Thesis Title: To Drink or not to drink: Clinically relevant models of alcohol consumption and liver disease to inform dynamic and interpretable community alcohol policies

Advisor:

Dr. Turgay Ayer, School of Industrial and Systems Engineering, Georgia Institute of Technology

Thesis Committee:

Dr. Jagpreet Chhatwal, Institute for Technology Assessment, Massachusetts General Hospital, Harvard Medical School

Dr. David Goldsman, School of Industrial and Systems Engineering, Georgia Institute of Technology

Dr. Lauren Steimle, School of Industrial and Systems Engineering, Georgia Institute of Technology

Dr. Gian-Gabriel Garcia, School of Industrial and Systems Engineering, Georgia Institute of Technology

Date and Time: Monday, June 20th, 2022, 1:30 PM (EST)

Location: Groseclose 404 or meeting link below

Meeting Link:  https://us02web.zoom.us/j/84911917266?pwd=NkxwbFZxdHQyRmhhaDUwTzI4SmpEQT09

Meeting ID: 849 1191 7266

Passcode: chante

Abstract:

Alcohol-attributable liver disease rates have been on the rise globally and in the United States over the past two decades. Each disease event in the general population carries a significant cost for the individual, their community, and society at large. This thesis considers clinically relevant models that incorporate the regenerative abilities of the liver to project disease morbidity and mortality, expected impact of societal and individual trauma, future expected costs, and that can inform decision support tools for strategies to mitigate the worst effects are of critical importance.

We first study the general projection problem for disease morbidity and mortality at the population level for high-risk drinking. With evolving drinking rates, we project how changing population dynamics and drinking rates will affect morbidity and mortality and consider the potential impact of policy solutions similar to the ongoing attempt to control tobacco use in the United States. The incidence of alcohol-associated liver cirrhosis and cancer is expected to continue to increase and significant policy interventions rising to the level of interventions on smoking currently in place will stabilize but not eliminate current  mortality levels.

We next deepen our investigation to consider the combined impact of the liver’s regenerative ability and individual consumption choices to understand the impact of events and interventions that cause either increases or decreases in drinking on population level morbidity, mortality, and costs including expected costs of health care, labor-related economic losses, and consumption related losses due to mortality. COVID-19 related increases in drinking are associated with limited increases in short term mortality but significant rises in long-term morbidity, mortality, and costs.

By incorporating the liver’s regenerative ability, we expand the horizon of analyzable strategies and decisions to include those that impact drinkers who have not yet presented with end-stage liver disease and more fully consider the impact of harm-reduction strategies in the consideration of alcohol policy.