Korzec Aleksander, de Bruijn Carla, van Lambalgen Michiel
Sint Lucas Andreas Hospital, Postbus 9423, 1006 AE Amsterdam, The Netherlands.
J Clin Epidemiol. 2005 Oct;58(10):1024-32. doi: 10.1016/j.jclinepi.2005.02.020.
Conventional tests for alcoholism fail to confirm hazardous and harmful alcohol use (HHAU) accurately and objectively. We validated a Bayesian Alcoholism Test (BAT) for confirming the diagnosis of HHAU.
BAT is based on studies on the prevalence of HHAU and other diseases causing similar abnormalities, and on conditional probabilities of these disorders and associated biochemical markers and clinical signs. BAT was compared to carbohydrate-deficient transferrin (CDT) and gamma-glutamyltransferase (GGT) in treatment-seeking alcoholics, non-treatment-seeking heavy drinkers, and controls. Main outcome measures were test sensitivity and specificity, likelihood ratios, and receiver-operating characteristic (ROC) curves.
Comparing alcoholics and controls, sensitivity of BAT (94%) was significantly higher than CDT (63%) and GGT (73%). The area under the ROC curve for BAT (.989) was significantly higher than the area under the curve for CDT (.909) and area under the curve for GGT (.902). Using pooled data of all 182 subjects included in the study, the amount of drinking had a significant better correlation coefficient with BAT (.795) than with CDT (.657), and GGT (.604).
BAT has better diagnostic properties than CDT and GGT for confirming HHAU.
传统的酒精中毒检测方法无法准确、客观地确认危险及有害饮酒(HHAU)情况。我们验证了一种用于确诊HHAU的贝叶斯酒精中毒检测法(BAT)。
BAT基于对HHAU及其他导致类似异常的疾病的患病率研究,以及这些疾病与相关生化标志物和临床体征的条件概率。在寻求治疗的酗酒者、不寻求治疗的重度饮酒者和对照组中,将BAT与缺糖转铁蛋白(CDT)和γ-谷氨酰转移酶(GGT)进行了比较。主要结局指标为检测敏感性和特异性、似然比以及受试者操作特征(ROC)曲线。
比较酗酒者和对照组,BAT的敏感性(94%)显著高于CDT(63%)和GGT(73%)。BAT的ROC曲线下面积(.989)显著高于CDT的曲线下面积(.909)和GGT的曲线下面积(.902)。使用纳入研究的所有182名受试者的汇总数据,饮酒量与BAT的相关系数(.795)显著优于与CDT的相关系数(.657)以及与GGT的相关系数(.604)。
在确诊HHAU方面,BAT比CDT和GGT具有更好的诊断特性。