Comparison with Other Instruments

Publication Date Language Abstracts Access
Adewuya, A.O.
Validation of the Alcohol Use Disorders Identification Test (AUDIT) as a screening tool for alcohol-related problems among Nigerian University students. Alcohol and Alcoholism, Volume 40, Issue 6, 1 November 2005, Pages 575–577
2005 English Aims: To investigate the screening properties of the Alcohol Use Disorders Identification Test (AUDIT) in the detection of alcohol-related problems among Nigerian university students. Results: The AUDIT at cut-off of 5 and above could clearly identify participants with alcohol-related problems with sensitivity of 0.935 and specificity of 0.915. Conclusions: The AUDIT is a valid instrument for screening for alcohol-related problems in Nigerian university students. Open Access
Aertgeerts, B., Buntinx, F., Ansoms, S., Fevery, J.
Questionnaires are better than laboratory tests to screen for current alcohol abuse or dependence in a male inpatient population. Acta Clinica Belgica, Volume 57, Issue 5, September 2002, Pages 241-249
2002 English Objective: To assess the diagnostic performance of the CAGE and AUDIT (Alcohol Use Disorder Identification Test) and its derivatives, and laboratory tests for screening alcohol abuse or dependence in a male medical hospital population. Design: A diagnostic cross-sectional prevalence study. Setting: Three general hospitals and one university hospital. Patients: All male patients older than 18 years admitted to the hospitals, during a period of 6 weeks, were consecutively included in the study (N=233). Measurements: Calculation of diagnostic measurements with 95%CI and ROC curves for different scores of CAGE, AUDIT and derivatives, laboratory tests and % Carbohydrate Deficient Transferrin (CDT), using DSM-III-R as the reference standard, derived from the CIDI. Results: A current diagnosis of alcohol abuse or dependence was found in 29 medical male inpatients, representing 12.4% (95%CI: 8.6-17.5). Ten of these (4.2%) fulfilled criteria of alcohol abuse and 19 (8.2%) the criteria of alcohol dependence. Laboratory tests are useless as screening tools with sensitivities between 10% (%CDT) and 52% (GammaGT). Only the Fiveshot questionnaire seems to yield reasonable diagnostic parameters at the recommended cutpoint of ≥ 2.5 with a sensitivity of 79.3% and a specificity of 87.7%. Conclusions: With a prevalence of 12.4%, our results are similar with other published studies for alcohol abuse and dependence according DSM criteria. The AUDIT as well as the Fiveshot seems to have the best diagnostic properties in this male medical inpatient population, and regarding to brief interventions, these questionnaires can be used as screening instruments as well as opportunities to talk about alcohol problems with admitted patients. Via Publisher
Aertgeerts, B., Buntinx, F., Bande-Knops, J., (...), Ansoms, S., Fevery, J.
The value of CAGE, CUGE, and AUDIT in screening for alcohol abuse and dependence among college freshmen. Alcoholism: Clinical and Experimental Research, Volume 24, Issue 1, January 2000, Pages 53-57
2000 English This study attempted to (1) determine the prevalence of alcohol problems in college freshmen, (2) assess the performance of both the CAGE and the Alcohol Use Disorders Identification Test (AUDIT) questionnaires in this population, and (3) assess the possibility of improving the CAGE and/or AUDIT. Prevalence of alcohol problems in college students is confirmed to be high. When screening for alcohol problems in a college freshmen population, one question seems extremely important. The newly constructed CUGE questionnaire may improve screening efforts in students, compared with existing questionnaires. Via Publisher
Agabio, R., Gessa, G.L., Montisci, A., (...), Bedogni, G., Marchi, A.
Use of the screening suggested by the National Institute on Alcohol Abuse and Alcoholism and of a newly derived tool for the detection of unhealthy alcohol drinkers among surgical patients. Journal of Studies on Alcohol and Drugs, Volume 73, Issue 1, January 2012, Pages 126-133
2012 English Objective: The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has developed a two-question tool for the detection of unhealthy drinking (NIAAA-2Q) that investigates excessive alcohol consumption per single occasion. NIAAA-2Q can be commuted into a four-question tool (NIAAA-4Q) by the addition of two questions aimed at investigating excessive weekly alcohol intake. NIAAA-2Q and NIAAA-4Q may prove useful in busy settings such as an anesthesiological environment. However, to date, no study has evaluated their efficacy in a surgical setting. The purpose of this study was to evaluate the accuracy of NIAAA-2Q and NIAAA-4Q in detecting unhealthy drinking among surgical patients using the more complex Alcohol Use Disorders Identification Test (AUDIT) comprising 10 questions as the criterion method. Method: NIAAA-4Q and AUDIT were administered to 200 surgical patients by three anesthetists. Results: A total of 23.5%, 12.5%, and 28.5% surgical patients were unhealthy drinkers according to AUDIT, NIAAA-2Q, and NIAAA-4Q, respectively. NIAAA-2Q negative and positive predictive values were 0.78 and 0.36, respectively, and positive and negative likelihood ratios were 1.80 and 0.90, respectively. NIAAA-4Q negative and positive predictive values were 0.93 and 0.65, respectively, and positive and negative likelihood ratios were 6.00 and 0.24, respectively. Conclusions: NIAAA-4Q demonstrated a better satisfactory agreement than NIAAA-2Q with AUDIT in detecting unhealthy alcohol drinking among surgical patients. These results suggest that the detection of unhealthy alcohol drinking may be increased by the administration of questions aimed at assessing the weekly average of alcohol intake. The modest time required for NIAAA-4Q administration is a major advantage in clinical practice with respect to AUDIT. Further research will compare NIAAA-2Q and NIAAA-4Q with other brief alcohol screening tests. Via Publisher
Agabio, R., Marras, P., Gessa, G.L., Carpiniello, B.
Alcohol use disorders, and at-risk drinking in patients affected by a mood disorder, in Cagliari, Italy: Sensitivity and specificity of different questionnaires. Alcohol and Alcoholism, Volume 42, Issue 6, November 2007, Pages 575-581
2007 English Aims: (i) To evaluate the prevalence of alcohol use disorders, and at risk-drinking among outpatients admitted to the Division of Psychiatry, University of Cagliari, Italy, for mood disorders, and (ii) to compare the sensitivity and specificity of the questionnaires used. Methods: Fifty-six patients affected by mood disorders answered to the questions of (i) The NIAAA Guide for identification of at-risk drinking, (ii) AUDIT questionnaire, (iii) The CAGE questionnaire and, (iv) SCID-I application forms for mood and alcohol use disorders. Results: Fourteen subjects (25%) met the criteria for alcohol use disorders according to SCID-I; 17 (30.4%) achieved a score ≥1 in CAGE questionnaire; 12 (21.4%) reached AUDIT scores of ≥8 and 4 for men and women, respectively; 12 (21.4%) provided positive answers to NIAAA Guide. Despite these prevalence rates, no diagnosis of alcohol use disorders had previously been registered in their medical records. The CAGE questionnaire achieved the highest values of sensitivity and specificity in detecting alcohol use disorders tested against that of the SCID-I. Conclusions: Alcohol use disorders and at-risk drinking are frequent in patients affected by mood disorders, although often underestimated; this underestimation was virtually absolute in the sample of patients investigated. Combination of the CAGE questionnaire plus the first questions in the NIAAA Guide may be an effective tool for use in the identification of psychiatric patients with possible alcohol use disorders or at-risk drinking. Open Access
Balachova, T., Sobell, L.C., Agrawal, S., (...), Volkova, E., Bohora, S.
Evaluating alcohol use among Russian women at risk for an alcohol-exposed pregnancy: A comparison of three measures of alcohol use. Journal of Ethnicity in Substance Abuse, Volume 17, Issue 3, 3 July 2018, Pages 324-334
2018 English The Quick Drinking Screen (QDS) and Timeline Followback (TLFB), measures of alcohol use, have yielded similar reports of drinking with English speakers. The present study, a secondary data analysis, compared three measures of alcohol use (i.e., QDS, TLFB, and AUDIT) among Russian-speaking women. This is the first study to compare all three measures. This study replicated the findings of studies with English speakers and demonstrated that brief screening measures (QDS, AUDIT) provide reliable summary measures of alcohol use when compared to a detailed drinking measure (TLFB). The use of brief screening measures is recommended for use with Russian women. Via Publisher
Barry, K.L., Fleming, M.F.
The Alcohol Use Disorders Identification Test (AUDIT)and the SMAST-13: Predictive validity in a rural primary care sample. Alcohol and Alcoholism. Volume 28, Issue 1, January 1993, Pages 33-42
1993 English This study was conducted to compare the validity of a new screening instrument developed by the World Health Organization, the Alcohol Use Disorders Identification Test (AUDIT), to the short version of the MAST in 287 primary care patients. Subjects were classified as meeting a lifetime or current DSM-III diagnosis of alcohol misuse and/or dependence based on the DIS-R interview schedule. Using the original WHO guidelines (score of 11 or more), 37 (13%) scored positive on the AUDIT and 103 (36%) had a weighted score of 5 or more on the SMAST-13. The internal reliability of the AUDIT was 0.86, compared to the SMAST-13 at 0.85. Cut-off scores in this sample for current alcohol problems, utilizing Receiver Operating Curves, were 7-8 for the AUDIT and 5 for the SMAST. This study confirms the utility of the AUDIT for current alcohol problems and the SMAST-13 for lifetime or past problems in a rural clinical sample. © 1993 Medical Council on Alcoholism. Via Publisher
Bergman, H., Källmén, H.
Alcohol use among Swedes as assessed by the Alcohol Use Disorders Identification Test (AUDIT): A psychometric study | [Befolkningens alkoholvanor enligt AUDIT-testet: Sänkt gränsvärde fördubblade andelen kvinnor med riskabla alkoholvanor]. Lakartidningen, Volume 97, Issue 17, 2000, Pages 2078-2084
2000 Swedish The Alcohol Use Disorders Identification Test (AUDIT) was completed by 997 persons randomly sampled from the general Swedish population (80 percent response rate). Eighteen percent of the men and 5 percent of the women had hazardous or harmful alcohol use according to the 8+ score criterion. Since women are more sensitive to alcohol than men, a cut-off score of 6+ was suggested for them. The female prevalence of hazardous or harmful alcohol use then increased to nearly 11 percent. Hazardous or harmful alcohol use decreased with increasing age in both genders. The »binge drinking» question explained half of the total AUDIT variance and is thus the best predictor of heavy drinking in the test. The internal and test-retest reliability of the AUDIT was satisfactory. Reference values for different ages and genders are presented. Open Access
Bischof, G., Reinhardt, S., Grothues, J., (...), John, U., Rumpf, H.-J.
Development and evaluation of a screening instrument for alcohol-use disorders and at-risk drinking: The Brief Alcohol Screening Instrument for Medical Care (BASIC). Journal of Studies on Alcohol and Drugs, Volume 68, Issue 4, July 2007, Pages 607-614
2007 English Objective: Screening for problem drinking has not yet become standard practice in primary health care settings, and lack of time is an important barrier for general practicioners to intervene. Very brief screening instruments might help to implement screening into the daily routine in primary health care. The present study describes the development and evaluation of the Brief Alcohol Screening Instrument for medical Care (BASIC), using two independently drawn samples. Method: Sample 1 was recruited from general practices in two northern German cities. In total, 10,803 screenings were conducted. Item selection and validation of the BASIC was carried out in two equally sized random subsamples drawn from Sample 1. Sample 2 consisted of 2,949 consecutively admitted patients from a general hospital. Two different screening tools, both containing the Lübeck Alcohol abuse and dependence Screening Test (LAST) and one containing the full Alcohol Use Disorders Identification Test (AUDIT) and the other one the BASIC, were randomly handed out to study participants and compared according to validity criteria. As a gold standard for the detection of alcohol-use disorders, the Munich-Composite International Diagnostic Interview (M-CIDI) was used for screening positive individuals. Results: In the first general-practice subsample, six items that performed comparably well to the AUDIT were identified. In the second study, these findings were replicated. Both questionnaires performed better than the complementary deployed AUDIT-C and LAST. Conclusions: Data show that the BASIC is an efficient screening tool that performs as well as the AUDIT in medical settings while being shorter in administration and scoring. Via Publisher
Bradley, K.A., Boyd-Wickizer, J., Powell, S.H., Burman, M.L.
Alcohol screening questionnaires in women: A critical review. Journal of the American Medical Association, Volume 280, Issue 2, 8 July 1998, Pages 166-171
1998 English Objective.— To describe the performance of alcohol screening questionnaires in female patients.
Data Sources.— We searched MEDLINE from 1966 to July 1997 for alcoholism or alcohol-drinking and for CAGE, AUDIT, BMAST, TWEAK, T-ACE, MAST, SMAST, or SAAST; Citations Indexes for newer screening questionnaires and those without acronyms; and MEDLINE from 1996 to July 1997 for alcoholism or alcohol-drinking and screening.
Study Selection and Data Extraction.— Reviewed studies presented data for women comparing brief alcohol screening questionnaires with valid criterion standards for heavy drinking (≥2 drinks per day) or alcohol abuse or dependence in US general clinical populations. Sensitivities, specificities, and areas under receiver operating characteristic curves (AUROCs) were extracted.
Data Synthesis.— Thirteen articles (9 studies) were reviewed. The CAGE questionnaire had AUROCs of 0.84 to 0.92 for alcohol abuse and dependence in predominantly black populations of women, but using the traditional cut point of 2 or more resulted in low sensitivities (38%-50%) in predominantly white female populations. The TWEAK and Alcohol Use Disorders Identification Test (AUDIT) questionnaires had high AUROCs (0.87-0.93) for past-year alcohol abuse or dependence in black or white women, but had sensitivities less than 80% at traditional cut points. For detecting heavy drinking, the AUDIT questionnaire had AUROCs of at least 0.87 in female primary care patients. The TWEAK and T-ACE questionnaires had higher AUROCs (0.84-0.87) than the CAGE questionnaire (0.76-0.78) for detecting heavy drinking before pregnancy was recognized in black obstetric patients.
Conclusions.— The CAGE questionnaire was relatively insensitive in predominantly white female populations. The TWEAK and AUDIT questionnaires have performed adequately in black or white women, using lower cut points than usual.
Via Publisher
Bradley, K.A., Bush, K.R., McDonell, M.B., Malone, T., Fihn, S.D.
Screening for problem drinking: Comparison of CAGE and AUDIT. Journal of General Internal Medicine Volume 13, Issue 6, 1998, Pages 379-388
1998 English OBJECTIVE: To compare self-administered versions of three questionnaires for detecting heavy and problem drinking: the CAGE, the Alcohol Use Disorders Identification Test (AUDIT), and an augmented version of the CAGE.
SETTING: Three Department of Veterans Affairs general medical clinics.
MAIN RESULTS: Of 393 eligible patients, 261 (66%) returned the AUDIT and completed interviews. For detection of active alcohol abuse or dependence, the CAGE augmented with three more questions (AUROC 0.871) performed better than either the CAGE alone or AUDIT (AUROCs 0.820 and 0.777, respectively). For identification of heavy-drinking patients, however, the AUDIT performed best (AUROC 0.870). To identify both heavy drinking and active alcohol abuse or dependence, the augmented CAGE and AUDIT both performed well, but the AUDIT was superior (AUROC 0.861).CONCLUSIONS: For identification of patients with heavy drinking or active alcohol abuse or dependence, the self-administered AUDIT was superior to the CAGE in this population.
Via Publisher
Bradley, K.A., Kivlahan, D.R., Zhou, X.-H., (...), McDonell, M.B., Fihn, S.D.
Using Alcohol Screening Results and Treatment History to Assess the Severity of At-Risk Drinking in Veterans Affairs Primary Care Patients. Alcoholism: Clinical and Experimental ResearchVolume 28, Issue 3, March 2004, Pages 448-455
2004 English Background: Primary care providers need practical methods for managing patients who screen positive for at-risk drinking. We evaluated whether scores on brief alcohol screening questionnaires and patient reports of prior alcohol treatment reflect the severity of recent problems due to drinking. Methods: Veterans Affairs general medicine outpatients who screened positive for at-risk drinking were mailed questionnaires that included the Alcohol Use Disorders Identification Test (AUDIT) and a question about prior alcohol treatment or participation in Alcoholics Anonymous ("previously treated"). AUDIT questions 4 through 10 were used to measure past-year problems due to drinking (PYPD). Conclusions: AUDIT-C scores combined with one question about prior alcohol treatment can help estimate the severity of PYPD among male Veterans Affairs outpatients. Via Publisher
Bryson, C.L., Au, D.H., Sun, H., (...), Kivlahan, D.R., Bradley, K.A.
Alcohol screening scores and medication nonadherence. Annals of Internal Medicine, Volume 149, Issue 11, 2 December 2008, Pages 795-803
2008 English Objective: To identify whether alcoholmisuse, as identified by a simple screening tool, is associated in a dose-response manner with increased risk for medication nonadherence in veterans attending primary care clinics. Measurements: Patients completed the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) questionnaire, a validated 3-question alcohol misuse screening test. Their scores were categorized into nondrinkers; low-level alcohol use; and mild, moderate, and severe alcohol misuse. Medication adherence, defined as having medications available for at least 80% of the observation days, was measured from pharmacy records for either 90 days or 1 year after the alcohol screening date. Logistic regression was used to estimate the predicted proportions of adherent patients in each AUDIT-C group and adjusted for demographic and clinical covariates. Results: The proportion of patients treated for hypertension and hyperlipidemia who were nonadherent increased with higher AUDIT-C scores. For 1-year adherence to statins, the percentage of adherent patients was lower in the 2 highest alcohol misuse groups (adjusted percentage of adherent patients, 58% [95% CI, 52% to 65%] and 55% [CI, 47% to 63%]) than in the nondrinker group (66% [CI, 64% to 68%]). For 1-year adherence to antihypertensive regimens, the percentage of adherent patients was lower in the 3 highest alcohol misuse groups (adjusted percentage of adherent patients, 61% [CI, 58% to 64%]; 60% [CI, 56% to 63%]; and 56% [CI, 52% to 60%]) than in the nondrinker group (64% [CI, 63% to 65%]). No statistically significant differences were observed for oral hypoglycemics in adjusted analyses. Conclusion: Alcohol misuse, as measured by a brief screening questionnaire, was associated with increased risk for medication nonadherence. Open Access
Burns, E., Gray, R., Smith, L.A.
Brief screening questionnaires to identify problem drinking during pregnancy: A systematic review. Addiction, Volume 105, Issue 4, April 2010, pages 601-614.
2010 English Aims: Although prenatal screening for problem drinking during pregnancy has been recommended, guidance on screening instruments is lacking. We investigated the sensitivity, specificity and predictive value of brief alcohol screening questionnaires to identify problem drinking in pregnant women. Results: Five studies (6724 participants) were included. In total, seven instruments were evaluated: TWEAK (Tolerance, Worried, Eye‐opener, Amnesia, Kut down), T‐ACE [Take (number of drinks), Annoyed, Cut down, Eye‐opener], CAGE (Cut down, Annoyed, Guilt, Eye‐opener], NET (Normal drinker, Eye‐opener, Tolerance), AUDIT (Alcohol Use Disorder Identification Test), AUDIT‐C (AUDIT‐consumption) and SMAST (Short Michigan Alcohol Screening Test). Study quality was generally good, but lack of blinding was a common weakness. For risk drinking sensitivity was highest for T‐ACE (69‐88%), TWEAK (71–91%) and AUDIT‐C (95%), with high specificity (71–89%, 73–83% and 85%, respectively). CAGE and SMAST performed poorly. Sensitivity of AUDIT‐C at score ≥3 was high for past year alcohol dependence (100%) or alcohol use disorder (96%) with moderate specificity (71% each). For life‐time alcohol dependency the AUDIT at score ≥8 performed poorly.Conclusion: T‐ACE, TWEAK and AUDIT‐C show promise for screening for risk drinking, and AUDIT‐C may also be useful for identifying alcohol dependency or abuse. However, their performance as stand‐alone tools is uncertain, and further evaluation of questionnaires for prenatal alcohol use is warranted. Via Publisher
Bush, K.R., Kivlahan, D.R., Davis, T.M., (...), Epler, A.J., Bradley, K.A.
The TWEAK is Weak for Alcohol Screening among Female Veterans Affairs Outpatients. Alcoholism: Clinical and Experimental Research, Volume 27, Issue 12, December 2003, Pages 1971-1978
2003 English Background: The optimal brief questionnaire for alcohol screening among female patients has not yet been identified. This study compared the performance of the TWEAK (tolerance, worried, eye-opener, amnesia, cutdown), the Alcohol Use Disorders Identification Test (AUDIT), and the AUDIT Consumption (AUDIT-C) as self-administered screening tests for hazardous drinking and/or active alcohol abuse or dependence among female Veterans Affairs (VA) outpatients. Methods: Women were included in the study if they received care at VA Puget Sound and completed both a self-administered survey containing the AUDIT and TWEAK screening questionnaires and subsequent in-person interviews with the Alcohol Use Disorders and Associated Disabilities Interview Schedule. Sensitivities, specificities, positive and negative likelihood ratios, and areas under Receiver Operating Characteristic curves were computed for each screening questionnaire compared with two interview-based comparison standards: (1) active DSM-IV alcohol abuse or dependence and (2) hazardous drinking and/or active DSM-IV alcohol abuse or dependence, the more appropriate target for primary care screening. Results: Of 393 women who completed screening questionnaires and interviews, 39 (9.9%) met diagnostic criteria for alcohol abuse or dependence, and 89 (22.7%) met criteria for hazardous drinking or alcohol abuse or dependence. The TWEAK had relatively low sensitivities (0.62 and 0.44) but adequate specificities (0.86 and 0.89) for both interview-based comparison standards, even at its lowest cut-point (≥1). The AUDIT and AUDIT-C were superior, with the following areas under the receiver operating characteristic curve for active alcohol abuse or dependence and hazardous drinking and/or active alcohol abuse or dependence, respectively: AUDIT, 0.90 [95% confidence interval (CI), 0.85-0.95] and 0.87 (95% CI, 0.84-0.91); AUDIT-C, 0.91 (95% CI, 0.88-0.95) and 0.91 (95% CI, 0.88-0.94); and TWEAK, 0.76 (95% CI, 0.66-0.86) and 0.67 (95% CI, 0.60-0.74). Conclusions: The TWEAK has low sensitivity as an alcohol-screening questionnaire among female VA outpatients and should be evaluated further before being used in other female primary care populations. The three-item AUDIT-C was the optimal brief alcohol-screening questionnaire in this study. Via Publisher
Canagasaby, A., Vinson, D.C.
Screening for hazardous or harmful drinking using one or two quantity-frequency questions. Alcohol and Alcoholism Volume 40, Issue 3, May 2005, Pages 208-213
2005 English Aims: To address the accuracy of quantity-frequency (QF) questions in screening for hazardous or harmful drinking. Conclusions: In clinical settings, one way to put these findings into practice is to screen first with a single question, such as the SASQ, a single question about typical quantity, or a question about the frequency of heavy drinking such as the third item of the alcohol use disorders test (AUDIT). Open Access
Carey, K.B., Carey, M.P., Chandra, P.S.
Psychometric evaluation of the Alcohol Use Disorders Identification Test and short drug abuse screening test with psychiatric patients in India. Journal of Clinical Psychiatry, Volume 64, Issue 7, 1 July 2003, Pages 767-774
2003 English The Alcohol Use Disorders Identification Test (AUDIT) and the short Drug Abuse Screening Test (DAST-10) are brief self-report screens for alcohol and drug problems that have not been evaluated for use with psychiatric patients in developing countries. This study was designed to evaluate the factor structure, reliability, validity, and utility of the AUDIT and the DAST-10 in an Indian psychiatric hospital.Conclusion: The AUDIT and the DAST-10 demonstrate strong psychometric properties when used in an Indian psychiatric hospital. Routine use of these brief screens can facilitate detection of substance use disorders among psychiatric patients. Via Publisher
Cherpitel, C.J.
Screening for alcohol problems: A comparison of instrument performance among black emergency department and primary care patients. Journal of Substance Use, Volume 5, Issue 4, 2001, Pages 290-297
2001 English While alcohol problems are over-represented in primary care settings and in emergency departments (EDs), screening for alcohol use disorders has not been a routine part of care in the United States, and little is known of the performance of screening instruments for problem drinking, particularly among women and ethnic minorities. The sensitivity and specificity of the CAGE, BMAST, AUDIT, TWEAK, and RAPS are compared against DSM-IV and ICD-10 criteria for alcohol dependence in probability samples of black patients interviewed in the ED (n = 1091) and primary care clinics (n = 711) in Jackson, Mississippi. Instruments appeared to perform better in the ED than in primary care. The CAGE and RAPS appeared to perform best in the primary care sample, and the AUDIT and RAPS in the ED sample. While the prevalence of alcohol dependence in the primary care clinics was lower than in the ED, findings suggest that both sites are important for screening and identification of patients with alcohol use disorders. Further research is needed for determining those screening instruments which perform optimally in identifying problem drinking patients across clinical sites. Via Publisher
Cherpitel, C.J., Bazargan, S.
Screening for alcohol problems: Comparison of the AUDIT, RAPS4 and RAPS4-QF among African American and Hispanic patients in an inner city emergency department. Drug and Alcohol Dependence, Volume 71, Issue 3, 10 September 2003, Pages 275-280
2003 English Objective: to compare brief screening instruments for alcohol use disorders, the RAPS4, RAPS4-QF, and AUDIT, against DSM-IV criteria for alcohol dependence and alcohol abuse among African Americans and Hispanics in a sample of inner city emergency department (ED) patients. Results: no difference was found between the RAPS4 and AUDIT for alcohol dependence. Sensitivity of the RAPS4-QF (the RAPS4 plus a quantity item and a frequency item) was significantly better than the AUDIT for African Americans and Hispanics, and for males, but not for females, although the RAPS4-QF identified all of those women positive for alcohol abuse criteria, compared to 93% identified by the AUDIT. Conclusion: the data suggest the RAPS4 and the RAPS4-QF perform well for identifying alcohol dependence and alcohol abuse, respectively, among minority ED patients. Additional research is needed to evaluate the RAPS4-QF as a stand-alone instrument and to evaluate both instruments across gender and ethnic subgroups in other populations and in other cultural settings Via Publisher
Cherpitel, C.J., Borges, G.
Performance of screening instruments for alcohol problems in the ER: A comparison of Mexican-Americans and Mexicans in Mexico. American Journal of Drug and Alcohol Abuse, Volume 26, Issue 4, 2000, Pages 683-702
2000 English The performance of standard screening instruments and alternate measures against ICD-10 (International Classification of Diseases, 10th revision) and DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th revision) criteria for alcohol dependence and separately for harmful drinking/abuse were compared between probability samples of 1511 emergency room (ER) patients from three hospitals in Pachuca, Mexico, and 586 Mexican-American ER patients in Santa Clara County, California. Sensitivity was highest for the Alcohol Use Disorders Identification Test (AUDIT), TWEAK, and Rapid Alcohol Problems Screen (RAPS) for alcohol dependence; sensitivity was highest for holding five or more drinks for harmful drinking/abuse in both samples. All instruments performed better for alcohol dependence than for abuse/harmful drinking. Arrests for drinking and driving performed better in Santa Clara than in Pachuca, while a positive Breathalyzer reading and reporting drinking prior to the event performed better in Pachuca; both were significantly more sensitive among the injured compared to the noninjured in Pachuca. The data suggest that instrument performance may be similar between those in Pachuca and those in the low acculturation group in Santa Clara, relative to those scoring higher on acculturation. While standard screening instruments appear to work reasonably well in both samples for alcohol dependence, variation across gender, injury, and acculturation subgroups suggests attention should be given to choosing the 'best' instrument. Via Publisher
Cherpitel, C.J., Borges, G.
Screening instruments for alcohol problems: A comparison of cut points between Mexican American and Mexican patients in the emergency room. Substance Use and Misuse, Volume 35, Issue 10, 2000, Pages 1419-1430
2000 English The performance of alcohol use disorder screening instruments (CAGE, BMAST, AUDIT, TWEAK) at various cut points were compared between a Mexican American emergency room (ER) sample (n = 586) and a sample of ER patients in Mexico (n = 1,417) using ICD-10 and DSM-IV criteria for alcohol dependence and harmful drinking/abuse by gender and injury status. Lowering cut points improved instrument performance substantially for females in both samples. Further research is needed to explore instrument performance by gender and level of acculturation. Via Publisher
Cherpitel, C.J., Ye, Y., Moskalewicz, J., Swiatkiewicz, G.
Screening for alcohol problems in two emergency service samples in Poland: Comparison of the RAPS4, CAGE and AUDIT. Drug and Alcohol Dependence, Volume 80, Issue 2, 1 November 2005, Pages 201-207
2005 English Prior research on alcohol-related problems among emergency service patients in Poland found substantial alcohol involvement on the part of injured males, suggesting emergency services may be a productive venue for identifying patients who could benefit from a brief intervention or referral for treatment. Performance of the RAPS4, CAGE and AUDIT against ICD-10 and DSM-IV criteria for alcohol dependence and for alcohol abuse/harmful drinking was compared in probability samples of emergency service patients from two regions of Poland. Sensitivity of the RAPS4 and AUDIT was significantly better than the CAGE for alcohol dependence among males in Warsaw, but specificity was poorer. Among females, although numbers were small, sensitivity for alcohol abuse/harmful drinking and for alcohol dependence or abuse/harmful drinking was significantly better for the RAPS4-QF than for the CAGE or AUDIT at a cut point of 8 across both sites. Performance of the AUDIT at a cut point of 3 was similar to the RAPS4-QF for females. Among males, sensitivity was higher but specificity considerably lower for the RAPS4-QF compared to the CAGE at a cut point of 1 or for the AUDIT at a cut point of 8. Alternate cut points for the AUDIT optimized performance. Findings suggest some regional and gender differences in performance of screening instruments in these Polish samples, but no instrument or cut point is optimal in identifying those with alcohol use disorders. Additional cross-cultural research is needed to evaluate the performance of instruments, especially among females with alcohol use disorders. Via Publisher
Cherpitel, Cheryl, J.
Performance of screening instruments for alcohol problems in a black primary care population. Journal of Addictions Nursing, Volume 11, Issue 2, 1999, Pages 54-60
1999 English While alcohol use disorders have been found to be overrepresented in some primary care settings, the majority of patients with these disorders go undetected by primary health care providers, and little is known of the performance of screening instruments for identifying problem drinking, particularly among females or ethnic minorities. The performance of several screening instruments CAGE, Brief Michigan Alcoholism Screening Test (BMAST), Alcohol Use Disorders Identification Test (AUDIT), TWEAK, Rapid Alcohol Problems Screen (RAPS) and holding five or more drinks (HOLD), against International Classification of Diseases, 10th revision (ICD-10) and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for alcohol dependence/harmful drinking/alcohol abuse, was compared by gender in a probability sample of black primary care clinic patients (n = 711). Sensitivity of all measures except BMAST and HOLD was significantly better for males than for females. The RAPS performed best among males (sensitivity, 91%; specificity, 98%), while sensitivity of all measures was unacceptably low among females (none was above 44%). Among current drinkers, 19% of males and 10% of females met diagnostic criteria for an alcohol use disorder, suggesting the importance of identifying those who may benefit from a brief intervention in primary care settings, and suggesting the need for further research in determining those instruments that may have the best potential for identifying problem drinking among female primary care patients. Via Publisher
Cho, K.-C., Kim, J.-S., Jung, J.-G., (...), Lee, J.-G., Choi, D.-H.
Effects of insight level on the sensitivity of alcoholism screening tests in alcohol dependent patients. Korean Journal of Family Medicine, Volume 31, Issue 7, July 2010, Pages 523-528
2010 Korean Background: Alcoholism screening tests are commonly used in primary medical care. This study examined how much the level of insight of alcohol-dependent patients would impact on the sensitivity of alcoholism screening tests. Methods: The sample consisted of 122 subjects who had been diagnosed with alcohol dependence and who completed Alcohol Use Disorders Identification Test (AUDIT), and CAGE questionnaire. AUDIT positive was defined as a score of 20 points or above and CAGE positive, 3 points or above. Insight level was classified as poor, fair, and good using the Hanil Alcohol Insight Scale (HAIS). Positive rates on the AUDIT and CAGE were analyzed according to the level of insight. Results: In good insight group, the sensitivity of AUDIT and CAGE identified 96.9% and 96.9% of the participants as alcohol dependence, respectively. In fair insight group, those were 92.7% and 96.4%, respectively. However, in poor insight group, these decreased substantially to 62.9% and 65.7%, respectively. After adjusting for general characteristics on the basis of good insight group, we found that the possibility of positive on the AUDIT was significantly lower in poor insight group (Odd ratios [OR], 0.025; 95% confidence interval [CI], 0.002 to 0.411). Also, the possibility of positive on the CAGE was significantly lower in poor insight group (OR, 0.016; 95% CI, 0.001 to 0.358). Conclusion: Alcohol-dependent patients with poor insight showed a high rate of false negatives in alcoholism screening tests. These suggest that primary care physicians should be careful in interpreting the results of alcoholism screening tests.  Open Access
Conley, T.B.
Construct validity of the MAST and AUDIT with multiple offender drunk drivers. Journal of Substance Abuse Treatment, Volume 20, Issue 4, 2001, Pages 287-295
2001 English The construct validity of the Michigan Alcoholism Screening Test (MAST) and the Alcohol Use Disorders Identification Test (AUDIT) in screening for current DSM-IV alcohol dependence disorders with persons convicted of multiple offenses of Driving Under the Influence (DUI) is evaluated. These tests were administered to 126 DUI offenders presenting for court-ordered inpatient treatment at an agency. DSM-IV alcohol disorders are evaluated for a representative subset of clients in this program using National Longitudinal Alcohol Epidemiologic Surveys' DSM-IV Alcohol Dependence Diagnostic Criteria and Associated Questionnaire Items. Both instruments exhibit acceptable internal consistency. The MAST and The AUDIT correlate moderately well with each other (r=0.617). The MAST correlates more highly (r=0.602) than the AUDIT (r=0.432) with DSM-IV. Future research should examine if the results reported here apply to other multiple offender DUI programs. It is recommended that such programs employing test instruments evaluate their construct validity in a similar method.  Via Publisher
Conley, T.B.
Court ordered multiple offender drunk drivers: Validity and reliability of rapid assessment. Journal of Social Work Practice in the Addictions, Volume 6, Issue 3, 20 September 2006, Pages 37-51
2006 English The Alcohol Use Disorders and Associated Disabilities Interview Schedules' (AUDADIS) DSM-IV related items are used to evaluate the convergent validity of the Severity of Alcohol Dependence Questionnaire (SAD-Q), the Michigan Alcoholism Screening Test (MAST), and the Alcohol Use Disorders Identification Test (AUDIT) with persons convicted for multiple offences of driving under the influence. A total of 187 participants underwent semi-structured interviewing; of these 84% were alcohol dependent. The instruments exhibit acceptable internal consistency (all alphas > .85) as well as test/re-test reliability (all r = s ≥ .85). The MAST converged most closely with a DSM-IV diagnosis. Implications for rapid assessment instrument research as well as practice in public agencies are discussed. Via Publisher
Cook, R.L., Chung, T., Kelly, T.M., Clark, D.B.
Alcohol screening in young persons attending a sexually transmitted disease clinic: Comparison of AUDIT, CRAFFT, and CAGE instruments. Journal of General Internal Medicine, Volume 20, Issue 1, January 2005, Pages 1-6
2005 English OBJECTIVE: To compare the ability of 3 brief alcohol screens (Alcohol Use Disorders Identification Test [AUDIT], CRAFFT, and CAGE) to identify adolescents and young adults with a current alcohol use disorder (AUD) and to determine whether there are gender-based or race-based differences in screening performance. CONCLUSIONS: Clinicians should use the AUDIT or CRAFFT, rather than the CAGE, to screen young persons for AUDs. The AUDIT performs best, but its length may limit its utility in this setting. The CRAFFT is a suitable alternative, with excellent sensitivity and no gender-based or race-based differences. Via Publisher
Coulton, S., Drummond, C., James, D., (...), Parrott, S., Peters, T.
Opportunistic screening for alcohol use disorders in primary care: Comparative study. British Medical Journal Volume 332, Issue 7540, 4 March 2006, Pages 511-514
2006 English Objective: To evaluate the efficacy and relative costs of different screening methods for the identification of alcohol use disorders in an opportunistic screening programme in primary care in the United Kingdom. Design: Comparative study. Setting: Six general practices in south Wales. Participants: 194 male primary care attendees aged 18 or over who completed an alcohol use disorders identification test (AUDIT) questionnaire. Results: A significant correlation was observed between alcohol consumption and score on the alcohol use disorders identification test (Pearson's correlation coefficient r = 0.74) and measures of γ-glutamyltransferase (r=0.20) and per cent carbohydrate deficient transferrin (r = 0.36) but not aspartate aminotransferase (r = 0.08) or erythrocyte mean cell volume (r = 0.02). The alcohol use disorders identification test exhibited significantly higher sensitivity, specificity, and positive predictive value than all of the biochemical markers for hazardous consumption (69%, 98%, and 95%), weekly binge consumption (75%, 90%, and 71%), monthly binge consumption (66%, 97%, and 91%), and alcohol dependence (84%, 83%, and 41%). The questionnaire was also more cost efficient, with a lower cost per true positive for all consumption outcomes. Conclusion: The alcohol use disorders identification test questionnaire is an efficient and cost efficient diagnostic tool for routine screening for alcohol use disorders in primary care. Open Access
Cremonte, M., Cherpitel, C.J.
Performance of screening instruments for alcohol use disorders in emergency department patients in Argentina. Substance Use and Misuse, Volume 43, Issue 1, January 2008, Pages 125-138
2008 English The performance of the Alcohol Use Disorders Identification Test (AUDIT), CAGE, Brief Michigan Alcohol Screening Test (Brief MAST), Rapid Alcohol Problems Screen (RAPS), Rapid Alcohol Problems Screen-Quantity and Frequency (RAPS4-QF), and TWEAK was evaluated against a diagnosis of alcohol dependence and harmful drinking or alcohol abuse from ICD-10 and DSM-IV criteria. Data were collected from a probability sample of 779 patients admitted to the emergency department of a public general hospital in Mar del Plata, Argentina, during the year 2001. The majority of the patients sampled were male. The age range was 18 to 89 years, with a mean value of 36 years and a median of 31 years. Almost half of the sample had an elementary school education or less. All instruments were more sensitive for alcohol dependence than for harmful drinking or abuse and more sensitive for men than for women. Findings suggest the RAPS4 and RAPS4-QF may be preferred when screening for alcohol use disorders in the emergency department in Argentina. The study's limitations are noted.  Via Publisher
Cremonte, M., Ledesma, R.D., Cherpitel, C.J., Borges, G.
Psychometric properties of alcohol screening tests in the emergency department in Argentina, Mexico and the United States. Addictive Behaviors, Volume 35, Issue 9, September 2010, Pages 818-825
2010 English The objective of this article is to report psychometric characteristics of the AUDIT, CAGE, RAPS4, and TWEAK and to compare them across three countries: Argentina, Mexico, and the United States which used a similar protocol and methodology. Probability samples of patients 18. years and older were drawn from emergency departments in Mar del Plata, Argentina (n=780), Pachuca, Mexico (n=1624) and Santa Clara, U.S. (n=1220). Concurrent validity was assessed by comparing their performance against a diagnosis of alcohol dependence (DSM-IV) obtained through the Composite International Diagnostic Interview, and for the briefer measures, also by their correlation with the AUDIT. The internal consistency of the CAGE, RAPS4, and TWEAK scores was estimated by the KR-20 formula and by Cronbach's Alpha for the AUDIT. Corrected item-total correlation and D-values were used as item discrimination measures.In Argentina and Mexico the AUDIT and the RAPS4 showed the highest validity. Reliability of all instruments was higher in the US than in Argentina or Mexico. In all three countries, reliability of the TWEAK was lowest, while the AUDIT was highest. With a few exceptions, all items showed good discrimination powers.  Via Publisher
Davey, J.D., Obst, P.L., Sheehan, M.C.
The use of AUDIT as a screening tool for alcohol use in the police work-place. Drug and Alcohol Review, Volume 19, Issue 1, March 2000, Pages 49-54
2000 English There has been little research examining the use of the Alcohol Use Disorders Identification Test (AUDIT) as a work-place screening tool. In the current study a large scale sample (n = 4193) of police personnel completed the 10 AUDIT questions and two readiness-to-change questions. The sample represented 67% of all members of an Australian State Police organization. Analysis of AUDIT scores showed that 65% of the sample scored in the low risk of hazardous alcohol consumption range, 32% (33% of males and 24% of females) scored in the at risk for harmful alcohol consumption range and 3% scored in the range indicating risk of alcohol dependence. Age emerged as a clear risk factor of hazardous drinking patterns. The 18-25-year age group recorded higher average alcohol consumption, higher rates of risk of abnormal drinking behaviour, higher rates of adverse consequences from drinking alcohol and higher total AUDIT scores than other age groups. This was consistent for both males and females. Of those scoring in the at-risk range, 72.5% reported that they did not have a drinking problem. Sixty percent also reported that it would be easy to stop drinking. This study exemplifies how the AUDIT can be used to provide strong evidence for the need for work-based intervention programmes. Further, it can be used to target particular groups within the organization at risk of harmful alcohol use. Via Publisher
Fairlie, A.M., Sindelar, H.A., Eaton, C.A., Spirito, A.
Utility of the AUDIT for screening adolescents for problematic alcohol use in the emergency department. International Journal of Adolescent Medicine and Health, Volume 18, Issue 1, January/March 2006, Pages 115-122
2006 English The emergency department is a setting conducive to screening adolescents for problematic alcohol use, who can then be targeted for further evaluation and intervention. This study examined the utility of the Alcohol Use Disorders Identification Test (AUDIT) as a screening measure for identifying young adolescents in an urban emergency department (ED). Adolescents (13-17 years old) who presented to the ED were screened as part of a larger study. A total of 859 adolescents, who denied alcohol use prior to their ED visit were administered the AUDIT. Of the 500 younger adolescents (13-15 years old), approximately 4% (n = 22) were classified as AUDIT-positive using a cut-score of four or greater. Of the 359 older adolescents (16-17 years old), almost 19% (n = 67) were classified as AUDIT-positive. The ability of shorter versions of the AUDIT to identify AUDIT-positive adolescents (as classified by the 10-item AUDIT using a cut-score of four or greater) was also explored. Since the adolescents in the current study were not alcohol-positive at the time of the ED visit, they would likely have been missed by biochemical alcohol screening alone. Screening procedures that employ the AUDIT may be most efficient when adapted for the specific adolescent age group (younger versus older), thus identifying the highest number of adolescents who should be targeted for intervention. Lowering the recommended adult cut-scores on the shorter versions of the AUDIT appears necessary to identify adolescents who may benefit from intervention or referral.  Via Publisher
Fiellin, D.A., Reid, M.C., O'Connor, P.G.
Screening for alcohol problems in primary care: A systematic review. Archives of Internal Medicine. , 2000, Vol.160(13), p.1977-1989
2000 English Objective: To evaluate the accuracy of screening methods for alcohol problems in primary care.Results Thirty-eight studies were identified. Eleven screened for at-risk, hazardous, or harmful drinking; 27 screened for alcohol abuse and dependence. A variety of screening methods were evaluated. The Alcohol Use Disorders Identification Test (AUDIT) was most effective in identifying subjects with at-risk, hazardous, or harmful drinking (sensitivity, 51%-97%; specificity, 78%-96%), while the CAGE questions proved superior for detecting alcohol abuse and dependence (sensitivity, 43%-94%; specificity, 70%-97%). These 2 formal screening instruments consistently performed better than other methods, including quantity-frequency questions. Conclusions: Despite methodological limitations, the literature supports the use of formal screening instruments over other clinical measures to increase the recognition of alcohol problems in primary care.

Open Access
Foster, A.I., Blondell, R.D., Looney, S.W.
The practicality of using the SMAST and AUDIT to screen for alcoholism among adolescents in an urban private family practice. The Journal of the Kentucky Medical Association, Volume 95, Issue 3, March 1997, Pages 105-107
1997 English We assessed the practicality of using the Short Michigan Alcoholism Screening Test (SMAST) and the Alcohol Use Disorders Identification Test (AUDIT) in screening adolescents for alcoholism in a primary care setting. In addition, we sought to determine the prevalence of alcohol use among adolescents, 16-21 years of age, presenting to a private Family Medicine practice for medical care. A consecutive sample of 67 subjects presenting for medical care were asked to complete the SMAST and AUDIT questionnaires. Overall, 52 (78%) of the questionnaires were returned with complete data. Of the 52 patients, 25 (48%) admitted to drinking. Using a "positive" score on either the SMAST or AUDIT as a positive test for alcohol use yielded a sensitivity of 40% and a predictive value positive of 100%. Using a "negative" score on both the SMAST and AUDIT as a negative test for alcohol use yielded a specificity of 100% and a predictive value negative of 64%. Although alcohol use was relatively common considering the age group, using the SMAST and AUDIT to screen for alcoholism is labor intensive and is not practical in this situation. Because patients appeared to misinterpret some questions and were often accompanied to the office by their parents, their answers may not be valid. History of alcoholism taken upon typical office examination and relevant advice appears to be a better alternative to the use of questionnaires in determining the prevalence of alcohol use in this age group. Via Publisher
Francis, J.M., Weiss, H.A., Helander, A., (...), Changalucha, J., Grosskurth, H.
Comparison of self-reported alcohol use with the alcohol biomarker phosphatidylethanol among young people in northern Tanzania. Drug and Alcohol Dependence, Volume 156, 1 November 2015, Article number 5753, Pages 289-296
2015 English Background: The one-month Time Line Follow Back calendar (TLFB) and the Alcohol Use Disorders Identification Test (AUDIT) are used to collect self-reported alcohol intake data. We compared these instruments with the alcohol biomarker phosphatidylethanol (PEth) among young-people in northern Tanzania. Methods: AUDIT and TLFB were applied in a cross-sectional study of 202 young people (18-24 years), who reported using alcohol during the past year (103 male casual labourers; 99 college students). We assayed whole blood for PEth 16:0/18:1, using liquid chromatography-tandem mass spectrometry. Results: For both self-report methods, alcohol consumption was high, particularly among men (e.g. a median of 54 drinks per month in labourers), and about half of male students (48%) reported hazardous or harmful levels of drinking (AUDIT ≥8). Almost half (49%) of participants were PEth-positive (median concentration 0.03μmol/L). There were significant positive correlations between reported total alcohol intake and PEth concentration in males (Spearman's correlation rs=0.65 in college students and rs=0.57 in casual labourers; p<0.001). Self-reported use in the past month was a sensitive marker of having a positive PEth result (≥0.01μmol/L) with 89% of those with a PEth positive result reporting alcohol use, and this was similar in all groups. The proportion of those with AUDIT scores ≥8 and AUDIT-C scores ≥6 among those with a high cut-off positive PEth result (≥0.30μmol/L) ranged between 94 and 100%. Conclusion: TLFB and AUDIT are sensitive measures to detect heavy alcohol use among young-people in northern Tanzania. They can be used to identify young people who may benefit from alcohol-focused interventions. Open Access
Fujii, H., Nishimoto, N., Yamaguchi, S., (...), Kawada, N., Okawa, K.
The Alcohol Use Disorders Identification Test for Consumption (AUDIT-C) is more useful than pre-existing laboratory tests for predicting hazardous drinking: A cross-sectional study. BMC Public Health 2016, 16:379
2016 English Background: It is important to screen for alcohol consumption and drinking customs in a standardized manner. The aim of this study was 1) to investigate whether the AUDIT score is useful for predicting hazardous drinking using optimal cutoff scores and 2) to use multivariate analysis to evaluate whether the AUDIT score was more useful than pre-existing laboratory tests for predicting hazardous drinking. Methods: A cross-sectional study using the Alcohol Use Disorders Identification Test (AUDIT) was conducted in 334 outpatients who consulted our internal medicine department. The patients completed self-reported questionnaires and underwent a diagnostic interview, physical examination, and laboratory testing. Results: Forty (23 %) male patients reported daily alcohol consumption ≥ 40 g, and 16 (10 %) female patients reported consumption ≥ 20 g. The optimal cutoff values of hazardous drinking were calculated using a 10-fold cross validation, resulting in an optimal AUDIT score cutoff of 8.2, with a sensitivity of 95.5 %, specificity of 87.0 %, false positive rate of 13.0 %, false negative rate of 4.5 %, and area under the receiver operating characteristic curve of 0.97. Multivariate analysis revealed that the most popular short version of the AUDIT consisting solely of its three consumption items (AUDIT-C) and patient sex were significantly associated with hazardous drinking. The aspartate transaminase (AST)/alanine transaminase (ALT) ratio and mean corpuscular volume (MCV) were weakly significant. Conclusions: This study showed that the AUDIT score and particularly the AUDIT-C score were more useful than the AST/ALT ratio and MCV for predicting hazardous drinking. Open Access
Gammeter, R., Nay, C., Bissery, A., (...), Kaufmann, N., Daeppen, J.-B.
Frequency of alcohol use disorders in patients admitted in a psychiatric hospital according to admission diagnosis. Schweizer Archiv fur Neurologie und Psychiatrie, Volume 157, Issue 6, September 2006, Pages 290-296
2006 English Background: Comorbidities such as mental illness and alcohol use disorders (AUD) worsen the prognosis of both conditions. There is a need to identify early alcohol use disorders in psychiatric patients to prevent the development of dual diagnosis diseases, which are more difficult to treat. The Alcohol Use Disorders Identification Test (AUDIT) was developed by the World Health Organisation to promote early identification of alcoholuse disorders and has been validated mainly in primary care settings. No study has validated the AUDIT in a French-speaking psychiatric setting. There is also a need to identify the risk factors of heavy drinking with psychiatric disorders. Purpose: This study aims at (1) validating the French version of the Alcohol Use Disorders Identification test (AUDIT) for psychiatric inpatients and (2) determining the frequency of alcohol use disorders in four major psychiatric ICD-10 diagnostic categories: neurotic and depressive disorders (F3 and F4), personality disorders (F6), psychotic disorders (F2) and other disorders (n = 10). Subjects and methods: Of 383 consecutive psychiatric admissions, 219 completed the AUDIT. A subset was also interviewed with the CIDI (gold standard) and was retested with the AUDIT. Psychiatric diagnoses were recorded from hospital medical records. Results: Validation of the AUDIT showed a very good sensitivity (94.1%) and specificity (91.7%) in this psychiatric inpatient population. Frequency of alcohol use disorders was 35.1%. Personality disorders had the highest rate of AUDIT scores ≥8 (50.7%). Gender was the only statistically significant outcome in a multivariate model. Discussion: Male sex as an outcome associated with the presence of alcohol use disorders, is consistent with the other AUDIT studies in psychiatry. The uniqueness of the present study is the evaluation of personality disorders among the psychiatric diagnostic categories. Conclusion: This study strengthens the evidence that the AUDIT is reliable and valid with psychiatric patients and confirms the high frequency of alcohol use disorders in this population. Drinking habits of patients with emotionally labile personality disorders should be screened. Open Access
Gates, T., Duffy, K., Moore, J., Howell, W., McDonald, W.
Alcohol screening instruments and psychiatric evaluation outcomes in military aviation personnel. Aviation Space and Environmental Medicine, Volume 78, Issue 1, January 2007, Pages 48-51
2007 English Introduction: Alcohol-related disorders are the most prevalent psychiatric conditions in the aviation population. Efforts to effectively screen aviators for these disorders are continually sought, as under-diagnosis may negatively impact aviation safety. This study evaluates screening tools that have been validated in non-aviators in terms of their utility for aviator patients. Methods: There were 111 male aviation patients (27 ± 7 yr) referred for psychiatric evaluation at the Naval Aerospace Medicine Institute who completed the Self-Administered Alcohol Screening Test (SAAST), the Alcohol-Use Disorders Identification Test (AUDIT), and the Common Alcohol Logistical Scale-Revised (CAL-R) prior to evaluation by a staff psychiatrist or psychologist. Results: There were 40 patients who were qualified psychiatrically with no diagnosis and 49 patients who were disqualified for psychiatric reasons due to a non alcohol-related diagnosis. The remaining 22 patients were disqualified for psychiatric reasons with an alcohol-related diagnosis. The optimal aviator cut-off scores were consistent with those of the general population, although the cut-off score used for the SAAST was set at the published sub-threshold level to provide greater sensitivity. The sensitivity/specificity values for the SAAST, AUDIT, and CAL-R were 59%/94%, 46%/96%, and 68%/81%, respectively. Conclusion: The psychometrically sophisticated CAL-R is sensitive, specific, and has good negative predictive value, although its use requires a psychologist and its availability is limited. The SAAST and AUDIT can be administered by a flight surgeon or aviation medical examiner (AME). Given the higher sensitivity of the SAAST it may be the most beneficial if administered first. The AUDIT can be used as a follow-up diagnostic test given its higher specificity.  Via Publisher
Geneste, J., Pereira, B., Arnaud, B., (...), Malet, L., Brousse, G.
CAGE, RAPS4, RAPS4-QF and AUDIT screening tests for men and women admitted for acute alcohol intoxication to an emergency department: Are standard thresholds appropriate? Alcohol and Alcoholism, Volume 47, Issue 3, May 2012, Article number ags027, Pages 273-281
2012 English Aims: A number of screening instruments are routinely used in Emergency Department (ED) situations to identify alcohol-use disorders (AUD). We wished to study the psychometric features, particularly concerning optimal thresholds scores (TSs), of four assessment scales frequently used to screen for abuse and/or dependence, the cut-down annoyed guilty eye-opener (CAGE), Rapid Alcohol Problem Screen 4 (RAPS4), RAPS4-quantity-frequency and AUD Identification Test (AUDIT) questionnaires, particularly in the sub-group of people admitted for acute alcohol intoxication (AAI). Results suggest a statistically significant difference between men and women (P < 0.05) in performance of the screening tests RAPS4 (≥1) and CAGE (≥2) for detecting abuse. Also, in this population, we show an increase in TSs of RAPS4 (≥2) and CAGE (≥3) for detecting dependence compared with those typically accepted in non-intoxicated individuals. The AUDIT test demonstrates good performance for detecting alcohol abuse and/ or alcohol-dependent patients (≥7 for women and ≥12 for men) and for distinguishing alcohol dependence (≥11 for women and ≥14 for men) from other conditions. Conclusion: Our study underscores for the first time the need to adapt, taking into account gender, the thresholds of tests typically used for detection of abuse and dependence in this population. Open Access
Gmel, G., Heeb, J.-L., Rehm, J.
Is frequency of drinking an indicator of problem drinking? A psychometric analysis of a modified version of the alcohol use disorders identification test in Switzerland. Drug and Alcohol Dependence, Volume 64, Issue 2, 1 October 2001, Pages 151-163
2001 English Background: To study the psychometric properties of a modified Alcohol Use Disorders Identification Test in the multilingual context of Switzerland. Methods: Data were obtained from the most extensive health survey to date in Switzerland, with a response rate of 69%. Seven core items of AUDIT were used. The first two items of AUDIT (frequency of drinking, quantity of drinking) were not used in their original form, but reconstructed from a quantity-frequency instrument (QF) measuring alcohol consumption, and categorized according to the AUDIT. The third AUDIT item (frequency of binge drinking) was similarly not used in its original form, but 8+ drinks instead of 6+ drinks was used. All 10 items of the modified AUDIT were completed by 10 321 subjects - 6677 in the German-speaking region and 3644 in the Latin-language (French, Italian) regions. The dimensionality of the modified AUDIT was modelled by confirmatory factor analysis. The contribution of each item to the total modified AUDIT score was investigated by the prevalence of positively screened subjects when items were deleted, and factor loadings of the unidimensional model. Results: In Switzerland the modified AUDIT fitted neither a unidimensional nor the hypothesized tri-dimensional model. Consumption items, especially frequency of drinking, showed almost no correlation with items measuring alcohol-related problems, but the latent constructs 'harmful drinking' and 'alcohol dependence' were highly correlated, indicating a shared underlying factor. Frequency of drinking was the item that most influenced whether an individual screened positively or not. Except for the correlation of frequency and binge drinking, r esults were almost identical for both linguistic regions. Conclusions: The current form of the modified AUDIT may have to be changed for screening in Switzerland, as the study raised questions about the suitability of the frequency-of-drinking item as an indicator of a screening device for alcohol-related problems in this country.  Via Publisher
Gual, A., Contel, M., Segura, L., Ribas, A., Colom, J.
The ISCA (Systematic Interview of Alcohol Consumption), a new instrument to detect risky drinking. Medicina Clinica, Volume 117, Issue 18, 1 December 2001, Pages 685-689
2001 Spanish (English edition available) Background: The World Health Organisation Collaborative Project on Alcohol and Primary Health Care has stressed the need to develop standardised screening tools to enable early identification. The aim of this study was to develop a new systematic tool to register alcohol consumption and to validate its usefulness in order to detect risky drinking in primary health care settings. Subjects and Method: The Systematic Interview of Alcohol Consumption (ISCA) was administered together with the Alcohol Use Disorders Identification Test (AUDIT), which was used as main external criterium, to 255 patients who attended 5 primary health care centers. Results: The correlation between both procedures was highly positive and significant (r = 0.831; p < 0.001). The cut-off scores ( > 28 for men and > 17 for women) showed an ISCA sensitivity rank to detect risky drinking of 70-81% for men and 46-100% for women. The ISCA specificity ranks were 82-99% and 97-100%, respectively. Conclusions: The ISCA seems to be useful to detect risky drinking and it is easy to administer by primary health care professionals. ISCA and AUDIT can be used indistinctly and complementarily. Via Publisher
Gül, S., Akvardar, Y., Taş, G., Tuncel, P.
The diagnostic validity of screening tests and laboratory markers in alcohol use disorders. Turk Psikiyatri Dergisi, Volume 16, Issue 1, pages 3-12, Spring 2005
2005 Turkish, English Objective: To determine the validity of screening tests and markers suggested in the early detection of alcohol use disorders. Method: Male patients aged 20-65 were recruited from a psychiatry clinic. They had been consuming alcohol at least once a week. They were not drug users and had no other diseases that affected the markers mentioned in this study.According to the DSM-IV diagnostic criteria, the diagnostic validity of screening tests [Michigan Alcoholism Screening Test (MAST), CAGE (Cut down, Annoyed, Guilty, Eye-opener), Alcohol Use Disorders Identification Test (AUDIT)] and markers [Mean corpuscular volume (MCV), aspartate aminoransferase (AST), alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), carbohydrate-deficient transferrin (CDT)) was investigated in alcohol dependent patients (n=29), alcohol abusers (n=28) and social drinkers (n=28). Results: For the diagnosis of dependence, the sensitivity and specificity of the tests were respectively 69% and 100% for GGT, 41% and 93% for CDT, 100% and 57% for MAST, 97% and 86% for CAGE, and 100% and 75% for AUDIT. For the diagnosis of abuse, the sensitivity and specificity of the tests were respectively 32% and 100% for GGT 32% and 93% for CDT, 86% and 57% for MAST 75% and 85.7% for CAGE, and 89% and 75% for AUDIT. The widest.area under the ROC curve belonged to GGT as a marker and AUDIT as a screening test. Conclusion: According to the results of this study, the marker that has the highest validity is GGT, while AUDIT and CAGE are the best screening tests. Via Publisher
Gundersen, O.H., Mordal, J., Berman, A.H., Bramness, J.G.
Evaluation of the Alcohol Use Disorders Identification Test and the Drug Use Disorders Identification Test among patients at a Norwegian psychiatric emergency ward. European Addiction Research, Volume 19, Issue 5, 2013, Pages 252-260
2013 English High rates of substance use disorders (SUD) among psychiatric patients are well documented. This study explores the usefulness of the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT) in identifying SUD in emergency psychiatric patients. Of 287 patients admitted consecutively, 256 participants (89%) were included, and 61-64% completed the questionnaires and the Mini-International Neuropsychiatric Interview (MINI), used as the reference standard. Both AUDIT and DUDIT were valid (area under the curve above 0.92) and reliable (Cronbach's alpha above 0.89) in psychotic and nonpsychotic men and women. The suitable cutoff scores for AUDIT were higher among the psychotic than nonpsychotic patients, with 12 versus 10 in men and 8 versus 5 in women. The suitable cutoff scores for DUDIT were 1 in both psychotic and nonpsychotic women, and 5 versus 1 in psychotic and nonpsychotic men, respectively. This study shows that AUDIT and DUDIT may provide precise information about emergency psychiatric patients' problematic alcohol and drug use. Via Publisher
Harris, A.H.S., Bryson, C.L., Sun, H., Blough, D., Bradley, K.A.
Alcohol screening scores predict risk of subsequent fractures. Substance Use and Misuse, Volume 44, Issue 8, 2009, Pages 1055-1069
2009 English The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C; 012 points) was included on health surveys in a cohort of 32,622 general medicine outpatients from seven US Department of Veterans Affairs (VA) hospitals. Cox proportional hazards models were used to estimate the risk of fracture (mean follow-up 1.6 years) by AUDIT-C category. After adjusting for confounders, AUDIT-C scores of 89 and 1012 were associated with significantly increased risks for subsequent fractures, HR (95 CI) 1.37 (1.03 to 1.83) and 1.79 (1.38 to 2.33) respectively. These results can be used to provide feedback to patients linking their alcohol screening scores to medical outcomes, a critical component of evidence-based brief counseling for alcohol misuse. The study's limitations are noted. Via Publisher
Hermansson, U., Helander, A., Huss, A., Brandt, L., Rönnberg, S.
The Alcohol Use Disorders Identification Test (AUDIT) and carbohydrate- deficient transferrin (CDT) in a routine workplace health examination. Alcoholism: Clinical and Experimental Research Volume 24, Issue 2, February 2000, Pages 180-187
2000 English Background: Only a few studies on workplaces have examined the Alcohol Use Disorders Identification Test (AUDIT) or carbohydrate-deficient transferrin (CDT) as screening instruments for the early identification of elevated and risky levels of alcohol consumption. The purpose of this study was to compare the performances of AUDIT, CDT, and γ-glutamyltransferase (GGT) in a routine health examination (alcohol screening) in the workplace. Results: Of the 570 subjects who participated, 105 (18.4%) screened positive according to AUDIT, CDT, or both. Only 7.6% of the persons who screened positive did so according to both instruments. If GGT had been included as a screening instrument, the proportion of positive results would have increased to 22.0%. If we had only used AUDIT in the screening process, the proportion of positives would have fallen by nearly half. Conclusions: The present findings suggest that AUDIT and CDT are complementary instruments for alcohol screening in a routine workplace health examination, and each has value for identifying a different segment of the risky drinking population. Via Publisher
Hermansson, U., Knutsson, A., Brandt, L., (...), Rönnberg, S., Helander, A.
Screening for high-risk and elevated alcohol consumption in day and shift workers by use of the AUDIT and CDT. Occupational Medicine, Volume 53, Issue 8, December 2003, Pages 518-526
2003 English Background: Alcohol consumption levels and drinking patterns have been reported to vary between day and shift workers, although the results have been conflicting. Previous results indicate that questions about alcohol habits may be asked in the workplace. However, no studies have evaluated the Alcohol Use Disorders Identification Test (AUDIT) or the alcohol biomarker carbohydrate-deficient transferrin (CDT) in serum for this purpose. Aim: To investigate, in conjunction with routine health examinations, whether there is any difference between permanent day and shift workers in high-risk alcohol consumption, according to the AUDIT and CDT. Gamma-glutamyl transferase (GGT) in serum was included mainly as a comparison test. Methods. The employees who attended for a regular health examination during the study period were offered voluntary alcohol screening with the AUDITand CDT. Results: Altogether, 990 employees (day, two-shift, and three-shift workers) participated in the study, 194 (20%) of whom screened positive with the AUDIT and/or CDT. There were no significant differences in the screening results between day and shift workers, whereas significantly fewer of the two-shift workers (odds ratio = 0.5, 95% confidence interval = 0.3-0.9) screened positive with CDT. Conclusions: The present findings on employees who attended for regular health examinations suggest that shift workers did not show a higher level of risky alcohol consumption than day workers, according to the results with the AUDIT, CDT and GGT. On the contrary, the two-shift workers appeared to drink significantly less. Open Access
Hill, K.P., Chang, G.
Brief screening instruments for risky drinking in the outpatient psychiatry clinic. American Journal on Addictions, Volume 16, Issue 3, May 2007, Pages 222-226
2007 English In this pilot study, we compared two brief screening instruments, the T-ACE (Tolerance, Annoyed, Cut down, Eye-opener) and the Alcohol Use Disorders Identification Test (AUDIT), with a clinician interview and structured clinical interview (SCID) to determine if they improved identification of risky drinking in a psychiatry clinic compared to clinician interviews. Sixteen of 50 subjects satisfied DSM-IV criteria for lifetime alcohol abuse or dependence on the SCID, and four, all T-ACE positive, were listed "correctly" in the chart as having an alcohol problem. With an SCID gold standard, risky drinking was identified with sensitivities and specificities of 0.88 and 0.59 for the T-ACE and 0.63 and 0.85 for the AUDIT. Brief screening instruments improved the identification of risky drinking in a psychiatry clinic. Via Publisher
Johnson, J.A., Lee, A., Vinson, D., Seale, J.P.
Use of AUDIT-Based Measures to Identify Unhealthy Alcohol Use and Alcohol Dependence in Primary Care: A Validation Study. Alcoholism: Clinical and Experimental Research, Volume 37, Issue SUPPL.1, January 2013, Pages E253-E259
2013 English Background: As programs for screening, brief intervention, and referral to treatment (SBIRT) for unhealthy alcohol use disseminate, evidence-based approaches for identifying patients with unhealthy alcohol use and alcohol dependence (AD) are needed. While the National Institute on Alcohol Abuse and Alcoholism Clinician Guide suggests use of a single alcohol screening question (SASQ) for screening and Diagnostic and Statistical Manual checklists for assessment, many SBIRT programs use alcohol use disorders identification test (AUDIT) "zones" for screening and assessment. Validation data for these zones are limited. This study used primary care data from a bi-ethnic southern U.S. population to examine the ability of the AUDIT zones and other AUDIT-based approaches to identify unhealthy alcohol use and dependence. Conclusions: Combining lower AUDIT cutoff scores and binge drinking measures may increase the detection of unhealthy alcohol use in primary care. Use of lower cutoff scores and dependence subscale scores may increase diagnosis of AD; however, better measures for detecting dependence are needed. Via Publisher
Joy L.Morton, Thomas V.Jones, Maureen A. Manganaro.
Performance of alcoholism screening questionnaires in elderly veterans. American Journal of Medicine, Volume 101, Issue 2, 1996, Pages 153-159
1996 English Purpose: To validate three alcoholism screening questionnaires in elderly male veterans. METHODS: In this cross-sectional study, consecutive patients in the outpatient general medical practice at the Omaha VA Medical Center were interviewed with the alcohol module of the Revised Diagnostic Interview Schedule (DIS-III-R) and three alcoholism screening questionnaires, the Michigan Alcoholism Screening Test-Geriatric Version (MAST-G), the CAGE, and the Alcohol Use Disorders Identification Test (AUDIT). Performance characteristics (sensitivity, specificity, predictive values, likelihood ratios, and areas under the receiver operating curve [ROC]) of the screening questionnaires were determined in comparison with the DIS-III-R.
RESULTS: Forty-three participants (36%) met DSM-III-R (Diagnostic and Statistical Manual of Mental Disorders) criteria for alcohol abuse or dependence; 23% were active drinkers and 13% were inactive. Fifty of the 120 (42%) reported abstinence from drinking during the preceding year. A MAST-G score ≥5 had a sensitivity and specificity of 70% and 81%, respectively. A CAGE score ≥2 had a sensitivity and specificity of 63% and 82%. Using active drinkers only, an AUDIT score of ≥8 had a sensitivity and specificity of 33% and 91%. The positive predictive values (PPV) for the MAST-G, CAGE, and AUDIT were 67%, 66%, and 69%, respectively; the negative predictive values were 83%, 80%, and 68%, respectively. Areas under the receiver operating curves for the MAST-G, CAGE, and AUDIT were 0.84 ± 0.04, 0.77 ± 0.05, and 0.56 ± 0.08, respectively.
Conclusion: The MAST-G and the CAGE out performed the AUDIT for detecting alcohol abuse and dependence in an elderly male veteran population. The CAGE, requiring only four easily memorized questions to achieve similar accuracy, appears to offer an advantage over the 24-item MAST-G.
Via Publisher
Kader, R., Seedat, S., Koch, J.R., Parry, C.D.
A preliminary investigation of the AUDIT and DUDIT in comparison to biomarkers for alcohol and drug use among HIV-infected clinic attendees in Cape Town, South Africa. African Journal of Psychiatry (South Africa), Volume 15, Issue 5, 2012, Pages 346-351
2012 English Objective: There is growing concern about the effect of substance use on HIV treatment outcomes. The study objectives included: (i) evaluating whether the use of validated questionnaires (AUDIT and DUDIT) provide useful and consistent information of alcohol and drug consumption when compared with the use of biomarkers of alcohol in (urine and hair) and drugs in (urine) and (ii) assessing the feasibility of using self-report measures compared with urine and hair tests. Results: On the AUDIT, 18 (41.9%) participants screened positive for harmful and hazardous drinking and 13 (30.2%) participants on the DUDIT screened positive for having a drug-related problem. Two of 30 participants (7%) tested positive for alcohol abuse on FAEE analysis. For EtG, 6 of 24 (25%) participants tested positive for alcohol abuse. On hair drug analysis, all 30 participants tested negative for cannabis, amphetamines, opiates, cocaine, PCP and methaqualone. On the urinalysis, 1of 30 participants tested positive for cannabis and everyone tested negative for all other drugs included in the screening. Conclusion: Substance use among patients attending HIV clinics appears to be a problem, especially alcohol. Self-report measures seem to be a more cost effective option for screening of alcohol and drug abuse in resource poor settings. Open Access
Kelly, T.M., Donovan, J.E., Chung, T., Bukstein, O.G., Cornelius, J.R.
Brief screens for detecting alcohol use disorder among 18-20 year old young adults in emergency departments: Comparing AUDIT-C, CRAFFT, RAPS4-QF, FAST, RUFT-Cut, and DSM-IV 2-Item Scale. Addictive Behaviors Volume 34, Issue 8, August 2009, Pages 668-674
2009 English Background: This study compared six of the briefest screening instruments for detecting DSM-IV-defined Alcohol Use Disorder (AUD) among older adolescents treated in Emergency Departments (ED). Methods: The AUDIT-C, the RAPS4-QF, the FAST, the CRAFFT, the RUFT-Cut, and 2-Items from the Diagnostic and Statistical Manual IV of the American Psychiatric Association [American Psychiatric Association (1994). Conclusions: Two items from the DSM-IV criteria for AUD performed best for identifying ED-treated older adolescents with alcohol use disorders. The FAST and AUDIT-C performed well, but are longer and more difficult to score in the hectic environment of the Emergency Department. Via Publisher
Kelly, T.M., Donovan, J.E., Chung, T., Cook, R.L., Delbridge, T.R.
Alcohol use disorders among emergency department-treated older adolescents: A new brief screen (RUFT-Cut) using the AUDIT, CAGE, CRAFFT, and RAPS-QF. Alcoholism: Clinical and Experimental Research Volume 28, Issue 5, May 2004, Pages 746-753
2004 English Background: Early identification of alcohol use disorders (AUD) among emergency department (ED)-treated patients is important for facilitating intervention and further evaluation outside EDs. A number of brief screening instruments have been developed for identifying patients with AUD, but it is not clear whether they are practical and perform well with older adolescents in an ED setting. This study contrasted four brief screening instruments for detecting DSM-IV-defined AUD and tested a newly developed brief screen for use among ED-treated older adolescents. Methods: The Alcohol Use Disorders Identification Test (AUDIT), the CAGE, the CRAFFT, and a modified RAPS-QF were given to 93 alcohol-using older adolescents (55% men; aged 18-20 years) in an ED. Conclusions: Among existing alcohol screening instruments, the AUDIT performed best for identifying ED-treated older adolescents with alcohol use disorders. The RUFT-Cut is a brief screening instrument for AUD that shows promise for identifying ED-treated older adolescents who are in need of intervention or further evaluation. Future research should focus on use of the RUFT-Cut in other settings with larger, more diverse samples of adolescents. Via Publisher
Kelly, T.M., Donovan, J.E., Kinnane, J.M., Taylor, D.M.C.D.
A comparison of alcohol screening instruments among under-aged drinkers treated in emergency departments. Alcohol and Alcoholism, Volume 37, Issue 5, September 2002, Pages 444-450
2002 English Aims: Few studies have examined the adequacy of adult-validated alcohol screening measures when used with adolescents and young adults. A total of 103 subjects (55 males, 48 females) participated in a study of alcohol use among under-aged drinkers conducted in two emergency departments. Methods: Participants completed three brief screening instruments for problematic alcohol use: the Alcohol Use Disorders Identification Test (AUDIT); a modified version of the TWEAK; and the CAGE. Results and Conclusions: Missing data on the TWEAK, lower internal consistency for the TWEAK and CAGE, and the better ability of the AUDIT to differentiate problem drinkers from non-problem drinkers, suggest that the AUDIT performs best in screening for problematic alcohol use among under-aged drinkers treated in emergency departments. Open Access
Knight, J.R., Sherritt, L., Harris, S.K., Gates, E.C., Chang, G.
Validity of brief alcohol screening tests among adolescents: A comparison of the AUDIT, POSIT, CAGE, and CRAFFT. Alcoholism: Clinical and Experimental Research, Volume 27, Issue 1, 1 January 2003, Pages 67-73
2003 English Background: Adolescents should be screened for alcohol misuse as part of routine care. The objective of this study was to compare the criterion validity of the Alcohol Use Disorders Identification Test (AUDIT), the Problem Oriented Screening Instrument for Teenagers substance use/abuse scale (POSIT), and the CAGE and CRAFFT questions among adolescents.Conclusions: The AUDIT, POSIT, and CRAFFT have acceptable sensitivity for identifying alcohol problems or disorders in this age group. The CAGE is not recommended for use among adolescents. Via Publisher
Kydd, R.M., Connor, J.
Inconsistency in reporting abstention and heavy drinking frequency: Associations with sex and socioeconomic status, and potential impacts. Alcohol and Alcoholism, Volume 50, Issue 3, 25 August 2014, Article number agu106, Pages 333-345
2014 English Aims: To describe inconsistencies in reporting past-year drinking status and heavy drinking occasions (HDOs) on single questions from two different instruments, and to identify associated characteristics and impacts.Methods: We compared computer-presented Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) with categorical response options, and mental health interview (MHI) with open-ended consumption questions, completed on the same day. Participants were 464 men and 459 women aged 38 (91.7% of surviving birth cohort members). Differences in dichotomous single-item measures of abstention and HDO frequency, associations of inconsistent reporting with sex, socioeconomic status (SES) and survey order, and impacts of instrument choice on associations of alcohol with sex and SES were examined.Results: The AUDIT-C drinking frequency question estimated higher past-year abstention prevalence (AUDIT = 7.6%, MHI = 5.4%), with one-third of AUDIT-C abstainers being MHI drinkers. Only AUDIT-C produced significant sex differences in abstainer prevalence. Inconsistencies in HDO classifications were bidirectional, but with fewer HDOs reported on the MHI than AUDIT-C question. Lower SES was associated with inconsistency in abstention and weekly+ HDOs. Abstention and higher HDO frequency were associated with lower SES overall, but sex-specific associations differed by instrument. Conclusions: In this context, data collection method affected findings, with inconsistencies in abstention reports having most impact. Future studies should: (a) confirm self-reported abstention; (b) consider piloting data collection methods in target populations; (c) expect impacts of sex and SES on measurements and analyses. Open Access
Larsson, K., Nehlin, C.
Screening accuracy of brief alcohol screening instruments in a general hospital setting. Scandinavian Journal of Public Health, Volume 44, Issue 6, 1 August 2016, Pages 599-603
2016 English Aim: The aim of this study was to examine the screening accuracy of four brief alcohol screening instruments in a general hospital setting. Methods: Ten outpatient clinics were recruited to ensure a representative mix of demographics (e.g. sex, age and diagnosis). The staff at the reception desk handed out pre-sorted envelopes with questionnaires and information letters to the visitors. The questionnaires consisted of the 10-item Alcohol Use Disorders Identification Test (AUDIT), the Weekly Consumption Question (WCQ), the Heavy Episodic Drinking (HED) question and two questions on sex and age. Sensitivity and specificity were calculated for the AUDIT-C, AUDIT-3, WCQ and HED using the full 10-item AUDIT for comparison, with cut-off points of ≥6 for women and ≥8 for men. Results: In all, 898 questionnaires were included (52% women). According to the full AUDIT, 12.0% of the women and 14.8% of the men were drinking above the hazardous level. Corresponding percentages for the brief screening instruments for women and men, respectively, were as follows: AUDIT-C: 17.2% and 27.4%; the AUDIT-3: 6% and 16.2%; the WCQ: 2% and 1.6%; and the HED screener: 12.9% and 21.2%. Conclusions: The AUDIT-C may be used as a brief screener in a general hospital setting. The WCQ, as a stand-alone screening tool, may underestimate hazardous drinking habits. Screening results from the AUDIT-3 and the HED should be interpreted with caution when applied to women because of the risk of underestimation. Via Publisher
Lennings, C.J., Feeney, G.F., Sheehan, M., (...), McPherson, A., Tucker, J.
Work-place screening of mine employees using the Alcohol Use Disorders Identification Test (AUDIT) and alcohol breathalyzation. Drug and Alcohol Review, Volume 16, Issue 4, December 1997, Pages 357-363
1997 English Although public health campaigns focusing on alcohol in the work-place are receiving increasing attention, there is little empirical evidence regarding the use of screening. In this work-place study, 152 mining personnel (67% of the work-force) completed a self report screen using the Alcohol Use Disorders Identification Test (AUDIT). One hundred and thirty-three of these (58.5% of the work-force) also consented to be breathalysed and one (0.75%) recorded a BAC just over threshold for detection. Forty-eight males (37.7% of the male work-force) recorded AUDIT scores of eight or more consistent with hazardous alcohol use and one female registered a cumulative score above the female cut-off level for hazardous alcohol use. Eighty males (67% of the work-force), recorded binge drinking at least monthly and 81 males recorded a cumulative AUDIT score of less than eight; however, on item analysis, 64 (83%) of these recorded binge drinking at least sometimes. There is substantial hazardous alcohol use in this sample work group and younger males had higher alcohol consumption, more adverse consequences and higher total AUDIT scores identifying them as particularly at risk. The Cronbach & AUDIT was 0.72, confirming adequate internal consistency. Via Publisher
Leonardson, G.R., Ness, F.K., Daniels, M.C., (...), Koplin, B.A., Leonardson, G.A.
Validity and reliability of the AUDIT and CAGE-AID in Northern Plains American Indians. Psychological Reports, Volume 97, Issue 1, August 2005, Pages 161-166
2005 English According to the Indian Health Service, substance abuse and Type 2 diabetes are serious problems among Native Americans. To assess substance use in a medical setting, valid screening tests are needed so the Alcohol Use Disorders Identification Test (AUDIT), a simple brief screen for excessive drinking, and the CAGE-adapted to Include Drugs (CAGE-AID) for identifying primary care patients with alcohol and drug disorders were given 50 Northern Plains American Indians with diabetes. Both are short, easy to administer, have good sensitivity and specificity, and can be easily incorporated into a medical history protocol or intake procedure. Reliability coefficients were above .90 and appeared to have sufficient concurrent and divergent validity indicated by moderate correlations with the General Well-being Schedule (rs = -.39 and -.36), the Family-Adaptation, Partnership, Growth, Affection, & Resolve (r = -.47 and -.36), and the Beck Depression Inventory-II (r = .36 and .29). Via Publisher
Letourneau, B., Sobell, L.C., Sobell, M.B., Agrawal, S., Gioia, C.J.
Two Brief Measures of Alcohol Use Produce Different Results: AUDIT-C and Quick Drinking Screen. Alcoholism: Clinical and Experimental Research, Volume 41, Issue 5, May 2017, Pages 1035-1043
2017 English Background: Several psychometrically sound measures of alcohol use have been developed to assess drinking. The Alcohol Use Disorders Identification Test (AUDIT) and its shorter counterpart the AUDIT-C, which contains the first 3 AUDIT questions, were developed by the World Health Organization and have become the preferred brief measures for screening and evaluating problem severity. This study compared the first 3 questions on the AUDIT with another psychometrically sound brief measure of alcohol use, the Quick Drinking Screen (QDS). Methods: Data were obtained from a randomized controlled trial of a mail-based intervention promoting self-change with 472 alcohol abusers (n = 280, no prior alcohol treatment; n = 192, prior alcohol treatment). Participants’ retrospective self-reports of alcohol consumption were collected using the QDS and the 3 AUDIT-C questions and compared. Although both measures contain similar questions (2 quantity-frequency and 1 binge drinking), they differ in 2 important ways: (i) temporal interval over which data are collected, and (ii) formatting of response options (i.e., a continuous number vs. categorical). Results: Intraclass correlations for drinking variables were moderate to moderately high. A repeated-measures MANOVA using treatment condition and gender as variables revealed significant differences in absolute values between the 2 drinking measures with the QDS showing greater consumption on almost all variables. Participants’ numerical answers on the QDS were compared to their categorical answers to the similar alcohol use questions on the AUDIT-C. The comparison revealed that participants’ answers on the AUDIT-C were associated with extreme variability compared to their QDS answers. This variability suggests the AUDIT-C would be unreliable as a quantitative measure of alcohol consumption. Conclusions: The differences between the 3 alcohol use questions on the AUDIT-C and the same questions on the QDS may reflect the imprecision of the AUDIT-C's drinking response categories. Results suggest that the QDS can be used to identify risky drinking and to provide a more informative characterization of a drinker's alcohol consumption than that provided by the AUDIT-C. Via Publisher
Linskiy, I.V., Minko, A.I., Artemchuk, A.Ph., (...), Zhabenko, N., Zhabenko, O.
Addictive behavior among young people in Ukraine: A pilot study. Substance Use and Misuse, Volume 47, Issue 10, August 2012, Pages 1151-1158
2012 English The AUDIT-like tests system was created for complex assessment and evaluation of the addictive status of adolescents in a Ukrainian population. The AUDIT-like tests system has been created from the Alcohol Use Disorders Identification Test (AUDIT) developed by the World Health Organization. The AUDIT-like tests were minimally modified from the original AUDIT. Attention was brought to similarities between stages of different addictions (TV, computer games, the Internet, etc.) and alcohol addiction. Seventeen AUDIT-like tests were created to detect the different types of chemical and non-chemical addictions.  Via Publisher
López, M.B., Lichtenberger, A., Conde, K., Cremonte, M.
Psychometric properties of brief screening tests for alcohol use disorders during pregnancy in Argentina | [Propriedades psicométricas de instrumentos de triagem de consumo de álcool durante gestação na Argentina]. Revista Brasileira de Ginecologia e Obstetricia, Volume 39, Issue 7, July 2017, Pages 322-329
2017 English Background: Considering the physical, mental and behavioral problems related to fetal alcohol exposure, prenatal clinical guides suggest a brief evaluation of alcohol consumption during pregnancy to detect alcohol intake and to adjust interventions, if required. Even if any alcohol use should be considered risky during pregnancy, identifying women with alcohol use disorders is important because they could need a more specific intervention than simple advice to abstain. Most screening tests have been developed and validated in male populations and focused on the long-term consequences of heavy alcohol use, so they might be inappropriate to assess consumption in pregnant women. Objective: To analyze the internal reliability and validity of the alcohol screening instruments Alcohol Use Disorders Identification Test (AUDIT), Alcohol Use Disorders Identification Test - Consumption (AUDIT-C), Tolerance, Worried, Eye-Opener, Amnesia and Cut-Down (TWEAK), Rapid Alcohol Problems Screen - Quantity Frequency (RAPSQF) and Tolerance, Annoyed, Cut-Down and Eye-Opener (T-ACE) to identify alcohol use disorders in pregnant women. Methods: A total of 641 puerperal women were personally interviewed during the 48 hours after delivery. The receiver operating characteristics (ROC) curves and the sensitivity and specificity of each instrument using different cut-off points were analyzed. Results: All instruments showed areas under the ROC curves above 0.80. Larger areas were found for the TWEAK and the AUDIT. The TWEAK, the T-ACE and the AUDIT-C showed higher sensitivity, while the AUDIT and the RAPS-QF showed higher specificity. Reliability (internal consistency) was low for all instruments, improving when optimal cut-off points were used, especially for the AUDIT, the AUDIT-C and the RAPS-QF. Conclusions: In other cultural contexts, studies have concluded that T-ACE and TWEAK are the best instruments to assess pregnant women. In contrast, our results evidenced the low reliability of those instruments and a better performance of the AUDIT in this population. Open Access
Luchters, S., Geibel, S., Syengo, M., (...), Temmerman, M., Chersich, M.F.
Use of AUDIT, and measures of drinking frequency and patterns to detect associations between alcohol and sexual behaviour in male sex workers in Kenya. BMC Public Health Volume 11, 2011, Article number 384
2011 English Background: Previous research has linked alcohol use with an increased number of sexual partners, inconsistent condom use and a raised incidence of sexually transmitted infections (STIs). However, alcohol measures have been poorly standardised, with many ill-suited to eliciting, with adequate precision, the relationship between alcohol use and sexual risk behaviour. This study investigates which alcohol indicator - single-item measures of frequency and patterns of drinking ( > = 6 drinks on 1 occasion), or the Alcohol Use Disorders Identification Test (AUDIT) - can detect associations between alcohol use and unsafe sexual behaviour among male sex workers. Conclusions: Male sex workers have high levels of hazardous and harmful drinking, and require alcohol-reduction interventions. Compared with indicators of drinking frequency or pattern, the AUDIT measure has stronger associations with inconsistent condom use, STI symptoms and sexual violence. Increased use of the AUDIT tool in future studies may assist in delineating with greater precision the explanatory mechanisms which link alcohol use, drinking contexts, sexual behaviours and HIV transmission.  Open Access
MacKenzie, D.M., Langa, A., Brown, T.M.
Identifying hazardous or harmful alcohol use in medical admissions: A comparison of AUDIT, CAGE and brief MAST. Alcohol and Alcoholism, Volume 31, Issue 6, 1 November 1996, Pages 591–599
1996 English Two hundred and forty new medical inpatients received the Alcohol Use Disorders Identification Test (AUDIT), CAGE and brief Michigan Alcoholism Screening Test (brief MAST) questionnaires. Sensitivities when identifying weekly drinkers of>14 units (women) or>21 units (men) were 93, 79 and 35%, respectively (P<0.001). Sensitivities to>21 units (women) or>28 units (men) were 100%, 94% and 47%. Routine screening of medical admissions with the AUDIT (cut-off score 8) is recommended. Open Access
Maisto, S.A., Carey, M.P., Carey, K.B., Gordon, C.M., Gleason, J.R.
Use of the AUDIT and the DAST-10 to identify alcohol and drug use disorders among adults with a severe and persistent mental illness. Psychological Assessment, Volume 12, Issue 2, 2000, Pages 186-192
2000 English State Psychiatric Hospital outpatients (93 men, 69 women) diagnosed with a serious persistent mental illness (SPMI) completed the Alcohol Use Disorders Identification Test (AUDIT) and Drug Abuse Screening Test (DAST-10) by interview as part of a general health/behavior screening instrument. Responses to the AUDIT and DAST-10 were compared with criteria of current diagnosis and occurrence of symptoms in the last year for both alcohol and drug use disorders, respectively. Results showed that for both diagnosis and symptoms, AUDIT cutpoints of 7 and 8 had good sensitivity and specificity, and DAST-10 cutpoint of 2 was identified for both criteria. These and other findings suggest that both instruments have promising clinical utility when used with individuals diagnosed with an SPMI. (PsycINFO Database Record (c) 2016 APA, all rights reserved) Via Publisher
Maisto, S.A., Saitz, R.
Alcohol use disorders: Screening and diagnosis. American Journal on Addictions Volume 12, Issue SUPPL. 1, 2003, Pages S12-S25
2003 English The purpose of this article is to provide an overview of empirically supported, primarily self-report methods of screening and diagnosis related to alcohol use disorders (AUDs). The discussion of screening instruments focuses on the primary care setting, and the diagnosis instruments discussion centers on the alcohol (and other drug) treatment setting. The literature shows that the AUDIT and the CAGE are the most widely validated methods of screening for AUDs in primary care and may be applied readily in that context. Similarly, a number of instruments designed to derive DSM-IV (and ICD-10) AUD diagnoses, as well as constructs related to how AUDs are defined, are available and can meet a variety of clinical needs. Future research priorities include further development of brief methods to identify hazardous drinkers or individuals who have an AUD, as well as refinement of diagnosis instruments to increase their application across treatment settings and subpopulations. Via Publisher
Matano, R.A., Koopman, C., Wanat, S.F., (...), Borggrefe, A., Westrup, D.
Assessment of binge drinking of alcohol in highly educated employees. Addictive Behaviors, Volume 28, Issue 7, September 2003, Pages 1299-1310
2003 English This study evaluated the usefulness of the Alcohol Use Disorders Identification Test (AUDIT) and CAGE, a standardized screening instrument for detecting alcohol dependence in identifying binge drinking among highly educated employees. Brochures were mailed to an entire workforce inviting employees to learn about their coping strategies, stress levels, and risk for alcohol-related problems, with 228 employees providing complete data. Binge drinking in the previous 3 months was reported by 29% of the employees, with greater binge drinking reported by White employees, of mixed/other ethnic background, or younger. The AUDIT achieved a sensitivity of 35% in identifying respondents who reported binge drinking and a specificity of 98% in accurately identifying respondents who did not report binge drinking. Sensitivity using the cut-off of scoring one or more positive hits on the CAGE was 67%, and specificity was 84%. Therefore, neither the AUDIT nor the CAGE achieved adequate sensitivity, as well as specificity, as screening tools for assessing binge drinking. A more accurate method for assessing binge drinking appears to be by directly asking for the largest number of drinks consumed in a single drinking session. Via Publisher
McCusker, M.T., Basquille, J., Khwaja, M., Murray-Lyon, I.M., Catalan, J.
Hazardous and harmful drinking: A comparison of the AUDIT and CAGE screening questionnaires. QJM - Monthly Journal of the Association of Physicians, Volume 95, Issue 9, September 2002, Pages 591-595
2002 English Background: Hazardous and harmful use of alcohol remains a public health concern, and many general hospital admissions are alcohol-related. Aim: To compare the CAGE and Alcohol Use Disorders Identification Test (AUDIT) questionnaires in screening general medical admissions for harmful or hazardous drinking. Design: Prospective questionnaire-based study. Results: One hundred and three patients were included. Of these, 36% were identified by the AUDIT to be drinking hazardously or harmfully, and 22% were identified as CAGE cases. All CAGE cases were also AUDIT cases. Discussion: As the CAGE and the AUDIT are designed to identify different populations, it is not surprising that significantly fewer cases were identified using the CAGE. The AUDIT identifies not just the harmful drinkers detected by the CAGE, but also hazardous drinkers, who have not yet reached that level of harm. As drinkers at an earlier stage may respond better to interventions aimed at reducing their consumption, the AUDIT is preferable in clinical practice. Open Access
Merikallio-Pajunen, A., Strid, N., Suokas, A., Podlketnova, I., Alho, H.
Comparison of new alcohol use test, the Helsinki Alcohol Use Test questionnaire, and Alcohol Use Disorders Identification Test and laboratory markers serum γ-glutamyl transferase and carbohydrate-deficient transferrin. Addictive Behaviors, Volume 29, Issue 4, June 2004, Pages 717-722
2004 English The purpose of the present study was to compare and evaluate the new Helsinki Alcohol Use Test (HAUT) and Alcohol Use Disorders Identification Test (AUDIT) as screening instrument in the general working population. The relationship between the HAUT and serum γ-glutamyl transferase (GGT), and carbohydrate-deficient transferrin (CDT) was also evaluated. Our results seem to indicate that the HAUT has good performance as screening instrument for alcohol-related problems in the general population.  Via Publisher
Moore, A.A., Beck, J.C., Babor, T.F., Hays, R.D., Reuben, D.B.
Beyond alcoholism: Identifying older, at-risk drinkers in primary care. Journal of Studies on AlcoholVolume 63, Issue 3, 2002, Pages 316-324
2002 English Objective: To evaluate the validity and reliability of two self-report instruments: the Alcohol-Related Problems Survey (ARPS) and its shorter version the Short ARPS (shARPS) that identify older persons whose use of alcohol alone or with their comorbidities may be placing them at risk for or causing them harm. Method: We compared the two measures against a "LEAD" (longitudinal evaluation done by experts employing all available data) standard among a sample of 166 drinkers aged 60 years and older in 10 internal medicine clinics. The LEAD standard included a medical record review, a clinical interview and a telephone interview with a collateral informant. We tabulated reasons the LEAD identified subjects as harmful or hazardous drinkers. We also compared the Alcohol Use Disorders Identification Test (AU-DIT) and the Short Michigan Alcoholism Screening Test-Geriatric Version (SMAST-G) to the LEAD. Sensitivity and specificity of the AUDIT and the SMAST-G as compared to the LEAD were 28% and 100%, and 52% and 96%, respectively. Conclusions: The ARPS and shARPS are quite sensitive in identifying older drinkers with a spectrum of alcohol use disorders. They are more sensitive than the AUDIT and the SMAST-G in identifying older persons who may be at risk or experiencing harm as a result of their alcohol use and comorbidities. They also provide information on specific risks associated with alcohol use not obtained by other screening measures and may therefore facilitate interventions by busy clinicians to reduce such risks. Via Publisher
Moussas, G., Dadouti, G., Douzenis, A., (...), Christodoulou, C., Lykouras, L.
The Alcohol Use Disorders Identification Test (AUDIT): Reliability and validity of the Greek version. Annals of General Psychiatry, Volume 8, 14 May 2009, Article number 11
2009 English Background: Problems associated with alcohol abuse are recognised by the World Health Organization as a major health issue, which according to most recent estimations is responsible for 1.4% of the total world burden of morbidity and has been proven to increase mortality risk by 50%. Because of the size and severity of the problem, early detection is very important. This requires easy to use and specific tools. One of these is the Alcohol Use Disorders Identification Test (AUDIT). Aim: This study aims to standardise the questionnaire in a Greek population. Methods: AUDIT was translated and back-translated from its original language by two English-speaking psychiatrists. The tool contains 10 questions. A score ≥ 11 is an indication of serious abuse/dependence. In the study, 218 subjects took part: 128 were males and 90 females. The average age was 40.71 years (± 11.34). From the 218 individuals, 109 (75 male, 34 female) fulfilled the criteria for alcohol dependence according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), and presented requesting admission; 109 subjects (53 male, 56 female) were healthy controls. Results: Internal reliability (Cronbach α) was 0.80 for the controls and 0.80 for the alcohol-dependent individuals. Controls had significantly lower average scores (t test P < 0.001) when compared to the alcoholics. The questionnaire's sensitivity for scores >8 was 0.98 and its specificity was 0.94 for the same score. For the alcohol-dependent sample 3% scored as false negatives and from the control group 1.8% scored false positives. In the alcohol-dependent sample there was no difference between males and females in their average scores (t test P > 0.05). Conclusion: The Greek version of AUDIT has increased internal reliability and validity. It detects 97% of the alcohol-dependent individuals and has a high sensitivity and specificity. AUDIT is easy to use, quick and reliable and can be very useful in detection alcohol problems in sensitive populations.  Open Access
Myer, L., Smit, J., Roux, L.L., (...), Stein, D.J., Seedat, S.
Common mental disorders among HIV-infected individuals in South Africa: Prevalence, predictors, and validation of brief psychiatric rating scales. AIDS Patient Care and STDs, Volume 22, Issue 2, 1 February 2008, Pages 147-158
2008 English Despite the high prevalence of both mental disorders and HIV infection in much of sub-Saharan Africa, little is known about the occurrence of mental health disorders among HIV-infected individuals. We conducted a cross-sectional study among individuals enrolled into HIV care and treatment services near Cape Town, South Africa. Psychiatric diagnoses were measured using the Mini-International Neuropsychiatric Interview (MINI) administered by trained research nurses. In addition, all participants were administered brief rating scales for depression (the Center for Epidemiological Studies Depression Scale [CES-D]), posttraumatic stress disorder (PTSD), the Harvard Trauma Questionnaire (HTQ), and alcohol dependence/abuse (the Alcohol Use Disorders Identification Test [AUDIT]). While the AUDIT showed excellent sensitivity and specificity in detecting MINI-defined dependence/abuse (area under the receiver-operating characteristic curve, 0.96), the HTQ and CES-D had lower performance characteristics in detecting PTSD (0.74) and depression (0.76), respectively. These data demonstrate high levels of depression, PTSD and alcohol dependence/abuse among HIV-infected individuals in this setting. Additional research is required to refine these rating scales for maximum applicability in cross-cultural populations. More generally, HIV care and treatment services represent an important venue to identify and manage individuals with common mental disorders in resource-limited settings. Via Publisher
Nayak, M.B., Bond, J.C., Cherpitel, C., Patel, V., Greenfield, T.K.
Detecting alcohol-related problems in developing countries: A comparison of 2 screening measures in India. Alcoholism: Clinical and Experimental Research, Volume 33, Issue 12, December 2009, Pages 2057-2066
2009 English Background: There is inadequate recognition of alcohol misuse as a public health issue in India. Information on screening measures is critical for prevention and early intervention efforts. This study critically evaluated the full and shorter versions of the AUDIT and RAPS4-QF as screening measures for alcohol use disorders (AUDs) in a community sample of male drinkers in Goa, India. Results: All 4 measures performed well with area under the curves of at least 0.79. The full screeners that included both drinking patterns and problem items (the AUDIT and the RAP4-QF) performed better than their shorter versions (the AUDIT-C and the RAPS4) in detecting AUDs. Performance of the AUDIT and RAPS4-QF improved with lowered and raised thresholds, respectively, and alternate cut-off scores are suggested. Scores on the full measures were significantly correlated (0.80). Reliability estimates for the AUDIT measures were higher than those for the RAPS4 measures. Conclusions: All measures were efficient at detecting AUDs. When screening for alcohol-related problems among males in the general population in India, cut-off scores for screeners may need to be adjusted. Selecting an appropriate screening measure and cut-off score necessitates careful consideration of the screening context and resources available to confirm alcohol-related diagnoses. Via Publisher
Nayak, M.B., Bond, J.C., Greenfield, T.K.
Evaluating shortened versions of the AUDIT as screeners for alcohol use problems in a general population study. Substance Use and Misuse, Volume 50, Issue 12, 15 October 2015, Pages 1579-1589
2015 English  Background: Efficient alcohol screening measures are important to prevent or treat alcohol use disorders (AUDs). Objectives: We studied different versions of the Alcohol Use Disorders Identification Test (AUDIT) comparing their performance to the full AUDIT and an AUD measure as screeners for alcohol use problems in Goa, India. Methods: Data from a general population study on 743 male drinkers aged 18-49 years are reported. Drinkers completed the AUDIT and an AUD measure. We created shorter versions of the AUDIT by (a) collapsing AUDIT item responses into three and two categories and (b) deleting two items with the lowest factor loadings. Each version was evaluated using factor, reliability and validity, and differential item functioning (DIF) analysis by age, education, standard of living index (SLI), and area of residence. Results: A single factor solution was found for each version with lower factor loadings for items on guilt and concern. There were no significant differences among the different AUDIT versions in predicting AUD. No significant DIF was found by education, SLI or area of residence. DIF was observed for the alcohol frequency item by age. Conclusions/Importance: The AUDIT may be used with dichotomized response options without loss of predictive validity. A shortened eight-item dichotomized scale can adequately screen for AUDs in Goa when brevity is of paramount importance, although with lower predictive validity. Although the frequency item was endorsed more by older men, there is no evidence that the AUDIT items perform differently in other groups of male drinkers in Goa. Via Publisher
Nehlin, C., Fredriksson, A., Jansson, L.
Brief alcohol screening in a clinical psychiatric population: Special attention needed. Drug and Alcohol Review, Volume 31, Issue 4, June 2012, Pages 538-543
2012 English Introduction and Aims. Abbreviated versions of the Alcohol Use Disorders Identification Test (AUDIT) and single-item screeners show promising results but have not previously been investigated in a clinical psychiatric setting. The aim of the present study was to investigate the capacity of three brief screening methods to detect hazardous drinking in a psychiatric treatment-seeking population. Design and Methods. Data were collected from consecutive patients (n=1811) visiting a general psychiatric clinic. The screening capacity of the heavy episodic drinking (HED) screener, AUDIT item # 3 (AUDIT-3) and the three consumption items of AUDIT (AUDIT-C) was compared to the result of the full 10-item AUDIT with cut-off points 6 for women and 8 for men. Results. The HED screener and AUDIT-3 with recommended cut-offs captured low rates of hazardous drinkers when compared to the full AUDIT. Lowering the cut-offs created rates far above those of the full AUDIT. AUDIT-C with recommended cut-off limits categorised nearly the same rates of men as the full AUDIT but much higher rates of women. Raising the cut-off for women approached the detection rate of AUDIT-C closely to that of the full AUDIT. Discussion and Conclusions. The findings of this study suggest that the HED screener is not sensitive enough in the clinical psychiatric setting. When designing alcohol screening measures to be used all over health-care organisations, special attention should be paid to psychiatric patients. If a somewhat more extensive screening tool is used, the full AUDIT is recommended. Via Publisher
Neumann, T., Gentilello, L.M., Neuner, B., (...), Haas, N.P., Spies, C.D.
Screening trauma patients with the Alcohol Use Disorders Identification Test and biomarkers of alcohol use. Alcoholism: Clinical and Experimental Research, Volume 33, Issue 6, June 2009, Pages 970-976
2009 English Background: Alcohol screening and brief interventions have been shown to reduce alcohol-related morbidity in injured patients. Use of self-report questionnaires such as the Alcohol Use Disorder Identification Test (AUDIT) is recommended as the optimum screening method. We hypothesized that the accuracy of screening is enhanced by combined use of the AUDIT and biomarkers of alcohol use in injured patients. Conclusions: Screening properties of the AUDIT are superior to %CDT, MCV, and GGT for detection of alcohol problems in injured patients and are not clinically significantly enhanced by the use of biomarkers. Via Publisher
Newbury-Birch, D., Jackson, K., Hodgson, T., (...), McGovern, R., Kaner, E.
Alcohol-related risk and harm amongst young offenders aged 11-17. International Journal of Prisoner Health, Volume 11, Issue 2, 15 June 2015, Pages 75-86
2015 English Purpose: The purpose of this paper is to examine the prevalence of alcohol use disorders (AUDs) amongst young people in the criminal justice system (CJS) in the North East of England and to compare the ability of the Alcohol Use Disorders Identification Test (AUDIT) to the Youth Justice Board ASSET tool in identifying alcohol-related need in Youth Offending Team (YOT) clients. Design/methodology/approach: A validated screening tool (AUDIT) was used to identify alcohol-related health risk or harm. Findings from AUDIT were compared with those of the standard criminogenic risk screening tool used in CJS (ASSET). An anonymous cross-sectional questionnaire was administered during a one-month period in 2008. The questionnaires were completed by 11-17-year-old offenders who were in contact with three YOTs, one Youth Offending Institution and one Secure Training Estate. Findings: In total, 429 questionnaires were completed out of a possible 639 (67 per cent). The majority (81 per cent) of the young offenders were identified as experiencing alcohol-related health risk or harm and 77 per cent scored within a possibly alcohol-dependent range. In total, 77 (30 per cent) of young people completing both assessments were identified as having an AUD by AUDIT but not identified as needing alcohol-related treatment using ASSET. Research limitations/implications: This research was confined to one geographical area of England, however, the results show that even in this area of high drinking by young people the levels of AUDs amongst young people in the CJS are very high. Social implications: There are major social implications to this research. It is imperative for changes to be made to the care pathways in place in the UK for young people coming through the CJS with alcohol-related issues. Originality/value: This paper adds to the evidence base by using well-validated tools to measure alcohol use amongst young people in the CJS in the UK. Open Access
O'Connell, H., Chin, A.-V., Hamilton, F., (...), Coakley, D., Lawlor, B.A.
A systematic review of the utility of self-report alcohol screening instruments in the elderly. International Journal of Geriatric Psychiatry, Volume 19, Issue 11, November 2004, Pages 1074-1086
2004 English Background. Effective screening instruments are needed for the detection of alcohol use disorders (AUDs) in the elderly, in view of the significant physical, psychological and social problems associated with this phenomenon. Methods. This paper provides details on the different self-report alcohol screening instruments that have been studied in the elderly, describing both the instruments themselves and their effectiveness as screening instruments for AUDs in different elderly populations. Results. The vast majority of studies reviewed were carried out in the US, and a high proportion of these were carried out in Veterans Administrations institutions, thus limiting the generalizability of results. The CAGE was the most widely studied screening instrument, followed by the MAST or variations of the MAST, the AUDIT and variations of the AUDIT, and other screening instruments. Sensitivity and specificity of these instruments varied widely, depending on the prevalence of AUDs in the population being studied, the clinical characteristics of the population and the type of AUD being detected. The CAGE performed poorly in psychiatric populations but a newer instrument, the AUDIT-5, has had promising results to date. No studies focussed on elderly people with cognitive impairment, and there is a need for research in this area. Conclusions. Ease of use, patient acceptability, sensitivity and specificity must all be considered when selecting a self-report alcohol screening instrument for use in the elderly. Furthermore, the prevalence of AUDs in the population and the clinical characteristics of that population must also be taken into account. Via Publisher
O'Hare, T.
Comparing the AUDIT and 3 drinking indices as predictors of personal and social drinking problems in freshman first offenders. Journal of Alcohol and Drug Education, Volume 49, Issue 3, September 2005, Pages 37-61
2005 English The current study of 376 college freshman adjudicated the first time for breaking university drinking rules tested the predictive power of four alcohol consumption and problem drinking indices-recent changes in drinking (the Alcohol Change Index; ACI), heavy drinking, binge drinking index, and the Alcohol Use Disorders Identification Test (AUDIT) with two subscales of the College Alcohol Problem Scale (personal and social problems) as criterion measure. In addition, the ACI, heavy drinking, and the binge-drinking index were tested for receiver operating characteristics (ROC) (sensitivity, specificity, false positive rate, positive predictive value and the area under the curve) using the AUDIT as criterion. Results demonstrated that the AUDIT was the best predictor of personal and social problems, and the binge showed the best ROC data with the AUDIT as criteria. Recommendations for use of brief instruments are suggested. Via Publisher
Ouattara, Z.D., Koura, M., Sermé, A.K., Sawadogo, A.
Comparison of assessment methods of alcohol consumption in a population of patients hospitalized in Ouagadougou (Burkina Faso) | [Comparaison des méthodes d’évaluation de la consommation d’alcool dans une population de patients hospitalisés à Ouagadougou (Burkina Faso)]. Journal Africain d'Hepato-Gastroenterologie, Volume 11, Issue 2, 1 June 2017, Pages 47-51
2017 French Abstract: Alcohol consumption is a proven risk factor for cardiovascular diseases and cancers. There are several assessment methods that still need to be studied in Burkina Faso. Objective: The objective of this paper is to compare the AUDIT (Alcohol Use Disorder Identification Test) questionnaire, the CAGE (Cut-down, Annoyed, Guilty, Eyeopener) questionnaire, and the presence of macrocytosis as a biological marker in the screening for alcohol consumption in hospitalized patients. Methodology: A transversal analytical study was carried out during 2 months in 14 hospitalization wards of the University Hospital Yalgado Ouedraogo. Alcohol consumption was assessed comparatively with the AUDIT questionnaire, the CAGE questionnaire, and the value of the mean corpuscular volume (MCV), indicating the presence of macrocytosis; World Health Organization (WHO) standards were used as reference value for the comparison. Results: A total of 391 patients with an average age of 44 years were included in the study; the sex ratio was 1.34 in favor of men (34.53%) who were alcohol consumers. The prevalence of excess intake of alcohol was 7.92% (N = 41) according to WHO; 10.49% (N = 41) according to the AUDIT questionnaire; 8.18% (N = 32) according to the CAGE questionnaire; and 15.16% according to MCV. In taking into account WHO standards as reference, the sensitivity and specificity were 84% and 96%, respectively, for the AUDIT questionnaire, 64% and 96%, respectively, for the CAGE questionnaire, and 26.32% and 85.80%, respectively, with the macrocytosis as marker. Conclusion: Harmfull alcohol consumption is common among hospitalized patients in Ouagadougou. The complete AUDIT questionnaire is the most effective of screening test. Via Publisher
Pal, H.R., Jena, R., Yadav, D.
Validation of the Alcohol Use Disorders Identification Test (AUDIT) in urban community outreach and de-addiction center samples in North India. Journal of Studies on Alcohol, Volume 65, Issue 6, November 2004, Pages 794-800
2004 English Objective: The Alcohol Use Disorders Identification Test (AUDIT) developed by the World Health Organization for screening disorders related to alcohol use has been shown to have robust psychometric properties. This study compared the performance of AUDIT with that of the Short Michigan Alcoholism Screening Test (SMAST) in a region of North India. Results: The AUDIT had very high internal reliability (alpha 0.92) in this Indian sample. There was, in general, good correlation between the total and factor scores of the AUDIT and SMAST (ranging from 0.28 to 0.97), which were higher in the community than in the DAC sample. The AUDIT (area under the curve [AUC] = 0.883) and SMAST (AUC = 0.870) were similar in detecting harmful use of alcohol. The AUDIT optimal cutoff score was 16 (sensitivity 85.3, specificity 89.4) for ICD-10 harmful use and 24 (sensitivity 69.4, specificity 87.5) for ICD-10 alcohol dependence. Conclusions: The AUDIT and SMAST seem to be comparable in their ability to screen subjects with alcohol use disorders. The AUDIT score for screening harmful use in the sample appears to be higher than previously reported. The utility of such high cutoff for screening subjects for intervention is obvious, but it is quite likely that some positive cases might be missed. Via Publisher
Peltzer, K., Simbayi, L., Kalichman, S., (...), Cloete, A., Mbelle, N.
Alcohol Use in Three Different Inner Cities in South Africa: AUDIT-C and CAGE. Journal of Psychology in Africa, Volume 17, Issue 1-2, 1 January 2007, Pages 99-104
2007 English The aim of the present study was to describe the frequency of risky drinking among a general urban population survey (n=1379) in South Africa with the help of (Alcohol Use Disorders Identification Test) AUDIT-C scores, CAGE (Cut down, Annoyed, Guilty, Eye-opener) scores and compare the scores with calculated risky drinking in terms of weekly alcohol consumption or heavy episodic drinking. Results indicate 44.4% for men and 25.4% for women as hazardous or harmful drinkers and using the CAGE 44.7% (55% among men and 35.5% among women). AUDIT-C and CAGE cases were more likely to be women than men and were also more likely among Coloureds and Whites than Black Africans and Indians or Asians. This study showed a greater sensitivity of AUDIT to CAGE.  Via Publisher
Philpot, M., Pearson, N., Petratou, V., (...), Silverman, M., Marshall, J.
Screening for problem drinking in older people referred to a mental health service: A comparison of CAGE and AUDIT. Aging and Mental Health Volume 7, Issue 3, May 2003, Pages 171-175
2003 English The aim of the study was to evaluate the validity of the Alcohol Use Disorders Identification Test (AUDIT), the five-item version (AUDIT-5) and the CAGE as screening tests for problem drinking in mentally ill older people. The study was of prospective cross-sectional design with questionnaire survey and interview and included all consecutive referrals to an old age psychiatry service fulfilling inclusion criteria. Sensitivity, specificity and positive predictive values and areas under the receiver operating characteristic curves (AUROC) for the AUDIT, AUDIT-5, and CAGE were the primary outcome measures. Using clinical criteria as the gold standard, the AUDIT, AUDIT-5 and CAGE had AUROCs of 0.961, 0.964, and 0.780 respectively. The AUDIT-5 performed best of the three scales with a sensitivity of 75.0%, specificity of 97.2% and positive predictive value of 83.3% when using a 4/5 cut-point. The AUDIT-5 performed as well as the AUDIT and better than the CAGE in identifying problem drinking in this sample. The AUDIT-5 may be a useful addition to the specialist mental health assessment of older people. Via Publisher
Plackett, T.P., Ton-That, H.H., Mueller, J., (...), Kovacs, E.J., Esposito, T.J.
Screening for at-risk drinking behavior in trauma patients. Journal of the American Osteopathic Association, Volume 115, Issue 6, June 2015, Pages 376-382
2015 English Context: A blood alcohol level above 0 g/dL is found in up to 50% of patients presenting with traumatic injuries. The presence of alcohol in the blood not only increases the risk of traumatic injury, but it is also associated with worse outcomes and trauma recidivism. In light of these risks, the American College of Surgeons Committee on Trauma advocates screening for at-risk drinking. Although many institutions use blood alcohol levels to determine at-risk drinking in trauma patients, the Alcohol Use Disorders Identification Test (AUDIT) offers a cheap and easy alternative. Few direct comparisons have been made between these 2 tests in trauma patients. Objective: To compare the utility of blood alcohol level and AUDIT score as indicators of at-risk drinking in trauma patients. Methods: Records for all trauma patients aged 18 years or older who were admitted to a level I trauma center from May 2013 through June 2014 were reviewed in this retrospective cohort study. Inclusion criteria required patients to have undergone both blood alcohol level testing and AUDIT on admission. A blood alcohol level greater than 0 g/dL and an AUDIT score equal to or above 8 were considered positive for at-risk drinking. Performance of both tests was indexed against the National Institute of Alcohol Abuse and Alcoholism (NIAAA) criteria for at-risk drinking. Results: Of 750 patients admitted for trauma, 222 records (30%) contained data on both blood alcohol level and AUDIT score. The patients were predominantly male (178 [80%]) and had a mean (SD) age of 40.1 (16.7) years. Most patients (178 [80%]) had sustained blunt trauma. Ninety-seven patients (44%) had a positive blood alcohol level, 70 (35%) had a positive AUDIT score, and 54 (24%) met NIAAA criteria for at-risk drinking. The sensitivity and specificity of having a positive blood alcohol level identify at-risk drinking were 61% and 62%, respectively. The sensitivity and specificity of having a positive AUDIT score identify at-risk drinking were 83% and 81%, respectively. Conclusion: As a stand-alone indicator of at-risk drinking behavior in trauma patients, the AUDIT score was shown to be superior to blood alcohol level. The utility of obtaining routine blood alcohol levels in trauma patients as a screening tool for at-risk drinking should be reexamined. Open Access
Pradeep R., J., Dhilip, A.M., Mysore, A.
Do SADQ and AUDIT identify independent impacts of alcohol abuse-clinical and biochemical markers respectively? Indian Journal of Psychiatry, Volume 57, Issue 3, 1 July 2015, Pages 278-283
2015 English Background and Objectives: We have analyzed extant data to see if Alcohol Use Disorder Identification Test (AUDIT) and Severity of Alcohol Dependence Questionnaire (SADQ) assess overlapping aspects of alcoholism, and how they relate to lab measures of alcoholism. Materials and Methods: Consecutive male patients between 20 and 50 years were recruited from varied departments of a general hospital. AUDIT and SADQ, as well as liver function tests, were part of the data obtained. Results: Despite, a significant correlation between total scores of SADQ and AUDIT (ρ = 0.188, P < 0.021) and some of their sub-scores. SADQ scores alone were significantly correlating with clinical variables of alcoholism such as family history and age of onset; AUDIT did not. On the other hand, AUDIT total scores correlated with total and conjugated bilirubin, while SADQ did not. Interpretation and Conclusion: Our data suggests that the two scales, AUDIT and SADQ may be tapping into two different outcomes of increased alcohol use namely clinical and biochemical markers, respectively. SADQ could be useful in studies looking at withdrawal related severity and clinical aspects of alcoholism; while AUDIT could be more suitable for studies looking at alcoholism-related medical morbidity. This needs to be confirmed in larger unselected samples from different community and clinical settings. Open Access
Richoux, C., Ferrand, I., Casalino, E., (...), Ginsburg, C., Lejoyeux, M.
Alcohol use disorders in the emergency ward: Choice of the best mode of assessment and identification of at-risk situations. International Journal of Emergency Medicine, Volume 4, Issue 1, December 2011, Article number 27
2011 English Background: This study aims to identify the prevalence and at-risk situations of alcohol use disorders among patients examined in the emergency department and to compare the scales commonly used to identify alcohol use disorders. Methods: We used the CAGE and AUDIT questionnaires and a structured interview, the MINI. Findings: Of the presenting patients, 9.5% met the DSM-IV criteria for alcohol use disorders. The CAGE questionnaire was less sensitive (75%) and more specific (92%) than the AUDIT (87 and 80%, respectively). The typical alcohol-dependent patient is a young man who is unemployed and brought to the emergency department by the police. During the past 24 h, he has consumed alcohol, nicotine, cocaine, sedatives or cannabis. Conclusion: Of the patients, 9.5% examined in the emergency department present with alcohol abuse or dependence without asking spontaneously for treatment for their addiction. These results support the importance of systematically identifying alcohol use disorders with a simple and rapid questionnaire such as the CAGE questionnaire. Open Access
Rumpf, H.-J., Hapke, U., Meyer, C., John, U.
Screening for alcohol use disorders and at-risk drinking in the general population: Psychometric performance of three questionnaires. Alcohol and Alcoholism Volume 37, Issue 3, 2002, Pages 261-268
2002 English Most screening questionnaires are developed in clinical settings and there are few data on their performance in the general population. This study provides data on the area under the receiver-operating characteristic (ROC) curve, sensitivity, specificity, and internal consistency of the Alcohol Use Disorders Identification Test (AUDIT), the consumption questions of the AUDIT (AUDIT-C) and the Lübeck Alcohol Dependence and Abuse Screening Test (LAST) among current drinkers (n = 3551) of a general population sample in northern Germany. Alcohol dependence and misuse according to DSM-IV and at-risk drinking served as gold standards to assess sensitivity and specificity and were assessed with the Munich–Composite Diagnostic Interview (M-CIDI). AUDIT and LAST showed insufficient sensitivity for at-risk drinking and alcohol misuse using standard cut-off scores, but satisfactory detection rates for alcohol dependence. The AUDIT-C showed low specificity in all criterion groups with standard cut-off. Adjusted cut-points are recommended. Among a subsample of individuals with previous general hospital admission in the last year, all questionnaires showed higher internal consistency suggesting lower reliability in non-clinical samples. In logistic regression analyses, having had a hospital admission increased the sensitivity in detecting any criterion group of the LAST, and the number of recent general practice visits increased the sensitivity of the AUDIT in detecting alcohol misuse. Women showed lower scores and larger areas under the ROC curves. It is concluded that setting specific instruments (e.g. primary care or general population) or adjusted cut-offs should be used. Open Access
Saitz, R., Cheng, D.M., Allensworth-Davies, D., Winter, M.R., Smith, P.C.
The ability of single screening questions for unhealthy alcohol and other drug use to identify substance dependence in primary care. Journal of Studies on Alcohol and Drugs, Volume 75, Issue 1, January 2014, Pages 153-157
2014 English Objective: Single screening questions (SSQs) are recommended for the evaluation of unhealthy alcohol use and other drug use (risky use through dependence). In addition, SSQs could provide information on severity that is necessary for brief intervention, information thought to be available only from longer questionnaires. We assessed SSQ accuracy for identifying dependence. Method: In a cross-sectional study, 286 primary care patients were administered SSQs for alcohol and for other drugs (each asks how many times they were used in the past year), the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), the Drug Abuse Screening Test (DAST), and a diagnostic interview reference standard for dependence. For each test, we calculated area under the receiver operating characteristic (ROC) curve and the ability to discriminate dependence at an optimal cutoff. Results: The prevalence of alcohol and other drug dependence was 9% and 12%, respectively. Optimal cut points were eight or more times for the alcohol SSQ, a score of three or more for AUDIT-C, three or more times for the other drug SSQ, and a score of four or more for the DAST. The areas under the ROC curve ranged from 0.87 to 0.96. Sensitivity, specificity, and positive and negative likelihood ratios at optimal cut points for the alcohol SSQ were 88%, 84%, 5.6, and 0.1, respectively; for the other drug SSQ were 97%, 79%, 4.6, 0.04, respectively; for the AUDIT-C were 92%, 71%, 3.2, 0.1, respectively; and for the DAST were 100%, 84%, 6.3, 0, respectively. Alcohol SSQ and AUDIT-C positive likelihood ratio 95% confidence intervals did not overlap. Conclusions: SSQs can identify substance dependence as well as and sometimes better than longer screening tools. SSQs may be useful for both screening and preliminary assessment, thus overcoming a barrier (seen with lengthy questionnaires) to dissemination of screening and brief intervention in primary care settings. Via Publisher
Selin, K.H.
Alcohol Use Disorders Identification Test (AUDIT): What does it screen? Performance of the AUDIT against four different criteria in a Swedish population sample. Substance Use and Misuse, Volume 41, Issue 14, 1 July 2006, Pages 1881-1899
2006 English The purpose of this article was to examine the kinds of alcohol use disorder the AUDIT most accurately screens for since the literature is inconsistent in the use of the AUDIT. Sometimes it is viewed as a measure of hazardous or harmful drinking and sometimes as a measure of dependence. The performance of its subsets (consumption items, AUDIT-C; and problem items, AUDIT-P) and of the full AUDIT (AUDIT-10) was tested against four criteria: high-volume drinking, alcohol-related social problems, alcohol-related health problems, and alcohol dependence. A general population sample of 600 Swedish subjects was interviewed during the winter 2000-01. The results document that, at the recommended cutoff score of 8+, the AUDIT-10 performed well against all four criteria, even if less well against the alcohol-related health problems. The AUDIT-C also performed well against all the problem criteria, showing high areas under the ROC curve, even though significantly lower than the full scale. When measuring high-volume drinking, the AUDIT-C outperformed the full instrument. Scoring at least 1 on the AUDIT-P improved sensitivity of the instrument when screening for social problems and dependence and made it a satisfactory measure of health problems. It is suggested that, when using the full AUDIT to screen for problems more severe than high-volume drinking, the criterion of scoring at least 1 on the AUDIT-P should be applied in combination with a cutoff score on the AUDIT-C.  Via Publisher
Shakeshaft, A.P., Bowman, J.A., Sanson-Fisher, R.W.
Comparison of three methods to assess binge consumption: One-week retrospective drinking diary, AUDIT, and quantity/frequency. Substance Abuse, Volume 19, Issue 4, 1998, Pages 191-203
1998 English Binge consumption contributes substantially to the occurrence of alcohol-related harm. Despite its importance, binge drinking is not well defined in the literature. The present study examines the proportions of respondents identified as binge drinkers by three separate measures: a 1- week retrospective drinking diary (RD), the Alcohol Use Disorders Identification Test (AUDIT), and a quantity/frequency (QF) question. Overall, AUDIT detected the highest proportion of binge drinkers, followed by QF and RD. There was also good agreement between QF and RD, as well as QF and AUDIT. Ultimately, the measure of choice should be that which provides information most appropriate to the purposes of each study. Via Publisher
Sinadinovic, K., Berman, A.H., Hasson, D., Wennberg, P.
Internet-based assessment and self-monitoring of problematic alcohol and drug use. Addictive Behaviors, Volume 35, Issue 5, May 2010, Pages 464-470
2010 English A Swedish web-based service ( offers self-assessment and self-monitoring of alcohol and drug use via on-line screening with the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Use Disorders Identification Test (DUDIT) as well as in-depth risk assessment using extended versions of both tests (Alcohol-E and DUDIT-E). Users receive individualized feedback concerning their alcohol and drug consumption and can follow their alcohol and drug use over time in personal diagrams and by writing in an electronic diary. This study describes user characteristics, service utilization patterns, and psychometric test properties for 2361 individuals who created a valid account over 20 months starting in February 2007. Problematic alcohol use according to AUDIT criteria was indicated for 67.4%, while 46.0% met DUDIT criteria for problematic drug use. Men and women accessed the service equally, with a mean age of 23 years. Internal consistency reliability figures were 0.90 for 1846 first-time AUDIT users and 0.97 for 1211 first-time DUDIT users; among 213 second-time AUDIT users reliability was 0.93, and 0.96 for 97 second-time DUDIT users. Internet-based alcohol and drug monitoring could function as a self-help tool or as a complement to substance abuse treatment.  Via Publisher
Steinbauer, J.R., Cantor, S.B., Holzer III, C.E., Volk, R.J.
Ethnic and sex bias in primary care screening tests for alcohol use disorders. Annals of Internal Medicine, Issue: Volume 129(5), 1 September 1998, p 353–362
1998 English Objective:To test for ethnic and sex bias in three self-report screening tests for alcohol use disorders in a primary care population. Patients completed 1) a diagnostic interview to determine the presence of a current alcohol use disorder and 2) three screening tests: the CAGE questionnaire, the Self-Administered Alcoholism Screening Test (SAAST), and the Alcohol Use Disorders Identification Test (AUDIT).Positive likelihood ratios for the AUDIT were similar to or higher than those for the other screening tests, whereas negative likelihood ratios were lowest for the AUDIT (<0.33), indicating the superiority of this test in ruling out a disorder.
Conclusions: A marked inconsistency in the accuracy of common self-report screening tests for alcohol use disorders was found when these tests were used in a single clinical site with male and female family practice patients of different ethnic backgrounds. The AUDIT does not seem to be affected by ethnic and sex bias.
Via Publisher
T Chung , S M Colby , N P Barnett , D J Rohsenow , A Spirito , P M Monti.
Screening adolescents for problem drinking: Performance of brief screens against DSM-IV alcohol diagnoses. Journal of Studies on Alcohol, Volume 61, Issue 4, July 2000, Pages 579-587
2000 English Objective: The performance of three brief screens, the CAGE, TWEAK and Alcohol Use Disorders Identification Test (AUDIT), was evaluated against a DSM-IV diagnosis of alcohol abuse or dependence in an adolescent sample. Method: Adolescents (13-19 years old) who presented to an emergency department for treatment of an injury, and who tested negative for blood alcohol concentration at time of admission, were administered a structured diagnostic interview and modified versions of the CAGE, TWEAK and AUDIT. Conclusions: Routine alcohol screening among adolescents seen in a hospital setting is indicated. Two important directions for future research include the identification of adolescent-specific alcohol screening items, and the validation of an adolescent-specific definition of problem drinking that addresses limitations of DSM-IV alcohol diagnoses when applied to adolescents. Via Publisher
Thomas, B.A., McCambridge, J.
Comparative psychometric study of a range of hazardous drinking measures administered online in a youth population. Drug and Alcohol Dependence, Volume 96, Issue 1-2, 1 July 2008, Pages 121-127
2008 English Aims: To compare the psychometric performance of a range of existing alcohol measures when data are collected online with young people, and thereby to gain insights into the reliability and validity of this mode of data collection. Method: One hundred and sixty-seven U.K. resident young people aged 16-24 who had drunk alcohol within the past week participated in a cross-sectional psychometric study with a test-retest reliability component. Eight hazardous drinking measures were used: the alcohol use disorders identification test (AUDIT) summary instrument and dedicated assessments of consumption (timeline follow-back and diary-format recall of alcohol drunk in the last 7 days), dependence (Leeds dependence questionnaire and severity of dependence scale) and problems (Rutgers alcohol problem index, alcohol problems scale and academic role expectations and alcohol scale). Results: Internal consistency and test-retest correlation statistics were generally satisfactory, providing evidence of reliability. Validation data obtained in principal components analyses, investigation of the correlation matrix and in a multiple regression model of total AUDIT score were also supportive of the online use of these measures. Evidence was weakest for the alcohol problems scale. Conclusions: A range of hazardous drinking measures exhibit sound psychometric properties when administered online. Further comparative study of the relationships between different measures is needed Via Publisher
Umut, G., Delice, M.A., Cansiz, A., (...), Kurt, E., Evren, C.
Clinical characteristics of euthymic bipolar disorder patients comorbid with alcohol and drug use disorders and psychometric properties of the assessment tools. Klinik Psikofarmakoloji Bulteni, Volume 26, Issue 1, 2016, Pages 48-57
2016 English Objective: The primary objective of this study was to identify the frequency of alcohol and drug use disorder -abuse or dependence- (ADUD) in bipolar disorder patients who were followed in a specialized mood disorders unit and to investigate the clinical characteristics of the sample. Secondary aim of the study was to evaluate the psychometric properties of the scales related with alcohol and drug use disorder among bipolar patients in remission. Methods: Alcohol Use Disorders Identification Test (AUDIT), Michigan Alcoholism Screening Test (MAST), Drug Use Disorders Identification Test (DUDIT), and Drug Abuse Screening Test (DAST-10) were applied to 292 bipolar disorder patients in the euthymic state, diagnosed by using mood disorder and alcohol/drug use disorder modules of the Structured Clinical Interview Form for DSM-IV Axis I Disorders (SCID-I) and monitored in our Mood Disorders Center. Results: In our sample, frequency of bipolar disorder patients with ADUD was 6.16% (18/292). 15 of 18 patients with ADUD were men and 3 were women. ADUD in men (12.00%) was higher than in women (1.79%), and this difference was statistically significant (p<0.001). Alcohol use disorder frequency was detected as 5.14% in general (15/292), 9.60% in men (12/125) and 1.79% in women (3/167). The frequency of drug use disorder was found as 4.11% in general (12/292), 8.00% in men (10/125) and 1.19% in women (2/167). Proportion of depressive, manic, hypomanic, and mixed episodes did not differ between patients with ADUD and those without ADUD, whereas the proportion of total episodes was higher in patients with ADUD and difference was statistically significant (p=0.016). Conclusions: Frequency of bipolar disorder patients comorbid with ADUD followed up in our center was found to be lower than those reported in the literature. Open Access
Wurst, F.M., Dürsteler-MacFarland, K.M., Auwaerter, V., (...), Weinmann, W., Wiesbeck, G.A.
Assessment of alcohol use among methadone maintenance patients by direct ethanol metabolites and self-reports. Alcoholism: Clinical and Experimental Research, Volume 32, Issue 9, September 2008, Pages 1552-1557
2008 English Background: Heavy alcohol consumption may accelerate the progression of hepatitis C (HCV)-related liver disease and/or limit efforts at antiviral treatment. As most of the patients in methadone maintenance treatment (MMT) suffer from hepatitis C infection, this study was conducted to identify the alcohol intake among these patients at a Swiss Psychiatric University Clinic by self-reports and direct ethanol metabolites as biomarkers of ethanol consumption. Conclusion: (1) HEtG identified 20 cases of daily ethanol intake of more than 20 g, that would have been missed by the sole use of question 1 (frequency) and 2 (quantity) of the AUDIT. (2) Using the total score of the AUDIT, HEtG confirmed 10 more cases positive for alcohol intake. (3) Episodic heavy drinking is with 22.5% more frequent than in general population, and (4) of the 14 participants who reported no alcohol intake during the previous 7 days, 4 were UEtG positive. Improved detection of alcohol consumption, which is hazardous or harmful in the context of HCV and opiate dependence, would allow for earlier intervention in this population which is at particular risk of liver disease and fatal respiratory-depressed overdose. The combined use of self-reports and direct ethanol metabolites seems promising.  Via Publisher
Wurst, F.M., Rumpf, H.-J., Skipper, G.E., (...), Beschoner, P., Thon, N.
Estimating the prevalence of drinking problems among physicians. General Hospital Psychiatry, Volume 35, Issue 5, September 2013, Pages 561-564
2013 English Objective: Surveys assessing alcohol use among physicians have most commonly employed the Alcohol Use Disorders Identification Test (AUDIT) or the AUDIT-C, the most common short version of the AUDIT. As with other screeners, prevalence estimation is dependent on the accuracy of the test as well as choice of the cutoff value. The aim of the current study is to derive more precise prevalence estimates of alcohol problems in physicians by correcting for false-positive and false-negative results. Method: In the context of a survey, the AUDIT was sent out via email or standard postal service to all 2484 physicians in Salzburg, Austria. A total of 456 physicians participated. A published correction formula was used to estimate the real prevalence of alcohol use problems. Results: Applying a cutoff of 5 points for the AUDIT-C, 15.7% of female and 37.7% of male physicians screened positive. Use of a correction based on general population data and the sensitivity and specificity of the AUDIT-C resulted in much lower prevalence rates: 4.0% for female and 9.5% for male physicians. Using the full AUDIT, 19.6% of the female physicians and 48% of the male physicians were screened positive. Using the correction, the estimated prevalence rates for females and males were 6.3% and 15.5%, respectively. Conclusions: Our findings demonstrate that uncorrected screening results may markedly overestimate the prevalence of physicians drinking problems.  Via Publisher