EFFICACY OF THE ALCOHOL-USE DISORDERS IDENTIFICATION TEST AS A SCREENING TOOL FOR HAZARDOUS ALCOHOL INTAKE AND RELATED DISORDERS IN PRIMARY-CARE - A VALIDITY STUDY

Objective: To determine the properties of the alcohol use disorders id entification test in screening primary care attenders for alcohol prob lems. Design: A validity study among consecutive primary care attender s aged 18-65 years. Every third subject completed the alcohol use diso rders identification test (a 10 item self report questionnaire on alco hol intake and related problems) and nas interviewed by an investigato r with the composite international diagnostic interview alcohol use mo dule (a standardised interview for the independent assessment of alcoh ol intake and related disorders). Setting: 10 primary care clinics in Verona, north eastern Italy. Patients: 500 subjects were approached an d 482 (96.4%) completed evaluation. Results: When the alcohol use diso rders identification test nas used to detect subjects with alcohol pro blems the area under the receiver operating characteristic curve was 0 .95. The cut off score of 5 was associated with a sensitivity of 0.84, a specificity of 0.90, and a positive predictive value of 0.60. The s creening ability of the total score derived from summing the responses to the five items minimising the probability of misclassification bet ween subjects with and without alcohol problems provided an area under the receiver operating characteristic curve of 0.93. A score of 5 or more on the five items was associated with a sensitivity of 0.79, a sp ecificity of 0.95, and a positive predictive value of 0.73. Conclusion s: The alcohol use disorders identification test performs well in dete cting subjects with formal alcohol disorders and those with hazardous alcohol intake. Using five of the 10 items on the questionnaire gives reasonable accuracy, and these are recommended as questions of choice to screen patients for alcohol problems.