Opportunistic screening for alcohol use problems in adolescents attending emergency departments: an evaluation of screening tools

Simon Coulton, M Fasihul Alam, Sadie Boniface, Paolo Deluca, Kim Donoghue, Eilish Gilvarry, Eileen Kaner, Ellen Lynch, Ian Maconochie, Paul Mcardle, Ruth Mcgovern, Dorothy Newbury-birch, Robert Patton, Ceri J Phillips, Thomas Phillips, Hannah Rose, Ian Russell, John Strang, Colin Drummond

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Abstract

Objective
To estimate and compare the optimal cut-off score of Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-C in identifying at-risk alcohol consumption, heavy episodic alcohol use, ICD-10 alcohol abuse and alcohol dependence in adolescents attending ED in England.
Design
Opportunistic cross-sectional survey.
Setting
10 emergency departments across England.
Participants
Adolescents (n = 5377) aged between their 10th and 18th birthday who attended emergency departments between December 2012 and May 2013.
Measures
Scores on the AUDIT and AUDIT-C. At-risk alcohol consumption and monthly episodic alcohol consumption in the past 3 months were derived using the time-line follow back method. Alcohol abuse and alcohol dependence was assessed in accordance with ICD-10 criteria using the MINI-KID.
Findings
AUDIT-C with a score of 3 was more effective for at-risk alcohol use (AUC 0.81; sensitivity 87%, specificity 97%), heavy episodic use (0.84; 76%, 98%) and alcohol abuse (0.98; 91%, 90%). AUDIT with a score of 7 was more effective in identifying alcohol dependence (0.92; 96%, 94%).
Conclusions
The 3-item AUDIT-C is more effective than AUDIT in screening adolescents for at-risk alcohol use, heavy episodic alcohol use and alcohol abuse. AUDIT is more effective than AUDIT-C for the identification of alcohol dependence.
Original languageEnglish
Pages (from-to)e53-e60
Number of pages8
JournalJournal of Public Health
Volume41
Issue number1
DOIs
Publication statusPublished - 31 Mar 2018

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