New approach to the validity of the alcohol use disorders identification test: Stratum-specific likelihood ratios analysis
New approach to the validity of the alcohol use disorders identification test: Stratum-specific likelihood ratios analysis
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DOI：
10.1097/01.alc.0000159189.56671.ec
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发表时间：
2005-04-01
期刊：
影响因子：
--
通讯作者：
Cheng, ATA
中科院分区：
文献类型：
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作者：
Chen, CH;Chen, WJ;Cheng, ATA
背景：先前对酒精使用障碍识别测试（审核）的验证研究使用了固定阈值方法或接收器操作特征（ROC）分析。这项研究的目的是针对检测酒精使用障碍的审计有效性进行特异性的似然比（SSLR）分析。方法：在非精神病患者中，在一般医院对一般医院进行了两阶段验证研究第1阶段筛查和第2阶段访谈中神经精神病学的临床评估时间表。在第二阶段访问了所有具有阳性筛查结果的患者和筛查结果负面筛查结果的子样本。首先，使用ROC估算了当前酒精使用障碍的审计的有效性，随后进行了SSLR分析。回报：在完成筛查的422个住院患者中，193的成绩为零，103的结果为负结果。以非零得分，而126分为阳性。在第二阶段采访了20名筛查筛查的患者，其结果为阴性和非零评分和107例阳性结果，根据DSM-IV标准，发现59例患者患有目前的酒精使用障碍。当前酒精使用障碍审计的ROC曲线下的面积为0.98。在最佳临界值为8的审计的灵敏度和特异性分别为0.97和0.90。审计得分的三个层（0-7、8-13和> = 14）用于酒精使用障碍，SSLR为0.04、3.67和49.72，相应的后测试概率为0.01、0.42和0.91 ，分别。结论：审核是酒精使用障碍的有效筛查工具，从SSLR分析得出的三个层次是内容丰富，很容易适用于临床实践。
Background: Previous validation studies of the Alcohol Use Disorders Identification Test (AUDIT) used either the fixed-threshold approach or receiver operating characteristic (ROC) analyses. This study was aimed to conduct a stratum-specific likelihood ratio (SSLR) analysis on the validity of the AUDIT for detecting alcohol use disorders.Methods: A two-phase validation study was conducted among nonpsychiatric inpatients at a general hospital, using the AUDIT for phase 1 screening and the Schedules for Clinical Assessment in Neuropsychiatry for the phase 2 interview. All of the patients with positive screening results and a subsample of the patients with negative screening results were interviewed in the second phase. The validity of the AUDIT for current alcohol use disorders was estimated using the ROC first, and an SSLR analysis was performed subsequently.Results: In 422 inpatients who completed the screening, 193 had a negative result with a zero score, 103 had a negative result with a nonzero score, and 126 had a positive result. Twenty screened patients with a negative result and a nonzero score and 107 patients with a positive result were interviewed in the second phase, in which 59 patients were found to have current alcohol use disorders according to DSM-IV criteria. The area under the ROC curve of the AUDIT for current alcohol use disorders was 0.98. The sensitivity and specificity of the AUDIT at the optimal cutoff of 8 were 0.97 and 0.90, respectively. Three strata of the AUDIT scores (0-7, 8-13, and >= 14) were derived for alcohol use disorders, with the SSLRs being 0.04, 3.67, and 49.72, and the corresponding posttest probabilities being 0.01, 0.42, and 0.91, respectively.Conclusions: The AUDIT is a valid screening tool for alcohol use disorders, and the three strata derived from the SSLR analysis are informative and readily applicable in clinical practice.