Medicine:Alcohol Use Disorders Identification Test

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Alcohol Use Disorders Identification Test
Medical diagnostics
Purposescreen individuals for alcoholism
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The Alcohol Use Disorders Identification Test (AUDIT) is a ten-item questionnaire approved by the World Health Organization to screen patients for hazardous (risky) and harmful alcohol consumption. It was developed from a WHO multi-country collaborative study,[1][2][3] the items being selected for the AUDIT being the best performing of approximately 150 items including in the original survey. It is widely used as a summary measure of alcohol use and related problems. It has application in primary health care, medical clinics, and hospital units and performs well in these settings.[4][5][6] Using different cut-off points, it can also screen for Alcohol Use Disorder (DSM-5) and Alcohol Dependence. Guidelines for the use of the AUDIT have been published by WHO and are available in several languages.[7] It has become a widely used instrument and has been translated into approximately fifty languages.[8]

The AUDIT consists of ten questions, all of which ask explicitly about alcohol:

  1. Questions 1 to 3 ask about consumption of alcohol (frequency, quantity or typical drinking occasions, and consumption likely to cause impairment);
  2. Possible dependence on alcohol (Questions 4 to 6), and
  3. Harmful alcohol use, including concern expressed by others (Questions 7 to 10).

Each question is scored between 0 and 4 depending on the response and so the total score ranges between 0 and 40. Based on responses in the original WHO multi-centre study a score of 8 or more is the threshold for identifying hazardous or harmful alcohol consumption with a score of 15 or more indicating likely alcohol dependence, and 20 or more indicating likely severe dependence and harm. Using the cut-off point of 8, its performance in the original collaborative WHO study indicated a sensitivity of 92% and a specificity of 94% for the diagnoses of hazardous and harmful alcohol consumption.[3]

The AUDIT was designed to be used internationally, and was derived from a WHO collaborative study drawing patients from six countries, representing different regions of the world and different political and economic systems. More than 300 studies have been undertaken to examine its usefulness and validity in various settings.[8] Multiple studies have found that the AUDIT is a reliable and valid measure in identifying alcohol abuse, hazardous consumption and harmful alcohol use (consumption leading to actual harm) and it has also been found to be a valid indicator for severity of alcohol dependence.[6][9] There is some evidence that the AUDIT works in adolescents and young adults; it appears less accurate in older adults. It appears well-suited for use with college students, and also with women and members of minority groups.[10] There has also been significant evidence for its use in the trauma patient population to screen for possible alcohol use disorders.[11] In the trauma patient population, AUDIT has been shown to be more effective at identifying possible alcohol abuse than physician judgement and the blood alcohol content (BAC) test.[12]

A shorter version of the Alcohol Use Disorders Identification Test (AUDIT-C) has been created for rapid use, and is composed of the first 3-question of the full length AUDIT pertaining specifically to quantity of alcohol consumed. It is appropriate for screening for problem drinking in a doctor's office.[13]

See also

  • CAGE questionnaire
  • CRAFFT Screening Test
  • Clinical Institute Withdrawal Assessment for Alcohol
  • List of diagnostic classification and rating scales used in psychiatry
  • Michigan Alcoholism Screening Test
  • Paddington alcohol test
  • Severity of Alcohol Dependence Questionnaire
  • Substance abuse

References

  1. ↑ Saunders, JB; Aasland, OG (1987). WHO Collaborative Project on Identification and Treatment of Persons with Harmful Alcohol Consumption. Report on Phase 1. Development of a Screening Instrument. Geneva: World Health Organisation. 
  2. ↑ Saunders, JB; Aasland, OG; Amundsen, A; Grant, M (1993). "Alcohol consumption and related problems amongst primary health care patients:WHO collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption 1.". Addiction 88 (12): 349–362. doi:10.1111/j.1360-0443.1993.tb00822.x. PMID 8461852. 
  3. ↑ 3.0 3.1 Saunders, JB; Aasland, OG; TF, Babor; de la Fuente, JR; Grant, M (1993). "Development of the Alcohol Use Disorders Identification Test (AUDIT):WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption 1.". Addiction 88 (12): 791–804. doi:10.1111/j.1360-0443.1993.tb02093.x. PMID 8329970. 
  4. ↑ Bohn, MJ; Babor, TF; Kranzler, HR (July 1995). "The Alcohol Use Disorders Identification Test (AUDIT): validation of a screening instrument for use in medical settings.". Journal of Studies on Alcohol 56 (4): 423–32. doi:10.15288/jsa.1995.56.423. PMID 7674678. 
  5. ↑ Kitchens, JM (14 December 1994). "Does this patient have an alcohol problem?". JAMA 272 (22): 1782–7. doi:10.1001/jama.1994.03520220076034. PMID 7966928. 
  6. ↑ 6.0 6.1 Donovan, DM; Kivlahan, DR; Doyle, SR; Longabaugh, R; Greenfield, SF (December 2006). "Concurrent validity of the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT zones in defining levels of severity among out-patients with alcohol dependence in the COMBINE study.". Addiction 101 (12): 1696–704. doi:10.1111/j.1360-0443.2006.01606.x. PMID 17156168. 
  7. ↑ Babor, TF; Saunders, JB; Monteiro, M. AUDIT: The Alcohol Use Disorders Identification Test Guidelines for Use in Primary Care (second edition) Geneva: World Health Organization, 2001. 
  8. ↑ 8.0 8.1 "www.auditscreen.org". http://auditscreen.org. Retrieved 8 January 2020. 
  9. ↑ Fiellin, DA; Reid, MC; O'Connor, PG (10 July 2000). "Screening for alcohol problems in primary care: a systematic review.". Archives of Internal Medicine 160 (13): 1977–89. doi:10.1001/archinte.160.13.1977. PMID 10888972. 
  10. ↑ "Screening for alcohol use and alcohol related problems". http://pubs.niaaa.nih.gov/publications/aa65/aa65.htm. Retrieved 23 September 2015. 
  11. ↑ Neumann, Tim; Gentilello, Larry M.; Neuner, Bruno; Weiss-Gerlach, Edith; Schürmann, Hajo; Schröder, Torsten; Müller, Christian; Haas, Norbert P. et al. (June 2009). "Screening trauma patients with the alcohol use disorders identification test and biomarkers of alcohol use". Alcoholism, Clinical and Experimental Research 33 (6): 970–976. doi:10.1111/j.1530-0277.2009.00917.x. ISSN 1530-0277. PMID 19302090. 
  12. ↑ Plackett, Timothy P.; Ton-That, Hieu H.; Mueller, Jeanne; Grimley, Karen M.; Kovacs, Elizabeth J.; Esposito, Thomas J. (June 2015). "Screening for at-risk drinking behavior in trauma patients". The Journal of the American Osteopathic Association 115 (6): 376–382. doi:10.7556/jaoa.2015.078. ISSN 1945-1997. PMID 26024331. 
  13. ↑ Bush, K; Kivlahan, DR; McDonell, MB; Fihn, SD; Bradley, KA (14 September 1998). "The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test.". Archives of Internal Medicine 158 (16): 1789–95. doi:10.1001/archinte.158.16.1789. PMID 9738608. 

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