RAND Corporation.
Psychol Addict Behav. 2018 Aug;32(5):508-516. doi: 10.1037/adb0000377. Epub 2018 Jul 5.
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) screening guide (SG) uses a 2-question screening process to identify adolescents at risk for alcohol use. The aim of this study was to identify the optimal screening rule in terms of identifying adolescents with alcohol use disorder (AUD) using the NIAAA questions by examining whether the cutpoint should vary by gender, race/ethnicity, grade, and/or age. Youth aged 12 through 18 years ( = 1,573; 27% Black, 51% Hispanic) were screened using the NIAAA SG, and then completed a survey. We used receiver operating characteristic curve analyses to identify the optimal cutpoint for the NIAAA screener question on self-use with AUD as the outcome. We compared the resulting screening rule with the NIAAA SG rule. We found that the optimal cutpoint depended on age and grade of adolescents. The resulting screening rule was the same as the NIAAA SG, and thus independently validated the NIAAA SG, with the exception of screening for adolescents 18 years of age, for which a lower cutpoint was indicated. The performance of both screening rules was highly similar when applied to the study sample, with a sensitivity of 0.89 for the optimal screening rule and a sensitivity of 0.87 for the NIAAA SG. In settings in which the cost of a false positive is relatively low (depending on available resources and cost of the intervention), lower cutpoints for older adolescents should be considered, as this may increase sensitivity of identifying these individuals at risk for AUD. (PsycINFO Database Record
美国国家酒精滥用与酒精中毒研究所（NIAAA）的筛选指南（SG）使用 2 个问题的筛选过程来识别有饮酒风险的青少年。本研究的目的是通过检查性别、种族/民族、年级和/或年龄是否应该有所不同，确定使用 NIAAA 问题识别有酒精使用障碍（AUD）风险的青少年的最佳筛选规则。使用 NIAAA SG 对 12 至 18 岁的青少年（=1573 人；27%为黑人，51%为西班牙裔）进行了筛选，然后完成了一项调查。我们使用接受者操作特征曲线分析来确定 NIAAA 筛查者关于自我使用与 AUD 的问题的最佳切点作为结果。我们将得出的筛选规则与 NIAAA SG 规则进行了比较。我们发现，最佳切点取决于青少年的年龄和年级。得出的筛选规则与 NIAAA SG 相同，因此独立验证了 NIAAA SG，除了对 18 岁的青少年进行筛选，表明需要较低的切点。当应用于研究样本时，这两种筛选规则的性能非常相似，最佳筛选规则的灵敏度为 0.89，NIAAA SG 的灵敏度为 0.87。在假阳性成本相对较低的环境中（取决于可用资源和干预措施的成本），应考虑为年龄较大的青少年降低切点，因为这可能会提高识别这些有 AUD 风险的个体的敏感性。
