Chang G, Wilkins-Haug L, Berman S, Goetz M A
Brigham and Women's Hospital, Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
J Stud Alcohol. 1999 May;60(3):306-9. doi: 10.15288/jsa.1999.60.306.
The TWEAK is a screening instrument used to identify women who are risk drinkers. Potential limitations of previous studies of the TWEAK in the prenatal setting include indirect administration of the instrument to minority, indigent pregnant women. The purpose of this study is to assess the efficacy of the TWEAK when it is given directly to a sample of pregnant women of different socioeconomic backgrounds.
The original TWEAK, with two different tolerance questions, was administered to a sample of 135 pregnant women enrolled in a study of alcohol use during pregnancy at the obstetrics practices of the Brigham and Women's Hospital in Boston, Massachusetts.
The TWEAK, using the first tolerance question (number of drinks before feeling the first effects of alcohol) with the cut point set at more than two drinks, had the best predictive ability for lifetime alcohol diagnoses and risk drinking. The sensitivity of the TWEAK can be increased if the cut point for the first tolerance question is set at two drinks, with some loss of specificity and predictive ability. Medical record assessment was the least sensitive but most specific method of identifying alcohol use by pregnant women.
The TWEAK has promise as a screening instrument for identifying risk drinking during pregnancy. Future work should include testing in other clinical populations.
TWEAK是一种用于识别有饮酒风险女性的筛查工具。以往在产前环境中对TWEAK进行研究的潜在局限性包括通过间接方式将该工具应用于少数族裔、贫困孕妇。本研究的目的是评估直接将TWEAK应用于不同社会经济背景的孕妇样本时的有效性。
原始的TWEAK带有两个不同的耐受性问题，被应用于135名孕妇样本，这些孕妇参与了马萨诸塞州波士顿布里格姆妇女医院产科开展的一项孕期饮酒研究。
TWEAK使用第一个耐受性问题（在感觉到酒精的最初影响之前饮酒的杯数），将临界值设定为超过两杯时，对终生酒精诊断和有饮酒风险的预测能力最佳。如果将第一个耐受性问题的临界值设定为两杯，TWEAK的敏感性会提高，但特异性和预测能力会有所损失。病历评估是识别孕妇饮酒情况最不敏感但最具特异性的方法。
TWEAK有望作为一种筛查工具用于识别孕期有饮酒风险的情况。未来的工作应包括在其他临床人群中进行测试。
