Adam Angéline, Laska Eugene, Schwartz Robert P, Wu Li-Tzy, Subramaniam Geetha A, Appleton Noa, McNeely Jennifer
Addiction Medicine, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
Subst Use Addctn J. 2025 May 5:29767342251326678. doi: 10.1177/29767342251326678.
The Tobacco, Alcohol, Prescription Medication, and Other Substance (TAPS) tool is a screening and brief assessment instrument to identify unhealthy tobacco, alcohol, drug use, and prescription medication use in primary care patients. This secondary analysis compares the TAPS tool to the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) for alcohol screening.
Adult primary care patients (1124 female, 874 male) completed the TAPS tool followed by AUDIT-C. Performance of each instrument was evaluated against a reference standard measure, the modified World Mental Health Composite International Diagnostic Interview, to identify problem use and alcohol use disorder (AUD). Area under the curve (AUC) appraised discrimination, and sensitivity and specificity were calculated for Youden optimal score thresholds.
For identifying problem use: On the AUDIT-C, AUC was 0.90 (95% Confidence Interval: 0.86-0.92) for females and 0.91 (0.89-0.93) for males. Sensitivity and specificity for females were 0.89 (0.83-0.93) and 0.78 (0.75-0.80), respectively, and for males were 0.84 (0.79-0.88) and 0.82 (0.79-0.85). On the TAPS tool, AUC was 0.82 (0.79-0.86) for females and 0.81 (0.78-0.84) for males. Sensitivity and specificity for females were 0.78 (0.72-0.84) and 0.78 (0.75-0.81), respectively, and for males were 0.76 (0.71-0.81) and 0.76 (0.72-0.79). For AUD: On the AUDIT-C, AUC was 0.90 (0.88-0.93) for both females and males. Sensitivity and specificity for females were 0.83 (0.74-0.90) and 0.83 (0.80-0.85), respectively, while for males, they were 0.81 (0.74-0.87) and 0.84 (0.81-0.87). On the TAPS tool, AUC was 0.84 (0.80-0.89) for females and 0.82 (0.78-0.86) for males. Sensitivity and specificity for females were 0.73 (0.63-0.81) and 0.85 (0.83-0.88), respectively, while for males, they were 0.75 (0.68-0.81) and 0.84 (0.81-0.86).
The AUDIT-C performed somewhat better than the TAPS tool for alcohol screening. However, the TAPS tool had an acceptable level of performance for alcohol screening and may be advantageous in practice settings seeking to identify alcohol and other substance use with a single instrument.
烟草、酒精、处方药及其他物质（TAPS）工具是一种筛查和简要评估工具，用于识别初级保健患者中不健康的烟草、酒精、药物使用及处方药使用情况。本次二次分析将TAPS工具与酒精使用障碍识别测试-消耗量（AUDIT-C）用于酒精筛查进行比较。
成年初级保健患者（1124名女性，874名男性）完成TAPS工具，随后进行AUDIT-C测试。将每种工具的表现与参考标准测量方法——改良版世界心理健康综合国际诊断访谈进行比较，以识别问题使用情况和酒精使用障碍（AUD）。曲线下面积（AUC）评估辨别力，并针对约登最优分数阈值计算敏感性和特异性。
对于识别问题使用情况：在AUDIT-C上，女性的AUC为0.90（95%置信区间：0.86 - 0.92），男性为0.91（0.89 - 0.93）。女性的敏感性和特异性分别为0.89（0.83 - 0.93）和0.78（0.75 - 0.80），男性分别为0.84（0.79 - 0.88）和0.82（0.79 - 0.85）。在TAPS工具上，女性的AUC为0.82（0.79 - 0.86），男性为0.81（0.78 - 0.84）。女性的敏感性和特异性分别为0.78（0.72 - 0.84）和0.78（0.75 - 0.81），男性分别为0.76（0.71 - 0.81）和0.76（0.72 - 0.79）。对于AUD：在AUDIT-C上，女性和男性的AUC均为0.90（0.88 - 0.93）。女性的敏感性和特异性分别为0.83（0.74 - 0.90）和0.83（0.80 - 0.85），而男性分别为0.81（0.74 - 0.87）和0.84（0.81 - 0.87）。在TAPS工具上，女性的AUC为0.84（0.80 - 0.89），男性为0.82（0.78 - 0.86）。女性的敏感性和特异性分别为0.73（0.63 - 0.81）和0.85（0.83 - 0.88），而男性分别为0.75（0.68 - 0.81）和0.84（0.81 - 0.86）。
在酒精筛查方面，AUDIT-C的表现略优于TAPS工具。然而，TAPS工具在酒精筛查方面具有可接受的表现水平，并且在寻求使用单一工具识别酒精及其他物质使用情况的实际环境中可能具有优势。
