AUDIT‐C as a Brief Screen for Alcohol Misuse in Primary Care
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- 19 April 2007
- journal article
- research article
- Published by Wiley in Alcohol: Clinical and Experimental Research
- Vol. 31 (7), 1208-1217
- https://doi.org/10.1111/j.1530-0277.2007.00403.x
Abstract
The Alcohol Use Disorders Identification Test Consumption (AUDIT-C) questions have been previously validated as a 3-item screen for alcohol misuse and implemented nationwide in Veterans Affairs (VA) outpatient clinics. However, the AUDIT-C's validity and optimal screening threshold(s) in other clinical populations are unknown. This cross-sectional validation study compared screening questionnaires with standardized interviews in 392 male and 927 female adult outpatients at an academic family practice clinic from 1993 to 1994. The AUDIT-C, full AUDIT, self-reported risky drinking, AUDIT question #3, and an augmented CAGE questionnaire were compared with an interview primary reference standard of alcohol misuse, defined as a Diagnostic and Statistical Manual, 4th ed. alcohol use disorder and/or drinking above recommended limits in the past year. Based on interviews with 92% of eligible patients, 128 (33%) men and 177 (19%) women met the criteria for alcohol misuse. Areas under the receiver operating characteristic curves (AUROCs) for the AUDIT-C were 0.94 (0.91, 0.96) and 0.90 (0.87, 0.93) in men and women, respectively (p=0.04). Based on AUROC curves, the AUDIT-C performed as well as the full AUDIT and significantly better than self-reported risky drinking, AUDIT question #3, or the augmented CAGE questionnaire (p-values or =4 in men (sensitivity 0.86, specificity 0.89) and > or =3 in women (sensitivity 0.73, specificity 0.91). The AUDIT-C was an effective screening test for alcohol misuse in this primary care sample. Optimal screening thresholds for alcohol misuse among men (> or =4) and women (> or =3) were the same as in previously published VA studies.Keywords
This publication has 40 references indexed in Scilit:
- Alcohol Screening Scores and Risk of Hospitalizations for GI Conditions in MenAlcohol: Clinical and Experimental Research, 2007
- Effects of item sequence on the performance of the AUDIT in general practicesDrug and Alcohol Dependence, 2005
- Brief Physician Advice for Problem Drinkers: Long‐Term Efficacy and Benefit‐Cost AnalysisAlcohol: Clinical and Experimental Research, 2002
- Brief physician advice for problem alcohol drinkers. A randomized controlled trial in community-based primary care practicesJAMA, 1997
- The alcohol use disorder and associated disabilities interview schedule (AUDADIS): reliability of alcohol and drug modules in a general population sampleDrug and Alcohol Dependence, 1995
- Ruling Out or Ruling In Disease with the Most sensitiue or Specific Diagnostic TestMedical Decision Making, 1994
- Reliability of a Timeline Method: assessing normal drinkers' reports of recent drinking and a comparative evaluation across several populationsBritish Journal of Addiction, 1988
- Use of a questionnaire in general practice to increase the recognition of patients with excessive alcohol consumption.BMJ, 1985
- Detecting alcoholism. The CAGE questionnaireJAMA, 1984