Measurement of alcohol-involved injury in community prevention: the search for a surrogate III.

Alcohol is involved in a substantial percentage of injuries, with estimates in the United States ranging from 3% of drownings up to 50% of fatal traffic crashes. Thus, alcohol-involved injury is a natural target for prevention efforts, particularly at the community level. Although a potentially valuable target, the measurement of alcohol-involved injuries for purposes of outcome evaluation of such prevention is problematic. The consistent measurement of alcohol in the blood of injured persons is not a regular aspect of acute medical treatment. Thus, alternatives are needed both for epidemiological, as well as prevention, research. This study will review three alternative measurements of alcohol-involved injury [i.e., (a) emergency room interviews and breath testing for blood alcohol concentration, (b) telephone surveys of self-reported injuries after drinking, and (c) injury surrogate derived archival data from hospital inpatient treatment]. After comparing the strengths and weaknesses of all three and investigating the sensitivity of the injury surrogate to detect changes in alcohol-involved injuries, this study concludes that the injury surrogate is a reliable, low-cost, and valid outcome measure for prevention evaluation.