A cross-sectional study investigated whether the AUDIT score is useful for predicting hazardous drinking and whether the AUDIT score was more useful than pre-existing laboratory tests. 334 outpatients who consulted internal medicine department in Japan completed self-reported questionnaires and underwent a diagnostic interview, physical examination, and laboratory testing. 40 (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 3 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.
In a comparative study 194 male primary care attendees completed an AUDIT questionnaire. A correlation was observed between alcohol consumption and score on the AUDIT (Pearson's correlation coefficient r = 0.74) and measures of gamma-glutamyltransferase (GGT) (r = 0.20) and per cent carbohydrate deficient transferring (CDT) (r = 0.36) but not aspartate aminotransferase (r = 0.08) or erythrocyte mean cell volume (r = 0.02). The AUDIT exhibited 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.
In a cross-sectional study a random sample of patients was given alcohol questionnaires at general practices in Belgium. The GPs identified 33.5% of patients with alcohol abuse or dependence (178/1992). All questionnaires had sensitivities of 68% - 93% among male patients. Only the sensitivity of the CAGE, even at its lowest cut-point of > or = 1 was lower (62%). In female patients the sensitivities were lower. The laboratory tests had low diagnostic accuracy with areas under the ROC curves (AUCs) between 0.60 and 0.67 for female patients and 0.57 and 0.65 for male patients.
In a study in hospitals the same investigators found a current diagnosis of alcohol abuse or dependence in 29/233 (12.4%) medical male inpatients, of which 4.2% fulfilled criteria of alcohol abuse and 8.2% of alcohol dependence. The sensitivity of CDT was 10% and GGT 52%. The AUDIT (5 or 10 questions) yielded reasonable diagnostic parameters at the recommended cutpoint of > or = 2.5 with a sensitivity of 79.3% and a specificity of 87.7%.
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