title: Adjustment for survey non-representativeness using record-linkage: refined estimates of alcohol consumption by deprivation in Scotland.
abstract: OBJECTIVE
  Analytical approaches to addressing survey non-participation bias typically use only demographic information to improve estimates. We applied a novel methodology which uses health information from data linkage to adjust for non-representativeness. We illustrate the method by presenting adjusted alcohol consumption estimates for Scotland.
  
  
  METHODS
  Data on consenting respondents to the Scottish Health Surveys (SHeSs) 1995-2010 were linked confidentially to routinely collected hospital admission and mortality records. Synthetic observations representing non-respondents were created using general population data. Multiple imputation was performed to compute adjusted alcohol estimates given a range of assumptions about the missing data. Adjusted estimates of mean weekly consumption were additionally calibrated to per-capita alcohol sales data.
  
  
  METHODS
  Scotland.
  
  
  METHODS
  13 936 male and 18 021 female respondents to the SHeSs 1995-2010, aged 20-64 years.
  
  
  METHODS
  Weekly alcohol consumption, non-, binge- and problem-drinking.
  
  
  RESULTS
  Initial adjustment for non-response resulted in estimates of mean weekly consumption that were elevated by up to 17.8% [26.5 units (18.6-34.4)] compared with corrections based solely on socio-demographic data [22.5 (17.7-27.3)]; other drinking behaviour estimates were little changed. Under more extreme assumptions the overall difference was up to 53%, and calibrating to sales estimates resulted in up to 88% difference. Increases were especially pronounced among males in deprived areas.
  
  
  CONCLUSIONS
  The use of routinely collected health data to reduce bias arising from survey non-response resulted in higher alcohol consumption estimates among working-age males in Scotland, with less impact for females. This new method of bias reduction can be generalized to other surveys to improve estimates of alternative harmful behaviours.
authors.affiliation: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.|Department of Economics, Lancaster University, Lancaster, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Gorman
authors.affiliation: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
authors.forename: Alastair H
authors.initials: AH
authors.lastname: Leyland
authors.affiliation: NHS Health Scotland, Glasgow, UK.
authors.forename: Gerry
authors.initials: G
authors.lastname: McCartney
authors.affiliation: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.
authors.forename: Srinivasa Vittal
authors.initials: SV
authors.lastname: Katikireddi
authors.affiliation: ScotCen Social Research, Edinburgh, UK.
authors.forename: Lisa
authors.initials: L
authors.lastname: Rutherford
authors.affiliation: Information Services Division, NHS National Services Scotland, Edinburgh, UK.
authors.forename: Lesley
authors.initials: L
authors.lastname: Graham
authors.affiliation: Department of Economics, Lancaster University, Lancaster, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Robinson
authors.affiliation: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK.|Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Linsay
authors.initials: L
authors.lastname: Gray
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D000437:Alcoholism / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012606:Scotland / Q000453:epidemiology; D055815:Young Adult
keywords: Alcohol consumption; Scotland; alcohol-related harm; bias; epidemiology; health surveys; non-participation; record-linkage