{"doi":"10.1159/000529200","title":"Using Direct and Indirect Estimates for Alcohol-Attributable Mortality: A Modelling Study Using the Example of Lithuania","abstract":"INTRODUCTION: Comparative risk assessments (CRAs) for alcohol use are based on indirect estimates of attributable harm, and usually combine country-specific exposure estimates and global risk relations derived from meta-analyses. CRAs for Eastern European countries, such as Lithuania, base their risk relations not on global risk relations, but on a large Russian cohort study. The availability of a direct estimate of alcohol-attributable mortality following the 2017 implementation of a large increase in alcohol excise taxes in Lithuania has allowed a comparison of these indirect estimates with a country-specific gold standard. METHODS: A statistical modelling study compared direct (predictions based on a time-series methodology) and indirect (predictions based on an attributable-fraction methodology) estimates of alcohol-attributable mortality before and after a large increase in alcohol excise taxes in Lithuania. Specifically, Russia-specific versus global relative risks were compared against the gold standard of time-series based predictions. RESULTS: Compared to direct estimates, indirect estimates markedly underestimated the reduction of alcohol-attributable mortality 12 months post intervention by at least 63%. While both of the indirect estimates differed markedly from the direct estimates, the Russia-specific estimates were closer to the direct estimates, primarily due to higher estimates for alcohol-attributable cardiovascular mortality. DISCUSSION: As all indirect estimates were markedly lower than direct estimates, current overall relative risks and price elasticities should be re-evaluated. In particular, global estimates should be replaced by new regional estimates based on cohort studies.","journal":"European Addiction Research","year":2023,"id":372157,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":5,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9502,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":796393,"name":"Huan Jiang","orcid":"0000-0003-0898-2339","position":1,"is_corresponding":false},{"id":767805,"name":"Kawon Victoria Kim","orcid":"0000-0002-5179-7668","position":2,"is_corresponding":false},{"id":23251,"name":"Robin Room","orcid":"0000-0002-5618-385X","position":3,"is_corresponding":false},{"id":816351,"name":"Pol Rovira","orcid":"0000-0002-5444-1560","position":4,"is_corresponding":false},{"id":48880,"name":"Kevin D. Shield","orcid":"0000-0003-1871-8849","position":5,"is_corresponding":false},{"id":566305,"name":"Alexander Tran","orcid":"0000-0001-9068-0625","position":6,"is_corresponding":false},{"id":663759,"name":"Shannon Lange","orcid":"0000-0002-8067-8932","position":7,"is_corresponding":false},{"id":671033,"name":"Mindaugas Štelemėkas","orcid":"0000-0002-2040-6900","position":8,"is_corresponding":false},{"id":244607,"name":"Jürgen Rehm","orcid":"0000-0001-5665-0385","position":0,"is_corresponding":true}],"reference_count":45,"raw_metadata":null,"created_at":"2026-07-19T01:15:54.000926Z","pmid":"36750037","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}