Health Services Research & Development, Veterans Affairs Puget Sound Health Care System, Seattle, WA 98108, USA.
Alcohol Clin Exp Res. 2013 Aug;37(8):1380-90. doi: 10.1111/acer.12092. Epub 2013 Apr 23.
Brief alcohol screening questionnaires are increasingly used to identify alcohol misuse in routine care, but clinicians also need to assess the level of consumption and the severity of misuse so that appropriate intervention can be offered. Information provided by a patient's alcohol screening score might provide a practical tool for assessing the level of consumption and severity of misuse.
This post hoc analysis of data from the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) included 26,546 U.S. adults who reported drinking in the past year and answered additional questions about their consumption, including Alcohol Use Disorders Identification Test-Consumption questionnaire (AUDIT-C) alcohol screening. Linear or logistic regression models and postestimation methods were used to estimate mean daily drinking, the number of endorsed alcohol use disorder (AUD) criteria ("AUD severity"), and the probability of alcohol dependence associated with each individual AUDIT-C score (1 to 12), after testing for effect modification by gender and age.
Among eligible past-year drinkers, mean daily drinking, AUD severity, and the probability of alcohol dependence increased exponentially across increasing AUDIT-C scores. Mean daily drinking ranged from < 0.1 to 18.0 drinks/d, AUD severity ranged from < 0.1 to 5.1 endorsed AUD criteria, and probability of alcohol dependence ranged from < 1 to 65% across scores 1 to 12. AUD severity increased more steeply across AUDIT-C scores among women than men. Both AUD severity and mean daily drinking increased more steeply across AUDIT-C scores among younger versus older age groups.
Results of this study could be used to estimate patient-specific consumption and severity based on age, gender, and alcohol screening score. This information could be integrated into electronic decision support systems to help providers estimate and provide feedback about patient-specific risks and identify those patients most likely to benefit from further diagnostic assessment.
简短的酒精筛查问卷越来越多地用于在常规护理中识别酒精滥用，但临床医生还需要评估饮酒量和滥用的严重程度，以便提供适当的干预措施。患者的酒精筛查评分所提供的信息可能是评估饮酒量和滥用严重程度的实用工具。
本研究是对 2001 年至 2002 年全国酒精相关状况流行病学调查（NESARC）数据的事后分析，包括 26546 名报告过去一年饮酒的美国成年人，并回答了有关其饮酒量的其他问题，包括酒精使用障碍识别测试-消费问卷（AUDIT-C）酒精筛查。使用线性或逻辑回归模型和后估计方法，在测试性别和年龄的效应修饰后，估计每个个体 AUDIT-C 评分（1 至 12）与平均每日饮酒量、认可的酒精使用障碍（AUD）标准数量（“AUD 严重程度”）和酒精依赖的概率之间的关系。
在合格的过去一年饮酒者中，平均每日饮酒量、AUD 严重程度和酒精依赖的概率随着 AUDIT-C 评分的增加呈指数增长。平均每日饮酒量范围为<0.1 至 18.0 份/天，AUD 严重程度范围为<0.1 至 5.1 个认可的 AUD 标准，得分 1 至 12 之间的酒精依赖概率范围为<1 至 65%。女性的 AUD 严重程度比男性更陡峭地随着 AUDIT-C 评分的增加而增加。AUD 严重程度和平均每日饮酒量都随着年龄组的年轻而比年长而更陡峭地随着 AUDIT-C 评分的增加而增加。
本研究的结果可用于根据年龄、性别和酒精筛查评分估计患者特定的饮酒量和严重程度。这些信息可以整合到电子决策支持系统中，以帮助提供者估计和提供患者特定风险的反馈，并识别那些最有可能从进一步诊断评估中受益的患者。
