OBJECTIVE We hoped to confirm the sensitivity and specificity of a single s
creening question far problem drinking: "When was the last time you had mor
e than X drinks in 1 day?", where X=4 for women and X=5 for men.
STUDY DESIGN Cross-sectional study.
POPULATION Adult patients presenting to 3 emergency departments in Boone Co
unty, Missouri, for care within 48 hours of an injury.
OUTCOMES MEASURED The answers to the question were coded as never, more tha
n 12 months ago, 3 to 12 months ago, and within the past 3 months. Problema
tic drinking was defined as either hazardous drinking (identified by a 29-d
ay retrospective interview) or a past-year alcohol use disorder (defined by
questions from the Diagnostic Interview Schedule).
RESULTS There was a 70% participation rate. Of 2517 interviewed patients: 2
9% were hazardous drinkers; 20% had a past-year alcohol use disorder; and 3
5% had either or both. Considering "within the last 3 months" as positive,
the sensitivity of the single question was 86%, and the specificity was 86%
. In men (n=1432), sensitivity and specificity were 88% and 81%; in women,
83% and 91%. Using the 4 answer options for the question, the area under th
e receiver-operating characteristic curve was 0.90. Controlling for age, se
x, tobacco use, injury severity, and breath alcohol level in logistic regre
ssion models changed the findings minimally.
CONCLUSIONS A single question about the last episode of heavy drinking has
clinically useful sensitivity and specificity in detecting hazardous drinki
ng and alcohol use disorders.