AUDIT-C as a brief screen for alcohol misuse in primary care
AUDIT-C as a brief screen for alcohol misuse in primary care
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DOI：
10.1111/j.1530-0277.2007.00403.x
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发表时间：
2007-07-01
影响因子：
3.2
通讯作者：
Kivlahan, Daniel R.
中科院分区：
文献类型：
--
作者：
Bradley, Katharine A.;DeBenedetti, Anna F.;Kivlahan, Daniel R.
背景：酒精使用障碍识别测试消费（AUDIT-C）问题先前已被验证为酒精滥用的3项筛选，并在全国退伍军人事务部（VA）门诊诊所实施。然而，AUDIT-C在其他临床人群中的有效性和最佳筛选阈值尚不清楚。方法：采用横断面验证法，对1993 ~ 1994年在某学术家庭诊所就诊的392例男性和927例女性成年门诊患者进行问卷筛选和标准化访谈。将审计- c、全面审计、自我报告的危险饮酒、审计问题#3和增强的CAGE问卷与酒精滥用的访谈主要参考标准进行比较，该标准定义为诊断和统计手册，第4版，过去一年中酒精使用障碍和/或饮酒超过建议限度。结果：根据对92%符合条件的患者的访谈，128名（33%）男性和177名（19%）女性符合酒精滥用标准。男性和女性的受试者工作特征曲线（auroc）下面积分别为0.94（0.91,0.96）和0.90 (0.87,0.93)（p=0.04）。根据AUROC曲线，AUDIT- c的表现与完整的AUDIT一样好，并且显著优于自我报告的风险饮酒、AUDIT问题#3或增强CAGE问卷（p值< 0.001）。同时敏感性和特异性最大的AUDIT-C筛查阈值男性为>= 4（敏感性0.86，特异性0.89），女性为>= 3（敏感性0.73，特异性0.91）。结论：AUDIT-C是该初级保健样本中酒精滥用的有效筛查试验。男性（>= 4）和女性（>= 3）酒精滥用的最佳筛查阈值与先前发表的VA研究相同。
Background: 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.Methods: 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.Results: 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 < 0.001). The AUDIT-C screening thresholds that simultaneously maximized sensitivity and specificity were >= 4 in men (sensitivity 0.86, specificity 0.89) and >= 3 in women (sensitivity 0.73, specificity 0.91).Conclusions: The AUDIT-C was an effective screening test for alcohol misuse in this primary care sample. Optimal screening thresholds for alcohol misuse among men (>= 4) and women (>= 3) were the same as in previously published VA studies.