Gómez Arnáiz A, Conde Martela A, Alberto Aguiar Bautista J, Manuel Santana Montesdeoca J, Jorrín Moreno A, Betancor León P
Medicina de Familia, Centro de Salud de San Gregorio.
Med Clin (Barc). 2001 Feb 3;116(4):121-4. doi: 10.1016/s0025-7753(01)71745-9.
To evaluate the diagnostic usefulness of AUDIT (Alcohol Use Disorders Identification Test) for detecting hazardous alcohol consumption in primary care settings, to assess the potential differences according to age or sex and to compare its diagnostic value with that of other conventionally used measures (CAGE questionnaire and biological markers).
This is a descriptive cross-sectional study for evaluation of diagnostic tests with 500 participating patients randomly selected among those attending a family health care center. Data about alcohol intake were collected using a semistructured interview, considering as hazardous alcohol consumption a weekly intake of 35 SDUs (standard drink unit) or above for men and 21 for women. AUDIT and CAGE questionnaires were administered and blood levels of GGT, MCV, AST, ALT, alkaline phosphatase, platelets, tryglicerides and uric acid were determined. For each one of those sensitivity, specificity, global value, predictive values, positive and negative probability ratio were calculated as well as ROC analysis for the questionnaires.
Sensitivity of AUDIT in detecting current hazardous drinkers was 89%, specificity was 93% and area under ROC was 0.98 (95% CI, 0.96-0.99). Its sensitivity was found to be lower in the female group (60 vs. 78%) as well as for age group under 60 years (86 vs. 100%). CAGE questionnaire showed a sensitivity of 48% and a specificity of 97%. Biological markers offered sensitivities lower than 40% and specificities over 90%.
AUDIT is a useful tool for detecting hazardous alcohol consumption in ambulatory care. Its sensitivity being lower for women and its diagnostic usefulness significantly exceeding that of other screening measures commonly used.
评估酒精使用障碍识别测试（AUDIT）在基层医疗环境中检测危险饮酒行为的诊断效用，评估其在年龄或性别方面的潜在差异，并将其诊断价值与其他常规使用的测量方法（CAGE问卷和生物标志物）进行比较。
这是一项描述性横断面研究，用于评估诊断测试，从一家家庭医疗保健中心的就诊患者中随机选取500名参与患者。通过半结构化访谈收集酒精摄入量数据，将男性每周摄入35个标准饮酒单位（SDU）及以上、女性每周摄入21个标准饮酒单位及以上视为危险饮酒行为。发放AUDIT和CAGE问卷，并测定血液中γ-谷氨酰转移酶（GGT）、平均红细胞体积（MCV）、天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）、碱性磷酸酶、血小板、甘油三酯和尿酸的水平。计算上述各项指标的敏感性、特异性、综合值、预测值、阳性和阴性概率比，以及问卷的ROC分析。
AUDIT检测当前危险饮酒者的敏感性为89%，特异性为93%，ROC曲线下面积为0.98（95%可信区间，0.96 - 0.99）。发现其在女性组（60%对78%）以及60岁以下年龄组（86%对100%）中的敏感性较低。CAGE问卷的敏感性为48%，特异性为97%。生物标志物的敏感性低于40%，特异性超过90%。
AUDIT是在门诊护理中检测危险饮酒行为的有用工具。其对女性的敏感性较低，但其诊断效用显著超过其他常用的筛查措施。
