University College of Norwegian Correctional Service, Norway.
Norwegian Institute of Public Health, Norway.
Drug Alcohol Depend. 2021 Dec 1;229(Pt B):109153. doi: 10.1016/j.drugalcdep.2021.109153. Epub 2021 Oct 29.
Whether brief versions of the Alcohol Use Disorder Identification Test (AUDIT) can be used as graded severity measures is largely unknown. We examined the performance of eight such brief screeners in a prison population, and compared their effectiveness in detecting hazardous drinking, harmful drinking, and possible alcohol dependence as classified by the full ten-item AUDIT.
The study sample included pre-prison drinkers who participated in the Norwegian Offender Mental Health and Addiction (NorMA) study (n = 758). We conducted receiver operating characteristic curve (ROC) analyses and estimated the area under the curve (AUROC) to assess the performance of AUDIT-C (three consumption items) and four-item versions that consisted of AUDIT-C and one additional item.
AUDIT-C performed very well in detecting unhealthy drinking of varying severity (AUROCs of 0.933 or 0.935). Four-item versions performed even better. Of these, the well-established AUDIT-4 was superior in identifying harmful drinking (AUROC=0.969) and possible alcohol dependence (AUROC=0.976). For AUDIT-C, the optimal cut-points in terms of the highest combined sensitivity and specificity were ≥ 6 (hazardous drinking), ≥ 8 (harmful drinking) and ≥ 8 or ≥ 9 (possible dependence). The corresponding cut-points on AUDIT-4 were ≥ 6, ≥ 9 and ≥ 10. The highest cut-point whereby all cases of possible dependence were identified was ≥ 6 on AUDIT-C and ≥ 8 on AUDIT-4. At these cut-points, almost all individuals with harmful drinking were also detected.
AUDIT-C and AUDIT-4 were both highly effective in detecting hazardous drinking, harmful drinking and possible alcohol dependence. AUDIT-4 was superior, notably as a graded severity measure.
简短版的酒精使用障碍识别测试（AUDIT）能否用作分级严重程度的衡量标准，目前还知之甚少。我们在监狱人群中检验了八种这样的简短筛查工具，比较了它们在检测有害饮酒、有害饮酒和可能的酒精依赖方面的有效性，这些都是根据完整的 10 项 AUDIT 进行分类的。
研究样本包括参加挪威罪犯心理健康和成瘾（NorMA）研究的入狱前饮酒者（n=758）。我们进行了接收者操作特征曲线（ROC）分析，并估计了曲线下面积（AUROC），以评估 AUDIT-C（三个饮酒项目）和四个项目版本的表现，这些版本由 AUDIT-C 和一个附加项目组成。
AUDIT-C 在检测不同严重程度的不健康饮酒方面表现非常出色（AUROCs 为 0.933 或 0.935）。四个项目版本的表现甚至更好。在这些版本中，经过验证的 AUDIT-4 在识别有害饮酒（AUROC=0.969）和可能的酒精依赖（AUROC=0.976）方面表现更优。对于 AUDIT-C，在综合敏感性和特异性最高的情况下，最佳切点分别为≥6（有害饮酒）、≥8（有害饮酒）和≥8 或≥9（可能依赖）。AUDIT-4 的相应切点分别为≥6、≥9 和≥10。所有可能依赖的病例都被识别出的最高切点是 AUDIT-C 上的≥6 和 AUDIT-4 上的≥8。在这些切点上，几乎所有有害饮酒者也都被检测到。
AUDIT-C 和 AUDIT-4 都非常有效地检测到有害饮酒、有害饮酒和可能的酒精依赖。AUDIT-4 表现更为出色，特别是作为一个分级严重程度的衡量标准。
