Selection biases in observational studies affect associations between 'moderate' alcohol consumption and mortality.
Selection biases may lead to systematic overestimate of protective effects from 'moderate' alcohol consumption. Overall, most sources of selection bias favor low-volume drinkers in relation to non-drinkers. Studies that attempt to address these types of bias generally find attenuated or non-significant relationships between low-volume alcohol consumption and cardiovascular disease, which is the major source of possible protective effects on mortality from low-volume consumption. Furthermore, observed mortality effects among established low-volume consumers are of limited relevance to health-related decisions about whether to initiate consumption or to continue drinking purposefully into old age. Short of randomized trials with mortality end-points, there are a number of approaches that can minimize selection bias involving low-volume alcohol consumption.
Section of General Internal Medicine, Boston Medical Center, Boston, MA, USA.|Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA.
Timothy S
TS
Naimi
Centre for Addiction Research of BC, University of Victoria, Victoria, British Columbia, Canada.
Timothy
T
Stockwell
Centre for Addiction Research of BC, University of Victoria, Victoria, British Columbia, Canada.
Jinhui
J
Zhao
Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA.
Ziming
Z
Xuan
University of Gothenburg, Gothenburg, Sweden.
Frida
F
Dangardt
Centre for Addiction Research of BC, University of Victoria, Victoria, British Columbia, Canada.
Rich
0000-0002-2535-1427
R
Saitz
National Drug Research Institute, Curtin University, Perth, Australia.
Wenbin
W
Liang
National Drug Research Institute, Curtin University, Perth, Australia.
Tanya
T
Chikritzhs
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000401:mortality*; D006801:Humans; D064887:Observational Studies as Topic / Q000706:statistics & numerical data*; D015983:Selection Bias; D055815:Young Adult
Alcohol; bias; epidemiology; moderate drinking; mortality; selection bias