Northwest Health Services Research and Development Center of Excellence, VA Puget Sound Health Care System, Seattle, WA 98101, USA.
Drug Alcohol Depend. 2010 Apr 1;108(1-2):29-36. doi: 10.1016/j.drugalcdep.2009.11.009. Epub 2009 Dec 29.
Brief alcohol counseling interventions can reduce alcohol consumption and related morbidity among non-dependent risky drinkers, but more intensive alcohol treatment is recommended for persons with alcohol dependence. This study evaluated whether scores on common alcohol screening tests could identify patients likely to have current alcohol dependence so that more appropriate follow-up assessment and/or intervention could be offered. This cross-sectional study used secondary data from 392 male and 927 female adult family medicine outpatients (1993-1994). Likelihood ratios were used to empirically identify and evaluate ranges of scores of the AUDIT, the AUDIT-C, two single-item questions about frequency of binge drinking, and the CAGE questionnaire for detecting DSM-IV past-year alcohol dependence. Based on the prevalence of past-year alcohol dependence in this sample (men: 12.2%; women: 5.8%), zones of the AUDIT and AUDIT-C identified wide variability in the post-screening risk of alcohol dependence in men and women, even among those who screened positive for alcohol misuse. Among men, AUDIT zones 5-10, 11-14 and 15-40 were associated with post-screening probabilities of past-year alcohol dependence ranging from 18 to 87%, and AUDIT-C zones 5-6, 7-9 and 10-12 were associated with probabilities ranging from 22 to 75%. Among women, AUDIT zones 3-4, 5-8, 9-12 and 13-40 were associated with post-screening probabilities of past-year alcohol dependence ranging from 6 to 94%, and AUDIT-C zones 3, 4-6, 7-9 and 10-12 were associated with probabilities ranging from 9 to 88%. AUDIT or AUDIT-C scores could be used to estimate the probability of past-year alcohol dependence among patients who screen positive for alcohol misuse and inform clinical decision-making.
简短的酒精咨询干预可以减少非依赖型高风险饮酒者的饮酒量和相关发病率，但建议对酒精依赖者进行更强化的酒精治疗。本研究评估了常见酒精筛查测试的分数是否可以识别出可能患有当前酒精依赖的患者，以便提供更适当的随访评估和/或干预。本横断面研究使用了 392 名男性和 927 名女性成年家庭医学门诊患者（1993-1994 年）的二级数据。使用似然比来实证确定和评估 AUDIT、AUDIT-C、两个关于 binge drinking 频率的单项问题以及 CAGE 问卷的分数范围，以检测 DSM-IV 过去一年的酒精依赖。根据该样本中过去一年的酒精依赖患病率（男性：12.2%；女性：5.8%），AUDIT 和 AUDIT-C 的分数区域在男性和女性中确定了酒精依赖的筛查后风险的广泛变异性，即使在那些筛查出酒精滥用的人中也是如此。在男性中，AUDIT 分数区域 5-10、11-14 和 15-40 与过去一年的酒精依赖的筛查后概率相关，范围从 18%到 87%，AUDIT-C 分数区域 5-6、7-9 和 10-12 与概率相关，范围从 22%到 75%。在女性中，AUDIT 分数区域 3-4、5-8、9-12 和 13-40 与过去一年的酒精依赖的筛查后概率相关，范围从 6%到 94%，AUDIT-C 分数区域 3、4-6、7-9 和 10-12 与概率相关，范围从 9%到 88%。AUDIT 或 AUDIT-C 分数可用于估计筛查出酒精滥用的患者中过去一年酒精依赖的概率，并为临床决策提供信息。
