Development and evaluation of a screening instrument for alcohol-use disorders and at-risk drinking: the brief alcohol screening instrument for medical care (BASIC).

OBJECTIVE

Screening for problem drinking has not yet become standard practice in primary health care settings, and lack of time is an important barrier for general practicioners to intervene. Very brief screening instruments might help to implement screening into the daily routine in primary health care. The present study describes the development and evaluation of the Brief Alcohol Screening Instrument for medical Care (BASIC), using two independently drawn samples.

METHOD

Sample 1 was recruited from general practices in two northern German cities. In total, 10,803 screenings were conducted. Item selection and validation of the BASIC was carried out in two equally sized random subsamples drawn from Sample 1. Sample 2 consisted of 2,949 consecutively admitted patients from a general hospital. Two different screening tools, both containing the Lübeck Alcohol abuse and dependence Screening Test (LAST) and one containing the full Alcohol Use Disorders Identification Test (AUDIT) and the other one the BASIC, were randomly handed out to study participants and compared according to validity criteria. As a gold standard for the detection of alcohol-use disorders, the Munich-Composite International Diagnostic Interview (M-CIDI) was used for screening positive individuals.

RESULTS

In the first general-practice subsample, six items that performed comparably well to the AUDIT were identified. In the second study, these findings were replicated. Both questionnaires performed better than the complementary deployed AUDIT-C and LAST.

CONCLUSIONS

Data show that the BASIC is an efficient screening tool that performs as well as the AUDIT in medical settings while being shorter in administration and scoring.