Enhanced Clinical Utility of γ‐CDT in a General Population

Abstract

Compared with single markers, a significant improvement of sensitivity was obtained when the combination of both markers was used, especially in females.

DOVER and QUVER—New Marker Combinations to Detect and Monitor At‐risk Drinking

“…These results are lower than those of the case-control studies: Alte et al (2004) [reference standard more than 40 (women)/60 (men) g ethanol per day in routine patients] showed a sensitivity of 64.8% at 80% specificity. Similar results were found by Mundle et al (1999a) in relapsing dependent drinkers and Sillanaukee et al (2000a) in men with more than 420 g alcohol/wk. This supports a higher diagnostic accuracy of g-GT in higher consumption (abuse or dependent drinking).…”

“…(2) In most previous studies, there are exclusions of patients with liver disease (Anton et al, 2002;Chen et al, 2003;Harasymiw et al, 2004;Mundle et al, 2000;Reynaud et al, 2000), patients on medications that affect the hepatic system (Mundle et al, 1999b(Mundle et al, , 2000Myrick et al, 2001;Sillanaukee et al, 2000aSillanaukee et al, , 2000b, or patients who are pregnant (Anton et al, 2002;Reynaud et al, 2000;Sillanaukee et al, 2000aSillanaukee et al, , 2000b. Although the potential impairment of the enzyme system is a logical reason for exclusion, those studies with exclusions cannot claim either a representative sample or a more realistic estimation of the practical use of the markers.…”

“…Analysis of the diagnostic properties was performed by calculating receiver-operating characteristics (ROC) for the parameters g-GT and %CDT, as well as for a combination using the g-CDT formula proposed by Sillanaukee et al (2000a) and for the new marker combinations DOVER (DOctor VERified) and QUVER (QUestionnaire VERified). Although Silanaukee used a different laboratory method (CDtect), our approach can be justified by the results of Anton et al (2001), who demonstrated that the 2 methods produce results that are linearly dependent from each other.…”

The Bayesian Alcoholism Test had better diagnostic properties for confirming diagnosis of hazardous and harmful alcohol use

“…A third advantage is that it also produces a probability that the clinical and biochemical abnormalities are caused by another disease. The fourth advantage above other suggestions for using combinations of biochemical tests for HHAU [30][31][32][33] is that BAT can be easily accommodated for other populations with a node of the expected prevalence of the disease, without changing cutoff values of the used tests.…”

“…Several attempts have been made to use combinations of two or more biochemical markers [30][31][32][33] or combinations of biochemical markers and clinical signs [34] to identify hazardous alcohol use. The proposals have found little application because: (a) there was not sufficient improvement of sensitivity and specificity; (b) the combination of tests was too complicated to be applicable in common clinical practice; or (c) the combination of tests was not applicable in legal and insurance settings because it resulted in too many false positives.…”