Revised equations allowing the estimation of the uncertainty associated with the Total Body Water version of the Widmark equation

Treatment retention and reductions in blood alcohol concentration (BAC) during the first 90 days of a telehealth program for alcohol use disorder

Background: Alcohol use disorder (AUD) treatments, including medications, are increasingly offered via telehealth.Objective: This study characterizes 90-day treatment retention and changes in objectively measured blood alcohol concentration (BAC) in a large cohort receiving AUD telehealth.Methods: Patients received AUD treatment through Ria, a virtual (telehealth) program offering AUD treatment that is tailored to patient goals (e.g. abstinence or controlled drinking). Patients were encouraged to complete breathalyzer readings twice daily for measurement-based care. We characterized rates of 90-day treatment retention (i.e. completing a BAC reading or medical/coaching encounter on the 90^th day or later) and used growth curve analyses to model changes in daily estimated peak BAC over 90 days.Results: Of 4121 patients (51.5% women), 50.1% had 90-day treatment retention (n = 2066, 52.2% women). Most patients received prescriptions for AUD medications (84.6%) and completed encounters with medical providers (86.7%) and coaches (86.1%). Patients with 90-day retention provided 184,817 BAC readings in the first 90 days. Growth curve analyses revealed significant reductions in daily estimated peak BAC (p < .001) from a mean of 0.092 (day 1) to 0.038 (day 90). Similar magnitudes of BAC reduction were observed for men and women and for patients with abstinence and controlled drinking goals.Conclusion: Telehealth appears to be a viable approach to delivering AUD treatments in a manner that promotes drinking reductions. Telehealth approaches can yield reductions in objectively measured BAC, including for some patient subgroups that have historically faced greater stigma in AUD treatment settings, such as women and people with non-abstinence drinking goals.

[Uncertainty estimate in calculation of ingested ethanol]

OBJECTIVE

To develop a method of uncertainty estimate in calculation of ingested ethanol by E. Widmark formula and its realization as a computer program.

MATERIAL AND METHODS

The methodological design of the study was an analytical construction of the equation of uncertainty estimates of the mass of ingested ethanol, obtained on the basis of E. Widmark kinetic model. Mathematical analysis operations were performed independently, as well as using WolframAlfa web application. The computer program code was compiled in the C# programming language using the free version of Microsoft Visual Studio application.

RESULTS

The equation of uncertainty estimate of the mass of ingested ethanol, obtained on the basis of E. Widmark kinetic equation, with standard deviation of the sought value as its measure has been derived. The Alcohol Calculator V 5.0 application was created in the C# programming language. This program implements a complex of computational procedures related to the use of developed uncertainty equation, and allows to determine the confidence error intervals for estimates of ingested ethanol for any probability of error.

CONCLUSION

The obtained equation of uncertainty estimates of the mass of ingested ethanol and the computer application implementing it are recommended for forensic medical evaluation of the kinetics of orally administered ethanol.