Fabbri Carlos E, Furtado Erikson F, Laprega Milton R
Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.
Rev Saude Publica. 2007 Dec;41(6):979-84. doi: 10.1590/s0034-89102006005000044. Epub 2007 Dec 4.
To assess the performance characteristics of the Brazilian version of the Tolerance, Annoyed, Cut down and Eye-opener (T-ACE) questionnaire to screen alcohol consumption during pregnancy.
Observational, cross-sectional study in a sequential sample of 450 women in the third trimester of pregnancy, attended in a maternity ward in a city of Southeastern Brazil, in 2001. The following instruments were used: a questionnaire to gather sociodemographic data, the T-ACE, a questionnaire to verify history of alcohol consumption throughout gestation, and a clinical interview to identify the harmful use of and dependence on alcohol, according to ICD-10 diagnostic criteria. Concordance tests among different interviewers as well as test-/re-test reliability tests were performed.
A total of 100 women (22.1%) were identified as positive by the T-ACE. The kappa indexes for concordance and reliability were 0.95, with 97% of concordant responses. When compared to the ICD-10 criteria and to the pattern of consumption, the T-ACE, with a cut-off point of two or higher, presented sensitivity and specificity coefficients of 100% and 85%, and of 97.9% and 86.6%, respectively.
The Brazilian version of the T-ACE seemed to appropriately meet the performance criteria that qualify it as a basic instrument for the screening of alcohol consumption during pregnancy. Its use in the routine and practice of obstetric services is recommended in view of the tendency for increased alcohol consumption among women, the difficulties to identify alcohol abuse by pregnant women, and the risk of developmental problems in children.
评估巴西版耐受、烦恼、减少饮酒量及眼 opener(T-ACE)问卷在筛查孕期饮酒情况方面的性能特征。
2001年,在巴西东南部一座城市的产科病房,对450名妊娠晚期妇女的连续样本进行观察性横断面研究。使用了以下工具:一份收集社会人口学数据的问卷、T-ACE问卷、一份核实整个孕期饮酒史的问卷,以及一次根据ICD-10诊断标准识别酒精有害使用和依赖情况的临床访谈。进行了不同访谈者之间的一致性测试以及重测信度测试。
共有100名妇女(22.1%)被T-ACE问卷判定为阳性。一致性和信度的kappa指数为0.95,一致回答率为97%。与ICD-10标准和饮酒模式相比,T-ACE问卷截断值为2或更高时,敏感性和特异性系数分别为100%和85%,以及97.9%和86.6%。
巴西版T-ACE问卷似乎恰当地满足了将其作为筛查孕期饮酒基本工具的性能标准。鉴于女性饮酒量有增加趋势、识别孕妇酒精滥用存在困难以及儿童发育问题风险,建议在产科服务的常规工作和实践中使用该问卷。