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Diagnosis-based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level?

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Title: Diagnosis-based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level?
Authors: Whitlam, Genevieve, Dinh, Michael, Rodgers, Craig, Muscatello, David J., McGuire, Rhydwyn, Ryan, Therese, Thackway, Sarah
Source: Drug & Alcohol Review. Nov2016, Vol. 35 Issue 6, p693-701. 9p. 3 Charts, 1 Graph.
Subjects: Alcohol drinking, Health policy, Emergency medical services, Alcoholism, Public health, Hospital emergency services, Public health surveillance, Medical triage, Alcohol-induced disorders, Alcoholic intoxication, Diagnosis
Geographic Terms: Australia
Abstract: Introduction and Aims: Acute harm from heavy drinking episodes is an increasing focus of public health policy, but capturing timely data on acute harms in the population is challenging. This study aimed to evaluate the precision of readily available administrative emergency department (ED) data in public health surveillance of acute alcohol harms.Design and Methods: We selected a random sample of 1000 ED presentations assigned an ED diagnosis code for alcohol harms (the 'alcohol syndrome') in the New South Wales, Australia, automatic syndromic surveillance system. The sample was selected from 68 public hospitals during 2014. Nursing triage free-text fields were independently reviewed to confirm alcohol consumption and classify each presentation into either an 'acute' or 'chronic' harm. Positive predictive value (PPV) for acute harm was calculated, and predictors of acute harm presentations were estimated using logistic regression.Results: The PPV of the alcohol syndrome for acute alcohol harm was 53.5%. Independent predictors of acute harm were ambulance arrival [adjusted odds ratio (aOR) = 3.4, 95% confidence interval (CI) 2.4-4.7], younger age (12-24 vs. 25-39 years: aOR = 3.4, 95% CI 2.2-5.3), not being admitted (aOR 2.2, 95% CI 1.5-3.2) and arriving between 10 pm and 5.59 am (aOR 2.1, 95% CI 1.5-2.8). PPV among 12 to 24-year-olds was 82%.Discussion and Conclusions: The alcohol syndrome provides moderate precision as an indicator of acute alcohol harms presenting to the ED. Precision for monitoring acute harm in the population is improved by filtering the syndrome by the strongest independent predictors of acute alcohol harm presentations. [Whitlam G, Dinh M, Rodgers C, Muscatello DJ, McGuire R, Ryan T, Thackway S. Diagnosis-based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level? Drug Alcohol Rev 2016;35:693-701]. [ABSTRACT FROM AUTHOR]
Copyright of Drug & Alcohol Review is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Diagnosis-based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level?
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  Data: <searchLink fieldCode="AR" term="%22Whitlam%2C+Genevieve%22">Whitlam, Genevieve</searchLink><br /><searchLink fieldCode="AR" term="%22Dinh%2C+Michael%22">Dinh, Michael</searchLink><br /><searchLink fieldCode="AR" term="%22Rodgers%2C+Craig%22">Rodgers, Craig</searchLink><br /><searchLink fieldCode="AR" term="%22Muscatello%2C+David+J%2E%22">Muscatello, David J.</searchLink><br /><searchLink fieldCode="AR" term="%22McGuire%2C+Rhydwyn%22">McGuire, Rhydwyn</searchLink><br /><searchLink fieldCode="AR" term="%22Ryan%2C+Therese%22">Ryan, Therese</searchLink><br /><searchLink fieldCode="AR" term="%22Thackway%2C+Sarah%22">Thackway, Sarah</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Drug+%26+Alcohol+Review%22">Drug & Alcohol Review</searchLink>. Nov2016, Vol. 35 Issue 6, p693-701. 9p. 3 Charts, 1 Graph.
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  Data: <searchLink fieldCode="DE" term="%22Alcohol+drinking%22">Alcohol drinking</searchLink><br /><searchLink fieldCode="DE" term="%22Health+policy%22">Health policy</searchLink><br /><searchLink fieldCode="DE" term="%22Emergency+medical+services%22">Emergency medical services</searchLink><br /><searchLink fieldCode="DE" term="%22Alcoholism%22">Alcoholism</searchLink><br /><searchLink fieldCode="DE" term="%22Public+health%22">Public health</searchLink><br /><searchLink fieldCode="DE" term="%22Hospital+emergency+services%22">Hospital emergency services</searchLink><br /><searchLink fieldCode="DE" term="%22Public+health+surveillance%22">Public health surveillance</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+triage%22">Medical triage</searchLink><br /><searchLink fieldCode="DE" term="%22Alcohol-induced+disorders%22">Alcohol-induced disorders</searchLink><br /><searchLink fieldCode="DE" term="%22Alcoholic+intoxication%22">Alcoholic intoxication</searchLink><br /><searchLink fieldCode="DE" term="%22Diagnosis%22">Diagnosis</searchLink>
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  Data: <bold>Introduction and Aims: </bold>Acute harm from heavy drinking episodes is an increasing focus of public health policy, but capturing timely data on acute harms in the population is challenging. This study aimed to evaluate the precision of readily available administrative emergency department (ED) data in public health surveillance of acute alcohol harms.<bold>Design and Methods: </bold>We selected a random sample of 1000 ED presentations assigned an ED diagnosis code for alcohol harms (the 'alcohol syndrome') in the New South Wales, Australia, automatic syndromic surveillance system. The sample was selected from 68 public hospitals during 2014. Nursing triage free-text fields were independently reviewed to confirm alcohol consumption and classify each presentation into either an 'acute' or 'chronic' harm. Positive predictive value (PPV) for acute harm was calculated, and predictors of acute harm presentations were estimated using logistic regression.<bold>Results: </bold>The PPV of the alcohol syndrome for acute alcohol harm was 53.5%. Independent predictors of acute harm were ambulance arrival [adjusted odds ratio (aOR) = 3.4, 95% confidence interval (CI) 2.4-4.7], younger age (12-24 vs. 25-39 years: aOR = 3.4, 95% CI 2.2-5.3), not being admitted (aOR 2.2, 95% CI 1.5-3.2) and arriving between 10 pm and 5.59 am (aOR 2.1, 95% CI 1.5-2.8). PPV among 12 to 24-year-olds was 82%.<bold>Discussion and Conclusions: </bold>The alcohol syndrome provides moderate precision as an indicator of acute alcohol harms presenting to the ED. Precision for monitoring acute harm in the population is improved by filtering the syndrome by the strongest independent predictors of acute alcohol harm presentations. [Whitlam G, Dinh M, Rodgers C, Muscatello DJ, McGuire R, Ryan T, Thackway S. Diagnosis-based emergency department alcohol harm surveillance: What can it tell us about acute alcohol harms at the population level? Drug Alcohol Rev 2016;35:693-701]. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Drug & Alcohol Review is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/dar.12458
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        Text: English
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      – SubjectFull: Alcohol drinking
        Type: general
      – SubjectFull: Health policy
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      – SubjectFull: Emergency medical services
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