Drug and alcohol review最新文献_第6页

Automated Detection of Digital Alcohol Marketing Using SCANNER: An Integrated Deep-Learning Approach 使用SCANNER自动检测数字酒精营销：一种集成的深度学习方法。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-12-25 DOI: 10.1111/dar.70095

Florentine Martino, Navoda Liyana Pathirana, Luai Saif, Asim Bhatti, Kathryn Backholer

Introduction

Alcohol marketing significantly influences consumption patterns, particularly among youth, heavy drinkers and women. Digital platforms have amplified this impact through targeted, immersive campaigns. However, monitoring such marketing remains a challenge due to its opaque and dynamic nature. This study introduces SCANNER Alcohol, an AI-enabled system designed to detect alcohol marketing in online content at the brand level.

Methods

SCANNER Alcohol integrates object detection (logos) and optical character recognition (text) to automatically identify 134 alcohol brands within image and video data. The system was trained using annotated datasets of brand logos and validated through standard machine learning metrics. Real-world performance was assessed using social media screen recordings (brand accounts and 12 h of general use), benchmarked against manual coding.

Results

SCANNER Alcohol achieved high algorithmic accuracy, with a mean average precision of 0.94, recall of 0.96 and F1 score of 0.95. In real-world testing, the model demonstrated strong performance, correctly identifying 98.9% of alcohol-branded posts in social media videos. SCANNER Alcohol achieved a low 6.7% false discovery rate, indicating high precision and low noise in the detection output.

Discussion and Conclusions

SCANNER Alcohol is the first system to combine brand-level object and text detection for automated digital alcohol marketing surveillance. Its high accuracy on real-world data and ethical design make it a valuable tool for public health monitoring. SCANNER Alcohol offers a scalable, adaptable and ethically sensitive solution to support regulatory efforts to hold alcohol companies accountable for their digital marketing practices and to ultimately reduce alcohol-related harm.

导言：酒类营销显著影响消费模式，特别是在青年、酗酒者和妇女中。数字平台通过有针对性的沉浸式活动放大了这种影响。然而，由于其不透明和动态的性质，监测这种营销仍然是一个挑战。本研究介绍了SCANNER Alcohol，这是一个人工智能支持的系统，旨在从品牌层面检测在线内容中的酒精营销。方法：结合物体检测（标识）和光学字符识别（文本），在图像和视频数据中自动识别134个酒精品牌。该系统使用带注释的品牌标识数据集进行训练，并通过标准机器学习指标进行验证。使用社交媒体屏幕记录（品牌账户和12小时的一般使用）评估真实世界的表现，并以手动编码为基准。结果：SCANNER Alcohol具有较高的算法准确度，平均精密度为0.94，召回率为0.96，F1评分为0.95。在现实世界的测试中，该模型表现出了很强的性能，正确识别了社交媒体视频中98.9%的酒精品牌帖子。SCANNER Alcohol实现了6.7%的低错误发现率，表明检测输出精度高，噪声低。讨论和结论：SCANNER Alcohol是第一个将品牌级对象和文本检测相结合的系统，用于自动数字酒精营销监控。它对真实世界数据的高准确性和道德设计使其成为公共卫生监测的宝贵工具。SCANNER Alcohol提供了一个可扩展的、适应性强的、道德敏感的解决方案，以支持监管机构的努力，使酒类公司对其数字营销实践负责，并最终减少与酒精相关的危害。

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引用次数: 0

Navigating the Gap: An Examination of Funder Rhetoric and Reality Regarding Community-Research Partnerships 导航差距：关于社区研究伙伴关系的资助者修辞和现实的检查。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-12-22 DOI: 10.1111/dar.70084

Danielle M. Russell, Ele Morrison, Jason Grebely, Carla Treloar, John Gobeil, Jess Doumany, M. J. Stowe, Paul Dietze, Kate Seear, Natalie Taylor, Alison Ritter

Partnerships between researchers and consumers—specifically, people who use drugs in the context of our research co-production—can significantly enhance the relevance and impact of research. Funders increasingly emphasise the value of community-researcher collaborations, yet translating this commitment into effective practice remains challenging. This commentary draws from our experience in developing an application for a collaborative grant with the National Health and Medical Research Council (NHMRC) in Australia, focusing on issues that impact people who use drugs. We reflect on four key insights that emerged from the grant-writing process: (i) expectations and resources, highlighting the gap between the expectations of funding bodies, the way resourcing is used in academic contexts and the resources required for meaningful community involvement; (ii) grant success metrics, examining the disconnect between funding criteria and the realities of co-production; (iii) representation, addressing the challenges of ensuring equitable and authentic consumer participation; and (iv) sharing power, discussing how power dynamics between researchers and community members influence the research process. In conclusion, we propose that researchers must work with consumers to foster more equitable working relationships and ensure there are adequate resources to support meaningful collaborations. Funding bodies, in turn, need to reconsider success metrics and ensure that their processes are mindful of the practical requirements that are necessary to facilitate genuine, equitable partnerships between researchers and consumers.

研究人员和消费者之间的伙伴关系-特别是在我们的研究合作生产背景下使用药物的人-可以显着提高研究的相关性和影响。资助者越来越强调社区研究人员合作的价值，然而将这一承诺转化为有效的实践仍然具有挑战性。本评论取材于我们与澳大利亚国家卫生和医学研究委员会（NHMRC）合作申请赠款的经验，重点关注影响吸毒者的问题。我们反思了从拨款撰写过程中产生的四个关键见解：(i)期望和资源，突出了资助机构的期望之间的差距，资源在学术环境中的使用方式以及有意义的社区参与所需的资源；（ii）资助成功指标，审查资助标准与合作制作现实之间的脱节；（iii）代表，解决确保公平和真实的消费者参与的挑战；(4)权力共享，讨论科研人员和社区成员之间的权力动态如何影响科研过程。总之，我们建议研究人员必须与消费者合作，以促进更公平的工作关系，并确保有足够的资源来支持有意义的合作。反过来，资助机构需要重新考虑成功的衡量标准，并确保它们的过程注意到促进科学家和消费者之间真正的、公平的伙伴关系所必需的实际要求。

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引用次数: 0

Work Hard… Drink Hard? Occupational, Sociodemographic and Health Determinants of High-Risk Alcohol Consumption Among Australian Workers 努力工作，努力喝酒？澳大利亚工人高危饮酒的职业、社会人口和健康决定因素。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-12-16 DOI: 10.1111/dar.70092

Gianluca Di Censo, Kirrilly Thompson, Jacqueline Bowden

Introduction

Although occupational stressors are acknowledged as contributors to high-risk alcohol consumption, their impact relative to sociodemographic and health factors is not well understood. This study investigated how occupational stressors compare with sociodemographic and health factors in influencing three high-risk drinking patterns among Australian workers.

Methods

This analysis included 26,255 employed individuals (48.2% female) drawn from 23 waves (2001–2023) of the Household Income and Labour Dynamics in Australia survey. The study conducted multivariate regressions on three types of high-risk drinking: (i) high-risk drinking across the week; (ii) single-occasion high-risk drinking; and (iii) any high-risk drinking.

Results

Working more than full-time hours was associated with higher odds of high-risk drinking across the week (OR 1.12, 95% CI [1.05, 1.19]). Shift workers were associated with single-occasion high-risk drinking (OR 1.09, 95% CI [1.02, 1.16]). Desiring to work more hours was associated with single-occasion high-risk drinking (OR 1.16, 95% CI [1.09, 1.24]). Workers aged 18–29 years had a twofold increased odds of any high-risk drinking (OR 1.99, 95% CI [1.77, 2.23]), while women had decreased odds (OR 0.11, 95% CI [0.10, 0.13]). Smoking was the modifiable risk factor most strongly associated with any high-risk drinking (OR 2.80, 95% CI [2.60, 3.02]).

Discussion and Conclusions

This analysis found that occupational factors were associated with high-risk drinking; however, their impact was less substantial than sociodemographic and health factors. Interventions targeting risk factors among high-prevalence groups and health promotion campaigns highlighting the health risks associated with high-risk alcohol consumption are warranted.

虽然职业压力因素被认为是导致高危饮酒的因素，但其与社会人口学和健康因素的影响尚未得到很好的理解。本研究调查了影响澳大利亚工人三种高危饮酒模式的职业压力因素与社会人口和健康因素的比较。方法：本分析包括从澳大利亚家庭收入和劳动力动态调查的23波（2001-2023）中抽取的26,255名就业人员（48.2%为女性）。该研究对三种高危饮酒类型进行了多变量回归分析：(1)一周内的高危饮酒；（ii）单次高危饮酒；（三）任何高危饮酒。结果：工作时间超过全职时间与一周内高风险饮酒的几率较高相关（OR 1.12, 95% CI[1.05, 1.19]）。轮班工人与单次高危饮酒相关（OR 1.09, 95% CI[1.02, 1.16]）。希望工作更长时间与单次高危饮酒相关（OR 1.16, 95% CI[1.09, 1.24]）。18-29岁的工人任何高危饮酒的几率增加了两倍（OR 1.99, 95% CI[1.77, 2.23]），而女性的几率降低了（OR 0.11, 95% CI[0.10, 0.13]）。吸烟是与任何高危饮酒最密切相关的可改变危险因素（OR 2.80, 95% CI[2.60, 3.02]）。讨论与结论：本分析发现职业因素与高危饮酒相关；然而，它们的影响不如社会人口和健康因素大。有必要针对高流行人群的风险因素采取干预措施，并开展健康促进运动，突出与高风险酒精消费相关的健康风险。

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引用次数: 0

The Prevalence of Anabolic-Androgenic Steroid Use Among Same-Sex Attracted Men: A Systematic Literature Review and Meta-Analysis 在同性吸引的男性中使用合成代谢雄激素类固醇的流行：系统的文献回顾和荟萃分析。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-12-15 DOI: 10.1111/dar.70091

Nicholas Pascual, Timothy Piatkowski, Eric H. Y. Lau, Matthew Dunn

Issues

This review aimed to estimate the prevalence of non-medical anabolic-androgenic steroid (AAS) use among same-sex attracted men (SSM).

Approach

We conducted a systematic review of peer-reviewed articles in English, focusing on AAS use among SSM. We excluded grey literature and studies that measure AAS use through some form of analysis (e.g., hair or urine). Ten databases were searched. Titles and abstracts for all articles were screened, followed by full-text assessment and data extraction by multiple authors. The pooled overall and subgroup (gym/community-recruited SSM) lifetime and past 12-month prevalence of AAS use among SSM was obtained using a generalised linear random effects model, which was reported when heterogeneity of estimates was not high. Risk of bias was assessed using the Joanna Briggs Institute Prevalence Critical Appraisal Tool.

Key Findings

Nine studies met inclusion criteria. All studies were conducted in high-income countries. Overall, the pooled lifetime and past 12-month prevalences of AAS use were 13.9% (95% CI 9.2%–20.5%, 6 studies) and 8.1% (95% CI 3.9%–16.2%, 3 studies), respectively. Among the gym subgroup, the pooled lifetime and past 12-month prevalences were 15.2% (95% CI 11.6%–19.6%, I² = 72.8%, 3 studies) in the gym subgroup and 13.3% (95% CI 9.9%–17.7%, I² = 73.1%, 2 studies). The difference in lifetime prevalence between gym and community-recruited SSM was not statistically significant (p = 0.676).

Conclusions

The non-medical use of AAS among SSM is higher than general global estimates, with some evidence that use may be higher among gym users.

问题：本综述旨在估计非医学合成代谢雄激素类固醇（AAS）在同性吸引男性（SSM）中使用的流行程度。方法：我们对同行评议的英文文章进行了系统综述，重点关注SSM中AAS的使用。我们排除了灰色文献和通过某种形式的分析（例如，毛发或尿液）来测量原子吸收剂使用的研究。检索了10个数据库。筛选所有文章的标题和摘要，然后由多位作者进行全文评估和数据提取。综合总体和亚组（健身房/社区招募的SSM）寿命和过去12个月SSM中AAS使用的患病率使用广义线性随机效应模型，当估计的异质性不高时报道。使用乔安娜布里格斯研究所流行关键评估工具评估偏倚风险。主要发现：9项研究符合纳入标准。所有研究均在高收入国家进行。总体而言，终生和过去12个月AAS使用的总患病率分别为13.9% （95% CI 9.2%-20.5%， 6项研究）和8.1% （95% CI 3.9%-16.2%， 3项研究）。在健身房亚组中，终生和过去12个月的总患病率为15.2% （95% CI 11.6%-19.6%, I2 = 72.8%， 3项研究），而健身房亚组为13.3% （95% CI 9.9%-17.7%, I2 = 73.1%， 2项研究）。健身房与社区招募的SSM终生患病率差异无统计学意义（p = 0.676）。结论：SSM中AAS的非医疗使用高于一般的全球估计，有证据表明健身房用户的使用可能更高。

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引用次数: 0

Rethinking iOAT Delivery: Could Community Pharmacies Provide a Scalable, Person-Centred Treatment Setting? 重新思考iOAT交付：社区药房能否提供可扩展的、以人为本的治疗环境？

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-12-15 DOI: 10.1111/dar.70090

Suzanne Nielsen, Louisa Picco

引用次数: 0

Patterns of Drug and Polydrug Detection in Drivers Suspected of Driving Under the Influence of an Intoxicant in Ireland 2019–2020: A Latent Class Analysis 爱尔兰2019-2020年涉嫌醉酒驾驶的司机的药物和多种药物检测模式：潜在类别分析。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-12-14 DOI: 10.1111/dar.70087

Louise Durand, Aoife O'Kane, Richard Maguire, Denis Cusack, Eamon Keenan, Gráinne Cousins

Introduction

Driving under the influence of drugs is a major risk factor for road traffic collisions. While increasing harms are observed in relation to polydrug use, evidence is needed about this issue in the context of road safety. We examined polydrug use patterns in drivers providing samples for toxicological analysis in Ireland between 2019 and 2020.

Methods

A cross-sectional study using LC–MS toxicology results from the Medical Bureau of Road Safety, which is responsible for the chemical testing of intoxicants in all drivers arrested under the Road Traffic Acts 1968–2024 in Ireland. Latent class analysis was performed on all samples with at least one drug detected (N = 4856). Descriptive statistics for age, gender and number of drug groups detected were calculated for each class identified.

Results

We identified six latent classes based on drug detection patterns. The cannabis only class (46.5%) is characterised by the detection of cannabis with no other drug involved, a high proportion of men and young age. The cocaine class (31.1%), which combines cocaine and cannabis use, and the stimulant class (2.5%), characterised by amphetamine/methamphetamine detection, have a similar demographic profile to the cannabis class. The polydrug non-opioid (11.8%), polydrug opioid (5.5%) and heroin (2.6%) classes are older, with lower male:female ratios.

Discussion and Conclusions

By identifying profiles of people driving under the influence of drugs, this study contributes to enhancing knowledge of drug and polydrug use in motor vehicle drivers in Ireland. Further work is needed to examine risks and develop interventions to address polydrug driving.

在药物影响下驾驶是道路交通碰撞的主要危险因素。虽然观察到多种药物使用的危害越来越大，但需要在道路安全的背景下就这一问题提供证据。我们在2019年至2020年期间检查了为爱尔兰毒理学分析提供样本的司机的多种药物使用模式。方法：使用道路安全医疗局的LC-MS毒理学结果进行横断面研究，该机构负责对根据1968-2024年《道路交通法》在爱尔兰被捕的所有司机进行毒物化学测试。对所有至少检测到一种药物的样本进行潜在分类分析（N = 4856）。对鉴定出的每一类药物进行年龄、性别和检出药物组数的描述性统计。结果：根据药物检测模式确定了6种潜在类型。仅大麻一类（46.5%）的特点是发现的大麻不涉及其他毒品，男性和年轻人的比例很高。可卡因类毒品（31.1%）结合了可卡因和大麻的使用，兴奋剂类毒品（2.5%）的特点是发现了安非他明/甲基苯丙胺，这两类毒品的人口统计特征与大麻类毒品相似。非阿片类多药物（11.8%）、阿片类多药物（5.5%）和海洛因（2.6%）类别年龄较大，男女比例较低。讨论和结论：通过确定在药物影响下驾驶的人的概况，本研究有助于提高爱尔兰机动车驾驶员对药物和多种药物使用的认识。需要进一步开展工作，审查风险并制定干预措施，以解决多种药物驾驶问题。

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引用次数: 0

Does Believing Alcohol Causes Cancer Moderate the Relationship Between Consumer Awareness of the Alcohol–Cancer Link and Support for Alcohol Policies? Findings From a Canadian Cross-Sectional Study 相信酒精导致癌症是否会缓和消费者对酒精与癌症联系的认识与对酒精政策的支持之间的关系？来自加拿大横断面研究的发现。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-12-07 DOI: 10.1111/dar.70072

Ashini Weerasinghe, Samantha M. Forbes, Erin Hobin

Introduction

Extending research observing an association between awareness that alcohol causes cancer and support for alcohol policies, this study examined if believing or accepting alcohol causes cancer moderates the relationship between awareness of alcohol as a carcinogen and policy support.

Methods

Adult alcohol consumers (n = 5180) in Canada completed an online survey in March–April 2023. Four separate logistic regression models were conducted with policy support affecting alcohol availability, pricing, marketing and labelling as outcomes to assess if believing alcohol causes seven types of cancer moderates the relationship between awareness of the alcohol–cancer link and support for alcohol policies. An interaction between awareness and belief was included as a predictor, adjusting for covariates.

Results

Overall, 29.3% were aware alcohol causes seven types of cancer and, of those aware, 83.6% believed this link. Those both aware of and believing that alcohol causes cancer had higher odds of supporting policies restricting alcohol availability (OR 1.76, 95% CI 1.13, 2.74) and marketing (OR 1.75, 95% CI 1.16, 2.64) than those not aware and did not believe. Consumers who were both aware of and believed the alcohol–cancer link had higher odds of supporting labelling policies (OR 1.59, 95% CI 1.05, 2.40), although this was not significant after adjusting for multiple comparisons.

Discussion and Conclusions

This study highlights that believing alcohol is a carcinogen moderates the relationship between awareness of the alcohol–cancer link and support for policies restricting alcohol availability and marketing. Future longitudinal studies are needed to test interventions for effectively raising awareness and strengthening belief and acceptance of alcohol-related cancer risks.

导言：本研究扩展了观察到酒精致癌意识与支持酒精政策之间关联的研究，考察了相信或接受酒精致癌是否会调节酒精作为致癌物的认识与政策支持之间的关系。方法：加拿大成年酒精消费者（n = 5180）于2023年3月至4月完成了一项在线调查。以影响酒精供应、定价、营销和标签的政策支持作为结果，进行了四个独立的逻辑回归模型，以评估相信酒精会导致七种癌症是否会调节对酒精与癌症之间联系的认识与对酒精政策的支持之间的关系。意识和信念之间的相互作用被包括作为预测因子，调整协变量。结果：总体而言，29.3%的人知道酒精会导致七种癌症，其中83.6%的人相信这一联系。那些知道并相信酒精导致癌症的人比那些不知道和不相信的人更有可能支持限制酒精供应的政策（OR 1.76, 95% CI 1.13, 2.74）和营销（OR 1.75, 95% CI 1.16, 2.64）。了解并相信酒精与癌症相关的消费者支持标签政策的几率更高（OR 1.59, 95% CI 1.05, 2.40），尽管在调整多重比较后这并不显著。讨论和结论：本研究强调，相信酒精是一种致癌物会缓和人们对酒精与癌症之间联系的认识和对限制酒精供应和营销政策的支持之间的关系。未来的纵向研究需要测试干预措施，以有效地提高认识，加强对酒精相关癌症风险的信念和接受。

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引用次数: 0

The Emergence of Novel Benzodiazepines in Australia, Evidence, Alerts, Clinical Management and Harm Reduction—A Narrative Review 新型苯二氮卓类药物在澳大利亚的出现，证据，警报，临床管理和减少危害-叙述性回顾。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-12-07 DOI: 10.1111/dar.70086

Jack Freestone, Stassi Kypri, Jennifer L. Schumann, Erica Franklin, Cameron Francis, Monica J. Barratt, Amy Peacock, Rachel Sutherland, Brendan Clifford, Harriet MacDonald, Nadine Ezard, Kathryn Fletcher, Liam Acheson, Krista J. Siefried

Issues

In Australia, detections of novel benzodiazepines (NBZ) and related overdoses have increased markedly over the last five years. This review summarises Australian peer-reviewed literature and NBZ-related drug alerts, outlines the pharmacology of commonly detected NBZs and discusses approaches to harm reduction, managing toxicity, dependence and withdrawal.

Approach

Australian peer-reviewed articles published between January 2020 and June 2025 were identified via Embase, PubMed, Scopus and PsycINFO. Drug alerts from this period were retrieved from an Australian online repository. Data were extracted, coded and synthesised. Global literature on the pharmacology associated with commonly detected NBZs in Australia, was retrieved via Google Scholar as were sources on benzodiazepine-related harm reduction and clinical management and narratively summarised.

Key Findings

Between 2020 and 2025, NBZs were frequently detected from data from emergency department, forensic, drug checking and coronial sources. The most common were etizolam, clonazolam, clobromazolam, bromazolam, flualprazolam and flubromazolam. Twenty-three NBZ-related alerts were issued over this period, with nearly half of these (n = 11) issued between January and June of 2025. Health responses are hindered by limited pharmacological data, detection challenges and little research on the experiences of consumers.

Implications

To inform interventions spanning harm reduction and clinical management, future research must develop understandings of the pharmacology of NBZs and the experiences of people who source NBZs from unregulated markets.

Conclusion

NBZs were consistently detected across Australian coronial, toxicological, forensic and drug checking data sources from 2020 to 2025. Their emergence represents a public health concern, worthy of ongoing attention and response.

问题：在澳大利亚，新型苯二氮卓类药物（NBZ）和相关过量的检测在过去五年中显着增加。本综述总结了澳大利亚同行评审的文献和nbz相关的药物警报，概述了常见的nbz药理学，并讨论了减少危害、管理毒性、依赖和戒断的方法。方法：通过Embase、PubMed、Scopus和PsycINFO对2020年1月至2025年6月间发表的澳大利亚同行评议文章进行鉴定。从澳大利亚在线存储库检索了这一时期的药物警报。数据被提取、编码和合成。通过谷歌Scholar检索了与澳大利亚常见的NBZs相关的全球药理学文献，以及苯二氮卓类药物相关的减少危害和临床管理的来源，并进行了叙述性总结。主要发现：在2020年至2025年期间，经常从急诊科、法医、药物检查和冠状来源的数据中检测到nbz。最常见的是乙替唑仑、氯硝唑仑、氯丙唑仑、氯丙唑仑、氟丙唑仑和氟丙唑仑。在此期间发布了23个与nbz相关的警报，其中近一半（n = 11）是在2025年1月至6月发布的。有限的药理学数据、检测方面的挑战以及对消费者经验的研究很少，阻碍了卫生反应。启示：为了为减少危害和临床管理的干预提供信息，未来的研究必须发展对nbz药理学的理解，以及从不受监管的市场购买nbz的人的经历。结论：从2020年到2025年，在澳大利亚的冠状、毒理学、法医和药物检查数据源中持续检测到nbz。它们的出现是一个值得持续关注和应对的公共卫生问题。

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引用次数: 0

From Clinical Trials to Real-World Impact: Introducing a Computational Framework to Detect Endpoint Bias in Opioid Use Disorder Research 从临床试验到现实世界的影响：引入一个计算框架来检测阿片类药物使用障碍研究中的终点偏差。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-12-07 DOI: 10.1111/dar.70085

Gabriel J. Odom, Laura Brandt, Aaron Marker, Salvatore Giorgi, Ganesh Jainarain, H. Andrew Schwartz, Larry Au, Clinton Castro, The ENDPOINT Consortium

Introduction

Clinical trial endpoints are a ‘finite sequence of instructions to perform a task’ (measure treatment effectiveness), making them algorithms. Consequently, they may exhibit algorithmic bias: internal and external performance can vary across demographic groups, impacting fairness, validity and clinical decision-making.

Methods

We developed the open-source Detecting Algorithmic Bias (DAB) Pipeline in Python to identify endpoint ‘performance variance’—a specific algorithmic bias—as the proportion of minority participants changes. This pipeline assesses internal performance (on demographically matched test data) and external performance (on demographically diverse validation data) using metrics including F1 scores and area under the receiver operating characteristic curve (AUROC). We applied it to representative opioid use disorder (OUD) trial endpoints.

Results

F1 scores remained stable across minority representation levels, suggesting consistency in precision-recall balance (F1) despite demographic shifts. Conversely, AUROC measures were more sensitive, revealing significant performance variance. Training on demographically homogeneous populations boosted internal performance (accuracy within similar cohorts) but critically compromised external generalisability (accuracy within diverse cohorts). This pattern reveals an ‘endpoint bias trade-off’: optimising performance for homogeneous populations vs. having generalisable performance for the real world.

Discussion and Conclusions

Consistently performing endpoints for one demographic profile may lose generalisability during population shifts, potentially introducing endpoint bias. Increasing minority representation in the training data consistently improved generalisability. The endpoint bias trade-off reinforces the importance of diverse recruitment in OUD trials. The DAB Pipeline helps researchers systematically pinpoint when an endpoint may suffer ‘performance variance’ (i.e., bias). As an open-source tool, it promotes transparent endpoint evaluation and supports selecting demographically invariant OUD endpoints.

临床试验终点是“执行任务的有限指令序列”（衡量治疗有效性），使其成为算法。因此，他们可能会表现出算法偏差：内部和外部表现可能因人口统计学群体而异，影响公平性、有效性和临床决策。方法：我们在Python中开发了开源的检测算法偏差（DAB）管道，以识别端点“性能方差”-特定的算法偏差-随着少数参与者比例的变化。该管道使用包括F1分数和接受者工作特征曲线（AUROC）下面积在内的指标评估内部性能（人口统计学匹配的测试数据）和外部性能（人口统计学不同的验证数据）。我们将其应用于具有代表性的阿片类药物使用障碍（OUD）试验终点。结果：F1分数在少数族裔代表水平上保持稳定，这表明尽管人口结构发生了变化，但精确-召回平衡（F1）的一致性。相反，AUROC测量更敏感，显示出显著的表现差异。对人口统计学上同质人群的培训提高了内部表现（相似队列内的准确性），但严重损害了外部通用性（不同队列内的准确性）。这种模式揭示了一种“终点偏差权衡”：为同质人群优化性能vs.为现实世界提供一般化性能。讨论和结论：在人口变化过程中，始终如一地对一个人口统计概况执行终点可能会失去普遍性，从而可能引入终点偏倚。在训练数据中增加少数族裔的代表性持续提高了通用性。终点偏倚权衡强化了OUD试验中多样化招募的重要性。DAB Pipeline可以帮助研究人员系统地确定端点何时可能遭受“性能差异”（即偏差）。作为一个开源工具，它促进了透明的端点评估，并支持选择人口统计不变的OUD端点。

{"title":"From Clinical Trials to Real-World Impact: Introducing a Computational Framework to Detect Endpoint Bias in Opioid Use Disorder Research","authors":"Gabriel J. Odom, Laura Brandt, Aaron Marker, Salvatore Giorgi, Ganesh Jainarain, H. Andrew Schwartz, Larry Au, Clinton Castro, The ENDPOINT Consortium","doi":"10.1111/dar.70085","DOIUrl":"10.1111/dar.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Clinical trial endpoints are a ‘finite sequence of instructions to perform a task’ (measure treatment effectiveness), making them algorithms. Consequently, they may exhibit algorithmic bias: internal and external performance can vary across demographic groups, impacting fairness, validity and clinical decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We developed the open-source Detecting Algorithmic Bias (DAB) Pipeline in Python to identify endpoint ‘performance variance’—a specific algorithmic bias—as the proportion of minority participants changes. This pipeline assesses internal performance (on demographically matched test data) and external performance (on demographically diverse validation data) using metrics including F1 scores and area under the receiver operating characteristic curve (AUROC). We applied it to representative opioid use disorder (OUD) trial endpoints.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>F1 scores remained stable across minority representation levels, suggesting consistency in precision-recall balance (F1) despite demographic shifts. Conversely, AUROC measures were more sensitive, revealing significant performance variance. Training on demographically homogeneous populations boosted internal performance (accuracy within similar cohorts) but critically compromised external generalisability (accuracy within diverse cohorts). This pattern reveals an ‘endpoint bias trade-off’: optimising performance for homogeneous populations vs. having generalisable performance for the real world.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusions</h3>\u0000 \u0000 <p>Consistently performing endpoints for one demographic profile may lose generalisability during population shifts, potentially introducing endpoint bias. Increasing minority representation in the training data consistently improved generalisability. The endpoint bias trade-off reinforces the importance of diverse recruitment in OUD trials. The DAB Pipeline helps researchers systematically pinpoint when an endpoint may suffer ‘performance variance’ (i.e., bias). As an open-source tool, it promotes transparent endpoint evaluation and supports selecting demographically invariant OUD endpoints.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11318,"journal":{"name":"Drug and alcohol review","volume":"45 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An Observational Study of Off-Premise Alcoholic Beverage Pricing Over Time in New South Wales, Australia 一项在澳大利亚新南威尔士州对非酒精饮料长期定价的观察性研究。

IF 2.6 3区医学 Q2 SUBSTANCE ABUSE

Drug and alcohol review

Pub Date : 2025-12-07 DOI: 10.1111/dar.70077

Nicola Man, Mia Miller, Matthew Craig, Lexi Buckfield, Michael Livingston, Sarah Callinan, Heng Jiang, Isabella Britton, Alexandra Henderson, Michala Kowalski, Yan Yang, Qingyuan Linghu, Vandit Sadaphale, Wing See Yuen, Amy Peacock

Introduction

The price of alcohol is a key determinant of purchasing and consumption, yet few studies have assessed alcohol price in Australia. This study aimed to determine: (i) the comparative price of different alcohol product types; (ii) changes in price of alcoholic products over time inclusive of an excise duty indexation; and (iii) the proportion of alcoholic products under different price thresholds.

Methods

Data were collected monthly (July–October 2023) from five major off-premise alcohol retailer websites in three New South Wales locations with high alcohol-related mortality and morbidity (capital city, major city and remote location). Multilevel models estimated price differences and the proportion of products under three price thresholds, both by beverage type, subtype, location and over time.

Results

Wine in > 1 L vessels and high-strength cider were the cheapest products. The nominal price of alcohol for beer, spirits and premix increased in August–October compared with July 2023. Only wine fell under the $0.80 threshold, including 6% of all wine and 99.4% of wine in vessel size > 2 L. 14.3% of all wine and 14.6% of cider fell under A$1.30, and 26.4% of wine, 36.8% of cider, and 23.2% of beer fell under $1.80.

Discussion and Conclusions

Cheap alcohol products are predominantly those that attract ad valorem taxation. Beer, spirits and premixes increased in price likely due to indexation in August 2023, whereas wine and cider became comparatively cheaper over time. Ongoing monitoring of alcohol prices is needed to comprehensively evaluate market responses to alcohol pricing and other supply reduction policies.

引言：酒精的价格是购买和消费的关键决定因素，但很少有研究评估澳大利亚的酒精价格。本研究旨在确定：(i)不同类型酒精产品的比较价格；（二）含消费税指数化在内的酒类产品价格随时间的变化；（三）不同价格阈值下的酒类产品比例。方法：每月（2023年7月至10月）从新南威尔士州三个酒精相关死亡率和发病率高的地区（首府城市、主要城市和偏远地区）的五个主要非本地酒精零售商网站收集数据。多层模型估计了价格差异和三个价格阈值以下的产品比例，包括饮料类型、子类、位置和时间。结果：bbbb1l容器中的葡萄酒和高强度苹果酒是最便宜的产品。与2023年7月相比，8月至10月啤酒、烈酒和预混酒的名义价格有所上涨。只有葡萄酒低于0.80美元的门槛，包括6%的葡萄酒和99.4%的容器尺寸为bbbb20升的葡萄酒。14.3%的葡萄酒和14.6%的苹果酒价格低于1.30澳元，26.4%的葡萄酒、36.8%的苹果酒和23.2%的啤酒价格低于1.80澳元。讨论和结论：廉价酒产品主要是那些吸引从价税的产品。啤酒、烈酒和预混酒的价格上涨可能是由于2023年8月的指数化，而葡萄酒和苹果酒随着时间的推移变得相对便宜。需要持续监测酒精价格，以全面评估市场对酒精定价和其他减少供应政策的反应。

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引用次数: 0