Identification of heavy drinkers by using the early detection of alcohol consumption score

Background: The objective of this study was to evaluate the use of routine blood chemistry and hematology tests to detect heavy drinkers among ambulat ory subjects. Heavy drinkers were defined as subjects who consumed an avera ge of four or more standard drinks per day if male and an average of three or more standard drinks per day if female, for at least 1 month before samp le collection (1 standard drink = 15 ml of absolute ethanol). Methods: A routine blood chemistry panel and the demographic factors of age , sex, and ethnicity were evaluated by using linear discriminant function ( LDF) analysis to classify subjects as heavy drinkers dr light drinkers. The classification was validated by comparison with drinking patterns establis hed by standardized questionnaire and interview. Subjects (n = 807) were ma les and females with known drinking patterns recruited from 25 centers that included detoxification and rehabilitation institutions, churches, and com munity groups in the Milwaukee and Boston areas. Results: With LDF, 88% of the heavy drinkers and 92% of the light drinkers were correctly identified by the Early Detection of Alcohol Consumption tes t. The LDF performed the best when used to identify heavy drinking in ages 30 and above, a group that showed 84% (120 of 143) sensitivity at 97% (152 of 157) specificity. Performance in females showed 73% (76 of 103) sensitiv ity at 94% (129 of 137) specificity, rates higher than obtained with any si ngle biochemical marker previously examined. Receiver operating characteris tic plot analysis showed areas under the curve of 0.94 for females and 0.95 for males (p < 0.0001). Conclusions: The Early Detection of Alcohol Consumption score is a practica l laboratory screen for detecting heavy drinking based on blood constituent s ordered routinely in clinical settings.