American Journal of Epidemiology Vol. 148, No. 8: 732-740
Copyright © 1998 by The Johns Hopkins University School of Hygiene and Public Health
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Analytical Considerations in the Use of Capture-Recapture to Estimate Prevalence: Case Studies of the Estimation of Opiate Use in the Metropolitan Area of Barcelona, Spain
1Institut Municipal d'Investigació Mèdica (IMIM) Barcelona, Spain.
2European Monitoring Center for Drugs and Drug Addiction (EMCDDA) Lisboa, Portugal.
3Centre d'Estudis Epidemiològics sobre la SIDA a Catalunya (CEESCAT) Badalona, Spain.
4Servei d'Epidemiologia, Institut Municipal de Salut Publica de Barcelona Barcelona, Spain.
5Department de Sanitat i Seguretat Social, Generalitat de Catalunya Barcelona, Spain.
Reprint requests to Dr. Antonia Domingo-Salvany, Institut Municipal d'lnvestigacio Medica (IMIM), Dr. Aiguader 80, 08003 Barcelona, Spain.
Capture-recapture, an indirect method widely used to estimate undetected populations, has been criticized because it causes problems due to a lack of compliance with several important assumptions and model selection strategies. This paper expands on the problems encountered when applying this methodology to drug abuse estimations, specifically the prevalence of opiate use in the metropolitan area of Barcelona, Spain, in 1993. Three samples of opiate users (from hospital emergency rooms, treatment centers, and prisons) were available in the area studied; an additional sample (mortality data) was analyzed for the city of Barcelona. Log-linear models that provided a good fit were considered, to which further model selection strategies were applied. A total of 3,207 unique individuals aged 15–44 years were identified in the three samples from the greater Barcelona area; the mortality sample from the city of Barcelona contained an additional 83 individuals. Heterogeneity was observed in different age, sex, and residence area subgroups. Population estimates differed widely according to the log-linear model chosen. Minimum Akaike‘s information criterion model and saturated model estimates were used to produce population prevalence rates. The main problems the authors encountered in this study were related to population definition, source heterogeneity, and assessment of an adequate model, a problem associated with sample size. Am J Epidemiol 1998;148:732–40.
heroin dependence; logistic models; prevalence; sample size; substance abuse
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