Screening Test for At-Risk Drinking: Development of New Abbreviated Version of Alcohol Use Disorder Identification Test for Young and Middle-Aged Adults

Abstract

Several abbreviated versions of the Alcohol Use Disorders Identification Test (AUDIT) have been developed for use in high-volume clinical situations such as emergency departments. In this study, we developed a new abbreviated version of AUDIT called the Screening Tool for At-risk Drinking (STAD) for young and middle-aged adults, consisting of two questions that reflect the structure of the AUDIT questionnaire using data from the Korea National Health and Nutrition Examination Survey (KNHANES). To derive the abbreviated test considering AUDIT item structure, we performed confirmatory factor analysis on the 10 AUDIT questions in the Korea National Health and Nutrition Examination Survey (KNHANES) IV. To validate the new abbreviated test, we analyzed the sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) on the KNHANES V-VI except for the KNHANES VI-2. Based on the two-factor structure of AUDIT, question (Q) 3 and Q7 were finally selected for STAD. In validation, AUROC was significantly wider for STAD than for AUDIT-QF, which has the same number of questions. There was no significant difference between AUDIT-C, consisting of three questions, and STAD. It can be used as a simple and reliable screening test in clinical settings.

Clinical validation of screening test for at-risk drinking for young and middle-aged adults in an emergency department

“…Subsequently, the combinations of Q3, Q7 and Q3, Q8 were compared in terms of AUROC, sensitivity, and specificity. Based on the results of the comparison, Q3 and Q7 were selected for the new abbreviated test, STAD 17 . This is an account of the development process of AUDIT.…”

“…Based on the results of the comparison, Q3 and Q7 were selected for the new abbreviated test, STAD. 17 This is an account of the development process of AUDIT.…”

“…These cut-off values are the same as previous study. 17 The cut-off values in men and women differ because of the different patterns of drinking behavior and alcohol-related problems according to gender and age. In the case of AUDIT, the cut-off value for at-risk drinking applies differently in men, women, and the elderly (8 points for men and 7 points for women and the elderly).…”

“…based on confirmatory factor analysis of AUDIT. 17 This study explored the validity STAD among patients in the ED…”

Provider perceptions of challenges to identifying women Veterans with hazardous substance use

“…For example, widely used screening tools, including the Alcohol Use Disorders Identification Test (AUDIT-C) -- a questionnaire that is considered the standard to reliably diagnose alcohol in the general populations–suffer from low sensitivity if not tailored for women [ 22 – 24 ]. In order to improve case-finding, new screening tools are being developed and deployed [ 25 ]. However, currently, there is a gap in the literature with regard to a gold standard method to identify women Veterans with hazardous substance use, inside and outside of the VHA.…”