Using the alcohol use disorders identification test to predict hospital admission for alcohol‐related conditions in the Danish general population: a record‐linkage study

Abstract

Background and Aims Most studies validating the alcohol use disorders identification test (AUDIT) have either assessed its factor structure and/or test–retest reliability or used diagnostic interviews as validators of current alcohol use disorders. The aim of the present study was to determine whether AUDIT and AUDIT‐Consumption (AUDIT‐C) scores are associated with subsequent risk of hospital admission for alcohol‐related disorders and diseases (ARDDs). Design We used a historical cohort study. Using national registers, survey respondents were tracked from 1 September 2011 to hospitalization for an ARDD, emigration, death, or 31 December 2018, whichever occurred first. Setting Denmark. Participants Respondents (n = 4522) from a Danish national survey conducted in autumn 2011. Measurements Outcome was incident ARDD admission recorded in the National Patient Register. Predictors were AUDIT and AUDIT‐C scores, and covariates were age, gender, highest level of education and previous psychiatric disorder. Findings During the study period, 56 respondents had a first‐time ARDD admission. Respondents who scored above the 8‐point AUDIT cut‐off and respondents who scored above the 5‐point AUDIT‐C cut‐off had a significantly increased risk of being admitted for an ARDD compared with respondents who scored below the cut‐offs, (AUDIT: hazard ratio (HR), 4.72; 95% CI, 2.59–8.60; AUDIT‐C: HR, 7.97; 95% CI, 3.66–17.31). Conclusions Scores above alcohol use disorders identification test (AUDIT) and AUDIT‐Consumption (AUDIT‐C) cut‐offs are associated with an increased risk of long‐term alcohol‐related hospital admissions. At widely used cut‐offs, the AUDIT‐C is a better predictor of alcohol‐related hospitalizations among members of the general population than the full AUDIT.

Impact of personalized alcohol intake and cognitive feedback on alcohol use behavior in hazardous drinkers: A quasi‐randomized trial

“…This level of intake has a profound impact as a contributor to burden of disease and mortality. Evidence has long suggested individuals who consume alcohol at hazardous levels are at greater risk of developing alcohol‐related disorders and diseases, hospitalization, and death (Au et al, 2007; Brummer et al, 2022; Conigrave et al, 1995; Kuitunen‐Paul & Roerecke, 2018; Liskola et al, 2021). Each year, 132.6 million healthy years (disability‐adjusted life years) are lost to alcohol, while alcohol consumption accounts for 5.3% of all deaths (WHO, 2018).…”

Commentary on Brummer et al.: When using screening tools, it is important to be aware of what you are screening for

“…The issues inherent to any scale measuring interrelated constructs with one score should also be considered. As demonstrated by Brummer et al [1], a given subscale of the AUDIT may add nothing or even take away from the predictive value of the scale, depending on the outcome. Future work considering the independent measurement of distinct alcohol-related constructs is critical.…”

“…predicting future alcohol-related hospitalisations than the full AUDIT (10 items assessing consumption, dependence and harmful drinking) [1]. The authors concluded that this may indicate that the shorter AUDIT-C is equally as useful as the AUDIT as a screening tool, especially in circumstances when time is limited.…”

“…Their high score on the AUDIT-C will be counterbalanced by their low score on the other two subscales. As demonstrated by Brummer et al [1], the inclusion of these other two subscales would add nothing or even take away from the prediction of an outcome that was primarily based on outcomes from consumption, rather than dependence or harm.…”

“…Using a large, representative Danish sample, Brummer et al . have found that the Alcohol Use Disorders Identification Test‐Concise (AUDIT‐C) (three survey items assessing consumption) is better at predicting future alcohol‐related hospitalisations than the full AUDIT (10 items assessing consumption, dependence and harmful drinking) [ 1 ]. The authors concluded that this may indicate that the shorter AUDIT‐C is equally as useful as the AUDIT as a screening tool, especially in circumstances when time is limited.…”