Brief Versus Full Alcohol Use Disorders Identification Test in National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome Network Clinical Trials.
Brief Versus Full Alcohol Use Disorders Identification Test in National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome Network Clinical Trials.
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DOI：
10.1097/ccm.0000000000001181
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发表时间：
2015-09
影响因子：
8.8
通讯作者：
National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome Network Investigators
中科院分区：
文献类型：
--
作者：
Reisinger MW;Moss M;Clark BJ;National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome Network Investigators
酒精使用障碍（AUDs）在入住重症监护病房的患者中很常见，但很少进行系统的筛查。我们试图确认完整的酒精使用障碍识别测试（AUDIT）的结构效度，并使用完整的AUDIT作为代理金标准来评估简短的3项AUDIT- c在患有医学危重疾病的患者群体中的表现。急性呼吸窘迫综合征（ARDS）网络是一个由12所大学中心（44家医院）组成的联盟，致力于对ARDS患者进行多中心临床试验。符合急性呼吸窘迫综合征共识标准的患者无。在参加三项ARDS网络研究的1133例患者中，1037例（92%）有完整的审计数据。在纳入的患者中，236例（23%）在全面审计中得分高于酒精使用障碍的筛查阈值。构建全审计支持的三因素效度分析模型。与完整的AUDIT相比，AUDIT- c的受试者工作特征（AuROC）曲线下面积男性为0.99，女性为0.98。男女的最佳分界点都是4分。在此截止点，AUDIT-C对男性的敏感性为95% (95% CI 92%, 98%)，特异性为94% (95% CI 92%, 96%)，对女性的敏感性为89% (95% CI 82%, 96%)，特异性为99% （95% CI 98%, 100%）。虽然在重症监护病房ARDS患者中证实了审计的3因素结构，但前3个问题关注酒精消耗提供的信息与完整的10项审计筛选问卷相当。由于缺乏真正的黄金标准，本研究受到限制，并且由于这一限制，审计- c的表现可能被高估。
Alcohol use disorders (AUDs) are common among patients admitted to an intensive care unit, yet systematic screening is rarely performed. We sought to confirm the construct validity of the full Alcohol Use Disorders Identification Test (AUDIT) and to evaluate the performance of the brief 3 item AUDIT-C using the full AUDIT as a proxy gold standard in a population of patients with a medical critical illness. Secondary Analysis The Acute Respiratory Distress Syndrome (ARDS) Network, a consortium of 12 university centers (44 hospitals) dedicated to conducting multicenter clinical trials in patients with ARDS. Patients meeting consensus criteria for Acute Respiratory Distress Syndrome None Of 1,133 patients enrolled in one of three ARDS Network studies, 1,037 (92%) had full AUDIT data available. Of the included patients, 236 (23%) scored above the screening threshold for an alcohol use disorder on the full AUDIT. Construct validity analysis of the full AUDIT supported a three factor model. Compared to the full AUDIT, the AUDIT-C had an area under the receiver operating characteristic (AuROC) curve of 0.99 for men and 0.98 for women. The optimal cutoff was 4 for both genders. At this cutoff, the AUDIT-C had a sensitivity of 95% (95% CI 92%, 98%) and specificity of 94% (95% CI 92%, 96%) for men and sensitivity of 89% (95% CI 82%, 96%) and specificity of 99% (95% CI 98%, 100%) for women. Though a 3 factor structure for the AUDIT was confirmed in ICU patients with ARDS, the first 3 questions focusing on alcohol consumption provide information that is comparable to the full 10 item AUDIT screening questionnaire. This study is limited by the lack of a true gold standard and the performance of the AUDIT-C is likely overestimated due to this limitation.