The effect of screening on prevalence estimates of alcohol dependence and social consequences

Objective: Screener items are often used in surveys to identify individuals who are at high risk of experiencing alcohol dependence or alcohol-related problems. The purpose of this study is to determine the effect of two scre ener items (5 or more drinks ever and greater than or equal to 12 drinks la st year) on prevalence estimates of alcohol dependence and negative social consequences. Method: The 1995 National Alcohol Survey data were analyzed. Differences in prevalence estimates between the unscreened current drinkers (n = 2,817) and the two screened samples: 5+ ever (n = 2,186) and greater than or equal to 12 drinks last year (n = 2,126) were compared. For each sc reened sample, prevalence estimates obtained from two base populations (scr eened positives only and all current drinkers assuming no alcohol-related p roblems among screened negatives) were examined. Results: Comparisons of pr evalence estimates of alcohol dependence and negative social consequences a cross the screened and unscreened samples revealed little bias in estimates with one exception. The only significant difference between the unscreened and screened samples was found among women when prevalence rates were obta ined from data of screened positive respondents only. Conclusions: The effe ct of screening on national prevalence estimates of alcohol dependence and social consequences is small. Less bias in prevalence estimates is found wh en negatively screened light drinkers were assumed to report no alcohol-rel ated problems rather than excluded from the estimation sample.