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cigdemdemir.net aims to support evidence-informed decision making in public health by providing current research evidence in a searchable online registry. Findings of a research project funded by the Canadian Institutes of Health Research, demonstrated a need for a reliable source of review evidence that public health practitioners and decision-makers could easily access and employ.
The cigdemdemir.net team regularly searches for, screens, and rates systematic and narrative reviews, and meta-analyses from a variety of electronic and print sources. Full-text access to this registry of reviews is provided where possible through the public domain, PubMed Identifiers or through IP authentication. Summary statements, which provide a synopsis of a review's content, highlight key evidence points, and present implications for practice and policy, are offered for a number of high-quality reviews in the registry.
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Abstract:
BACKGROUND: Alcohol consumption
has been linked with injuries through motor vehicle crashes, falls, drowning,
fires and burns, and violence. In the US, half of the estimated 100,000 deaths
attributed to alcohol each year are due to intentional and unintentional
injuries. The identification of effective interventions for the reduction of
unintentional and intentional injuries due to problem drinking is, therefore,
an important public health goal.
OBJECTIVES: To assess the effect of
interventions for problem drinking on subsequent injury risk.
SEARCH STRATEGY: We searched 12
twelve computerized databases: MEDLINE (1966-8/96),
EMBASE (1982-1/97), Cochrane Controlled Trials
Register (1997, issue #1), PsycINFO (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. The electronic and bibliographic searches
were updated in May 2002.
SELECTION CRITERIA: Randomized
controlled trials of interventions among participants with problem drinking,
which are intended to reduce alcohol consumption or to prevent injuries or
their antecedents, and which measured injury-related outcomes.
DATA COLLECTION AND ANALYSIS: Two
authors extracted data on participants, interventions, follow-up, allocation
concealment, and outcomes, and independently rated allocation concealment
quality.
MAIN RESULTS: Of 23 eligible trials
identified, 22 had been completed and 17 provided results for relevant
outcomes. Completed trials comparing interventions for problem drinking to no
intervention reported reduced motor-vehicle crashes and related injuries,
falls, suicide attempts, domestic violence, assaults and child abuse,
alcohol-related injuries and injury emergency visits, hospitalizations and
deaths. Reductions ranged from 27% to 65%. Because few trials were
sufficiently large to assess effects on injuries, individual effect estimates
were generally imprecise. We did not combine the results quantitatively
because the interventions, patient populations, and outcomes were so diverse.
The most commonly evaluated intervention was brief counseling in the clinical
setting. This was studied in seven trials, in which injury-related deaths were
reduced: relative risk (RR) 0.65; 95% confidence interval (CI) 0.21 to 2.00.
However, this reduction may have been due to chance. The majority of trials of
brief counseling also showed beneficial effects on diverse non-fatal injury
outcomes.
AUTHORS’ CONCLUSIONS:
Interventions for problem drinking appear to reduce injuries and their
antecedents (e.g. falls, motor vehicle crashes, suicide attempts). Because
injuries account for much of the morbidity and mortality from problem
drinking, larger studies are warranted to evaluate the effect of treating
problem drinking on injuries.