This study is limited to an analysis of data from patients with non-fatal injuries and medical emergencies who attended specific emergency departments. Although the study design provides a representative sample of patients from each ED facility, patients may not be representative of other ED facilities in the region or country. Additionally, reported here are data from only four countries, and while each demonstrated distinctly different drinking patterns, the inclusion of EDs from other countries may have influenced study findings. An additional limitation is that cultural factors may have influenced willingness to report the presence of specific criterion as well as the interpretation of survey items related to these criterion, such as the hazardous use criterion illustrated by drinking and driving behaviors[33]. It is important to note that even when we presented data on the inclusion of Q-F questions into current DSM-IV definition of alcohol use disorders, our definitions of Q-F were not exactly the same used by Saha et al. (2007) and replication of their findings may still be needed. Finally, results reported here are limited to the scope of
