Bentele Michael, Kriston Levente, Clement Hans-Willi, Härter Martin, Mundle Götz, Berner Michael M
Freiburg University Hospital, Department of Psychiatry and Psychotherapy, Freiburg, Germany.
Addict Biol. 2007 Mar;12(1):85-92. doi: 10.1111/j.1369-1600.2006.00049.x.
Especially in situations where it might be favorable for the patient to dissimulate the existing alcohol problem, 'objective' laboratory tests can be helpful. In this study we report validation of the two combinations DOVER (DOctor VERified) and QUVER (QUestionnarie VERified) of the biological markers percent carbohydrate-deficient transferrin (%CDT) and gamma-glutamyl-transferase (gamma-GT) to detect patients that have been identified by their physicians with at-risk drinking behavior. Fifty-eight general practitioners (GPs) participated at two study sites in South-West Germany. Patients filled in a questionnaire that included the alcohol use disorders identification test (AUDIT) and gave a blood sample. The GP recorded his/her assessment about the presence of an alcohol-related disorder in the patient. Receiver operating characteristics (ROC) analyses of the marker combinations DOVER and QUVER were performed. A total of 2940 patients participated in the study, of which 2496 completed data sets that could be used for further analysis. The area under the curve (AUC) of 79.5% for DOVER and 77.2% (QUVER) are in a higher range than the values for gamma%CDT (75.7%) or gamma-GT (72.5%) and %CDT (64.5%) and suggest superiority of the proposed marker combinations. Cross-validation results were almost identical with 76.6% and 73.3% for DOVER and QUVER, respectively. Our analysis demonstrated that the combination of the markers gamma-GT and %CDT with the physician's judgement of the condition as reference was superior to the use of single markers.
特别是在患者可能倾向于隐瞒现有酒精问题的情况下，“客观”的实验室检测会有所帮助。在本研究中，我们报告了生物标志物碳水化合物缺乏转铁蛋白百分比（%CDT）和γ-谷氨酰转移酶（γ-GT）的两种组合DOVER（医生验证）和QUVER（问卷验证）用于检测经医生认定有危险饮酒行为患者的验证情况。58名全科医生（GP）参与了德国西南部两个研究地点的研究。患者填写了一份包含酒精使用障碍识别测试（AUDIT）的问卷并提供了血样。全科医生记录了其对患者是否存在酒精相关障碍的评估。对DOVER和QUVER标志物组合进行了受试者操作特征（ROC）分析。共有2940名患者参与了该研究，其中2496名患者完成了可用于进一步分析的数据集。DOVER的曲线下面积（AUC）为79.5%，QUVER为77.2%，高于γ%CDT（75.7%）、γ-GT（72.5%）和%CDT（64.5%）的值，表明所提出的标志物组合具有优越性。交叉验证结果几乎相同，DOVER和QUVER分别为76.6%和73.3%。我们的分析表明，以医生对病情的判断为参考，γ-GT和%CDT标志物的组合优于单一标志物的使用。
