Differences in performance of screening instruments for problem drinking among blacks, whites and hispanics in an emergency room population
Differences in performance of screening instruments for problem drinking among blacks, whites and hispanics in an emergency room population
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DOI：
10.15288/jsa.1998.59.420
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发表时间：
1998-07-01
期刊：
影响因子：
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通讯作者：
Cherpitel, CJ
中科院分区：
文献类型：
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作者：
Cherpitel, CJ
目的：本研究的目的是在急诊室环境中按种族（黑人、西班牙裔和白色）以及种族和性别比较酒精依赖和有害饮酒/滥用的一些标准筛查工具的性能。方法：在位于加州圣何塞的圣克拉拉谷医疗中心对患者（N = 1，429）的概率样本进行呼吸分析和访谈。在目前饮酒者（n = 857）中分析CAGE、Brief MAST、AUDIT、TWEAK、RAPS和其他项目对酒精依赖的ICD-10或DSM-IV合并标准以及酒精依赖或有害饮酒或滥用的敏感性和特异性。结果：没有发现筛选措施在种族或性别方面表现同样好，女性的敏感性低于男性。一致性的敏感性的措施，发现有很大的不同种族和性别群体，与一些措施（最显着的RAPS和审计）显示出一贯的高敏感性在各亚组。没有一种工具在识别酒精依赖或有害饮酒或滥用方面表现得像单独识别酒精依赖一样好。结论：分析表明，虽然RAPS可能有希望识别跨种族和性别亚组的问题饮酒者，但它和目前使用的其他筛查工具需要在各种环境中进行额外的评估，以确定它们对识别那些可以从简短干预或转介问题饮酒中受益的人的有用性。
Objective: The purpose of this study was to compare the performance of a number of standard screening instruments for alcohol dependence and harmful drinking/abuse by ethnicity (black, Hispanic and white) and by ethnicity and gender in an emergency room setting. Method: A probability sample of patients (N = 1,429) was breath analyzed and interviewed at the Santa Clara Valley Medical Center in San Jose, California. Sensitivity and specificity were analyzed among current drinkers (n = 857) for the CAGE, Brief MAST, AUDIT, TWEAK, RAPS and other items against combined ICD-IO or DSM-IV criteria for alcohol dependence and separately for alcohol dependence or harmful drinking or abuse. Results: Screening measures were not found to perform equally well by ethnicity or gender, with lower sensitivity found for women compared to men. Consistency in sensitivity of measures was found to vary considerably across ethnic and gender groups, with some measures (most notably the RAPS and the AUDIT) showing consistently high sensitivity across subgroups. None of the instruments per formed nearly as well for identifying alcohol dependence or harmful drinking or abuse combined as for alcohol dependence alone. Conclusions: Analyses suggest that, while the RAPS may hold promise for identifying problem drinkers across ethnic and gender subgroups, it and other screening instruments currently in use require additional evaluation in a variety of settings to determine their usefulness for identifying those who could benefit from a brief intervention or referral for problem drinking.