  • 3 resources selected and critically appraised

7
Synthesis number and type of resources
  Australian Drinking Guidelines American Dietary Guidelines Babor - Book Chapter
Systematic reviews/meta-analyses 10 12 34
Primary studies 34 32 21
Other (methodology papers/datasets) 5 0 0
Total 148 49 44 55
8
Synthesis Tables
9
Effect sizes for health impacts for women (g/day)
Disease conditions 10g 20g 30g 40g
All-cause mortality (gt45 years) RR0.87 (gt0-10g) RR1.01 (gt10-30g) RR1.40 (gt30-50g) RR1.40 (gt30-50g)
Liver cirrhosis (mortality) RR1.32 RR1.73 RR2.25 RR2.89
Bone health RR0.84 RR0.91 (14-28g) RR1.39
Breast cancer (mortality) RR1.08 RR1.17 RR1.26 RR1.36
10
Effect sizes for health impacts for men (g/day)
Disease Conditions 10g 20g 30g 40g 50g
All-cause mortality (lt45 years) RR1.09 (gt0-10g) RR1.40 (gt10-20g) RR1.78 (gt20-30g) RR1.89 (gt30-40g) RR2.86 (gt40-70g)
All-cause mortality (gt45 years) RR0.85 (gt0-10g) RR0.80 (gt10-20g) RR0.91 (gt20-30g) RR0.96 (gt30-40g) RR1.04 (gt40-70g)
Liver cirrhosis (mortality) RR1.21 RR1.45 RR1.72 RR2.02 RR2.35
Hypertensive disease RR1.15 RR1.33 RR1.53 RR1.77 RR2.04
11
Results
  • Alcohol a risk factor for wide-range of
    conditions
  • Detrimental effects are seen at lt10g/day
  • Volume of drinking and dose-response relationship

Source Rehm et al. (2009). Evidence base for the
development of the Canadian LRDG.
12
Results
  • Irregular drinking patterns result in harms

13
Results
  • Sex/Gender differences
  • Women physiological
  • Men risky behaviours

14
Conclusions
  • Alcohol has detrimental effects, even at low
    levels of consumption
  • Alcohol data has limitations (i.e., self report,
    quality of data/research)
  • There is a lack of international consensus across
    LRADGs
  • Focus on mortality as an outcome morbidity and
    disability are important measures for public
    health

15
Acknowledgements
  • Many individuals assisted in the completion of
    the rapid review, including
  • Teresa Wan
  • Pat Bromby
  • Elizabeth Amorim
  • Suzanne Smith
  • Lori Greco
  • Dr. Megan Ward
  • Cathy Granger
  • Julie Stratton and Monali Varia

16
Questions???
  • Contact information
  • Simone Kaptein
  • Simone.kaptein_at_peelregion.ca
  • (905) 791-7800 x2016
  • Rapid reviews
  • http//www.peelregion.ca/health/library/literature
    -reviews.asp
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