Effectiveness of the derived Alcohol Use Disorders Identification Test (AUDIT-C) in screening for alcohol use disorders and risk drinking in the US general population
Effectiveness of the derived Alcohol Use Disorders Identification Test (AUDIT-C) in screening for alcohol use disorders and risk drinking in the US general population
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DOI：
10.1097/01.alc.0000164374.32229.a2
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发表时间：
2005-05-01
期刊：
影响因子：
--
通讯作者：
Zhou, Y
中科院分区：
文献类型：
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作者：
Dawson, DA;Grant, BF;Zhou, Y
背景：酒精使用障碍识别测试（AUDIT-C）中的三个消费问题越来越多地被用作酒精使用障碍（AUDs）和危险饮酒的筛查。在18岁及以上的美国成年人的代表性样本中，AUDIT-C评分（来自全国性大型调查中嵌入的消费问题）用于估计酒精依赖、任何AUD和风险饮酒的敏感性、特异性和接受者操作者特征曲线（auroc）下的面积。aud根据DSM-IV标准定义。对于男性来说，风险饮酒被定义为每周饮用140万杯或每月至少一次每天饮用140万杯；对于女性来说，每周和每天的饮酒量限制分别为700杯和100杯。衍生的AUDIT-C在过去一年的饮酒者（n = 26,946）中进行评估，在总人口（n = 43,093）中，按年龄，性别定义分组。以及种族/民族、孕妇、急诊患者和大学生。结果：对于过去一年的饮酒者，衍生的AUDIT-C的auroc对于酒精依赖为0.887，对于任何AUD为0.860，对于风险饮酒为0.966。总体得分较高，分别为0.931、0.917和0.981。衍生的AUDIT-C在筛查女性依赖方面的表现略好于男性。男性对风险饮酒的筛查效果更好，可能是因为AUDIT-C的第三个问题直接反映了男性对风险饮酒的定义之一，而不是女性。孕妇、过去一年的急诊室病人和大学生的表现与一般人群的表现相当。结论：推导出的AUDIT-C在筛查AUDs和危险饮酒方面表现良好。对男性和女性使用可变切割点提高了其敏感性和特异性。在现实的筛选情况下进行验证，将AUDIT-C问题作为独立的而不是嵌入的项目进行询问，这是未来的关键步骤。
Background: The three consumption questions from the Alcohol Use Disorders Identification Test (AUDIT-C) are increasingly used as a screener for alcohol use disorders (AUDs) and risk drinking,Methods: In a representative sample of US adults 18 years of age and older, AUDIT-C scores (derived from consumption questions embedded in a large national survey) were used to estimate sensitivity, specificity, and areas under receiver operator characteristic curves (AUROCs) for alcohol dependence, any AUD, and risk drinking. AUDs were defined according to DSM-IV criteria. For men, risk drinking was defined as consuming > 14 drinks per week or > 4 drinks in a single day at least once a month; for women, the weekly and daily limits were > 7 drinks and > 3 drinks, respectively. The derived AUDIT-C was evaluated among past-year drinkers (n = 26,946), within the total population (n = 43,093), in groups defined by age, sex. and race/ethnicity, and among pregnant women, persons attending an emergency room, and college students.Results: For past-year drinkers, the AUROCs for the derived AUDIT-C were 0.887 for alcohol dependence, 0.860 for any AUD, and 0.966 for risk drinking. Scores were higher in the total population, 0.931, 0.917, and 0.981, respectively. The derived AUDIT-C performed slightly better in screening for dependence among women than men. Screening for risk drinking was better among men, probably because the third AUDIT-C question directly mirrors one of the definitions of risk drinking for men but not for women. Performance in pregnant women, past-year emergency room patients, and college students was on a par with performance in the general population.Conclusions: The derived AUDIT-C performs well in screening for AUDs and risk drinking. The use of variable cut points for men and women improves its sensitivity and specificity. Validation in a realistic screening situation, in which the AUDIT-C questions are asked as stand-alone and not embedded items, is a critical future step.