THE AUDIT ALCOHOL-CONSUMPTION QUESTIONS - RELIABILITY, VALIDITY, AND RESPONSIVENESS TO CHANGE IN OLDER MALE PRIMARY-CARE PATIENTS

Objectives: To determine the reliability, validity, and responsiveness to change of AUDIT (Alcohol Use Disorders Identification Test) questi ons 1 to 3 about alcohol consumption in a primary care setting. Patien ts: Randomly selected, male general medical patients (n = 441) from th ree VA Medical Centers, who had 5 or more drinks containing alcohol in the past year and were willing to be interviewed about their hearth h abits, Measures: Three self-administered AUDIT consumption questions w ere compared with a telephone-administered version of the trilevel Wor ld Health Organization interview about alcohol consumption. Results: O f 393 eligible patients, 264(67%) completed interviews, Test-retest re liability-Correlations between baseline and repeat measures 3 months l ater for four dimensions of consumption according to the AUDIT, ranged from 0.65 to 0.85 among patients who indicated they had not changed t heir drinking (Kendall's Tau-b), Criterion validity-Correlations betwe en AUDIT and interview for four dimensions of alcohol consumption rang ed from 0.47 to 0.66 (Kendall's Tau-b), Discriminative validity - The AUDIT questions were specific (90 to 93%), but only moderately sensiti ve (54 to 79%), for corresponding criteria for heavy drinking. Respons iveness to change - The AUDIT consumption questions had a Guyatt respo nsiveness statistic of 1.04 for detecting a change of 7 drinks/week, s uggesting excellent responsiveness to change. Conclusions: AUDIT quest ions 1 to 3 demonstrate moderate to good validity, but excellent relia bility and responsiveness to change. Although they often underestimate heavy alcohol consumption according to interview, they performed adeq uately to be used as a proxy measure of consumption in a clinical tria l of heavy drinkers in this population.