Observational Research on Alcohol Use and Chronic Disease Outcome: New Approaches to Counter Biases

Background. The frequently reported protective effects of moderate alcohol consumption in observational studies may be due to unadjusted bias. Aim. To examine two new approaches that account for unknown confounding factors and allow the application of intention-to-treat analysis. Method. This study...

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Main Authors: Wenbin Liang, Tanya Chikritzhs
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:The Scientific World Journal
Online Access:http://dx.doi.org/10.1155/2013/860915
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author Wenbin Liang
Tanya Chikritzhs
author_facet Wenbin Liang
Tanya Chikritzhs
author_sort Wenbin Liang
collection DOAJ
description Background. The frequently reported protective effects of moderate alcohol consumption in observational studies may be due to unadjusted bias. Aim. To examine two new approaches that account for unknown confounding factors and allow the application of intention-to-treat analysis. Method. This study used data from the 2008, 2009, and 2010 National Health Interview Surveys conducted in the United States. Unknown confounding effects were estimated through the association between parental alcohol use and health outcomes for children, because the presence of hypothetical physiological effects of alcohol can be ruled out for this association. In order to apply intention-to-treat analysis, previous alcohol use of former drinkers was obtained by using multiple imputations. Estimates with new adjustment approaches were compared with the traditional approach. Results. The traditional analytical approach; appears to be consistent with findings from previous observational studies; when two further adjustment approaches were used, the “protective” effects of moderate drinking almost disappeared. Conclusion. Use of a proxy outcome to estimate and control residual confounding effects of alcohol use and application of the intention-to-treat principle could provide a more realistic estimation of the true effects of alcohol use on health outcomes in observational epidemiological studies.
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spelling doaj-art-22e9871b433d4cacbfcfebf4c9d9399b2025-08-20T03:54:48ZengWileyThe Scientific World Journal1537-744X2013-01-01201310.1155/2013/860915860915Observational Research on Alcohol Use and Chronic Disease Outcome: New Approaches to Counter BiasesWenbin Liang0Tanya Chikritzhs1National Drug Research Institute, Curtin University, GPO Box U1987, Perth, WA 6845, AustraliaNational Drug Research Institute, Curtin University, GPO Box U1987, Perth, WA 6845, AustraliaBackground. The frequently reported protective effects of moderate alcohol consumption in observational studies may be due to unadjusted bias. Aim. To examine two new approaches that account for unknown confounding factors and allow the application of intention-to-treat analysis. Method. This study used data from the 2008, 2009, and 2010 National Health Interview Surveys conducted in the United States. Unknown confounding effects were estimated through the association between parental alcohol use and health outcomes for children, because the presence of hypothetical physiological effects of alcohol can be ruled out for this association. In order to apply intention-to-treat analysis, previous alcohol use of former drinkers was obtained by using multiple imputations. Estimates with new adjustment approaches were compared with the traditional approach. Results. The traditional analytical approach; appears to be consistent with findings from previous observational studies; when two further adjustment approaches were used, the “protective” effects of moderate drinking almost disappeared. Conclusion. Use of a proxy outcome to estimate and control residual confounding effects of alcohol use and application of the intention-to-treat principle could provide a more realistic estimation of the true effects of alcohol use on health outcomes in observational epidemiological studies.http://dx.doi.org/10.1155/2013/860915
spellingShingle Wenbin Liang
Tanya Chikritzhs
Observational Research on Alcohol Use and Chronic Disease Outcome: New Approaches to Counter Biases
The Scientific World Journal
title Observational Research on Alcohol Use and Chronic Disease Outcome: New Approaches to Counter Biases
title_full Observational Research on Alcohol Use and Chronic Disease Outcome: New Approaches to Counter Biases
title_fullStr Observational Research on Alcohol Use and Chronic Disease Outcome: New Approaches to Counter Biases
title_full_unstemmed Observational Research on Alcohol Use and Chronic Disease Outcome: New Approaches to Counter Biases
title_short Observational Research on Alcohol Use and Chronic Disease Outcome: New Approaches to Counter Biases
title_sort observational research on alcohol use and chronic disease outcome new approaches to counter biases
url http://dx.doi.org/10.1155/2013/860915
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