Alcohol use is common among patients admitted to hospital following trauma1 and is associated with repeated trauma admissions2 and a higher risk of complications.3 Alcohol screening for trauma patients may be useful as an opportunity for brief intervention measures that aim to reduce further risk through prevention strategies. Lau and colleagues investigated blood alcohol testing in their observational study of 14 221 major trauma patients from Victoria, Australia, from 2018 to 2021.4 In their study, 32% of patients had a blood alcohol test. It was noted that alcohol tests for trauma patients were more likely to be undertaken according to some patient characteristics such as age, socioeconomic deprivation, pre-existing mental health conditions, substance abuse and smoking. The authors conclude that such discrepancies represent implicit human bias, which may hamper efforts to provide appropriate strategies for risk reduction. Importantly, there is a risk of actual or perceived prejudice, judgement, stigma and discrimination based on some patient characteristics. There may also be an element of ‘victim blaming’ that is especially problematic when combined with patient characteristics.

How might healthcare systems reduce the risk of bias when testing for alcohol in trauma patients? One way to address this question might be to examine all the different ways alcohol might …