Three questions can detect hazardous drinkers

OBJECTIVE We evaluated the Alcohol Use Disorders Identification Test (AUDIT ), the first 3 questions of the AUDIT (AUDIT-C), the third AUDIT question ( AUDIT-S), and quantity-frequency questions for identifying hazardous drinke rs in a large primary care sample. STUDY DESIGN Cross-sectional survey. POPULATION Patients waiting for care at 12 primary care sites in western Pe nnsylvania from October 1995 to December 1997. OUTCOMES MEASURED Sensitivity, specificity, likelihood ratios, and predicti ve values for the AUDIT, AUDIT-C, and AUDIT-S. RESULTS A total of 13,438 patients were surveyed. Compared with a quantity- frequency definition of hazardous drinking (greater than or equal to 16 dri nks/week for men and 112 drinks/week for women), the AUDIT, AUDIT-C, and AU DIT-S had areas under the receiver-operating characteristic curves (AUROC) of 0.940, 0.949, and 0.871, respectively. The AUROCs of the AUDIT and AUDIT -C were significantly different (P=.004). The AUROCs of the AUDIT-C (P <.00 1) and AUDIT (P <.001) were significantly larger than the AUDIT-3. When com pared with a positive AUDIT score of 8 or higher, the AUDIT-C (score greate r than or equal to3) and the AUDIT-3 (score greater than or equal to1) were 94.9% and 99.6% sensitive and 68.8% and 51.1% specific in detecting indivi duals as hazardous drinkers. CONCLUSIONS In a large primary care sample, a 3-question version of the AUD IT identified hazardous drinkers as well as the full AUDIT when such drinke rs were defined by quantity-frequency criterion. This version of the AUDIT may be useful as an initial screen for assessing hazardous drinking behavio r.