%0 Journal Article %T Estimating the number of alcohol-attributable deaths: methodological issues and illustration with French data for 2006. %+ Centre d'épidémiologie sur les causes médicales de décès (CépiDc) %+ Centre International de Recherche contre le Cancer - International Agency for Research on Cancer (CIRC - IARC) %A Rey, Grégoire %A Boniol, Mathieu %A Jougla, Eric %< avec comité de lecture %@ 0965-2140 %J Addiction %I Wiley %V 105 %N 6 %P 1018-29 %8 2010-06 %D 2010 %R 10.1111/j.1360-0443.2010.02910.x %M 20331552 %K Alcohol-attributable mortality: methods %Z Life Sciences [q-bio]/Santé publique et épidémiologieJournal articles %X AIMS: Computing the number of alcohol-attributable deaths requires a series of hypotheses. Using French data for 2006, the potential biases are reviewed and the sensitivity of estimates to various hypotheses evaluated. METHODS: Self-reported alcohol consumption data were derived from large population-based surveys. The risks of occurrence of diseases associated with alcohol consumption and relative risks for all-cause mortality were obtained through literature searches. All-cause and cause-specific population alcohol-attributable fractions (PAAFs) were calculated. In order to account for potential under-reporting, the impact of adjustment on sales data was tested. The 2006 mortality data were restricted to people aged between 15 and 75 years. RESULTS: When alcohol consumption distribution was adjusted for sales data, the estimated number of alcohol-attributable deaths, the sum of the cause-specific estimates, was 20 255. Without adjustment, the estimate fell to 7158. Using an all-cause mortality approach, the adjusted number of alcohol-attributable deaths was 15 950, while the non-adjusted estimate was a negative number. Other methodological issues, such as computation based on risk estimates for all causes for 'all countries' or only 'European countries', also influenced the results, but to a lesser extent. DISCUSSION: The estimates of the number of alcohol-attributable deaths varied greatly, depending upon the hypothesis used. The most realistic and evidence-based estimate seems to be obtained by adjusting the consumption data for national alcohol sales, and by summing the cause-specific estimates. However, interpretation of the estimates must be cautious in view of their potentially large imprecision. %G English %2 https://inserm.hal.science/inserm-00844666/document %2 https://inserm.hal.science/inserm-00844666/file/10-01_AAF_methods_addiction_vf.pdf %L inserm-00844666 %U https://inserm.hal.science/inserm-00844666 %~ INSERM %~ UNIV-PARIS7 %~ SANTE_PUB_INSERM %~ UNIV-PARIS