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Reliability and Validity of the Alcohol Use Disorders Identification Test - Consumption in Screening for Adults with Alcohol Use Disorders and Risky Drinking In Japan

  • Osaki, Yoneatsu (Division of Environmental and Preventive Medicine, Tottori University, Faculty of Medicine) ;
  • Ino, Aro (Kasumigaura Clinic) ;
  • Matsushita, Sachio (National Hospital Organization, Kurihama Medical and Addiction Center) ;
  • Higuchi, Susumu (National Hospital Organization, Kurihama Medical and Addiction Center) ;
  • Kondo, Yoko (Division of Environmental and Preventive Medicine, Tottori University, Faculty of Medicine) ;
  • Kinjo, Aya (Division of Environmental and Preventive Medicine, Tottori University, Faculty of Medicine)
  • Published : 2014.08.30

Abstract

Background: Alcohol is well established as a risk factor for cancer development in many organ sites. To assess the reliability and validity of the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) for detecting alcohol use disorders or risky drinking in Japanese adults the present study was conducted. Materials and Methods: A test-retest method was applied with a 2-week interval with 113 health care employees. The k coefficient, Cronbach's coefficient alpha, Spearman's correlation coefficient, and intraclass correlation coefficient (ICC) were determined and the validity of the AUDIT-C was analyzed using the data from a nationwide survey on adult alcohol use conducted in 2008 (n=4,123). Results: The reliability of the AUDIT-C score was high (${\kappa}$ coefficient=0.63, Cronbach's alpha=0.98, correlation coefficient=0.95, and ICC=0.95). According to the likelihood ratio and Youden index, appropriate cutoffs for the AUDIT-C were ${\geq}5points$ in men and ${\geq}4$ points in women. The sensitivity and specificity of these cutoffs for identifying ${\geq}8$ points on the AUDIT were 0.88 and 0.80, respectively, for men (positive likelihood ratio [LR+]=4.5) and 0.96 and 0.87, respectively, for women (LR+=7.7). The sensitivity and specificity of the cutoffs for identifying ${\geq}12$ points on the AUDIT were 0.90 and 0.84, respectively, for men (LR+=5.8) and 0.93 and 0.94, respectively, for women (LR+=15.8). The sensitivity and specificity of the cutoffs for identifying ${\geq}16$ points on the AUDIT were 0.93 and 0.80, respectively, for men (LR+=4.7) and 0.92 and 0.98, respectively, for women (LR+=55.6). With higher scores on the AUDIT, the specificity decreased and false-positives increased. The appropriate cutoffs for identifying risky drinking were the same for both genders. Conclusions: The reliability and validity of the AUDIT-C are high, indicating that it is useful for identifying alcohol use disorders or risky drinking among the general population in Japan, a group at high risk of cancer development.

Keywords

AUDIT-C;alcohol use disorders;alcohol use disorders identification test;screening;risk drinking

Acknowledgement

Supported by : Ministry of Health Labour and Welfare

References

  1. Akobeng AK (2007). Understanding diagnostic tests 3: receiver operating characteristic curves. Acta Paediatr, 96, 644-7. https://doi.org/10.1111/j.1651-2227.2006.00178.x
  2. Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG, World health organization dept of mental health and substance dependence (2001). audit: the alcohol use disorders identification test: guidelines for use in primary health care. 2nd ed. World Health Organization, Geneva.
  3. Bradley KA, DeBenedetti AF, Volk RJ, et al (2007). AUDIT-C as a brief screen for alcohol misuse in primary care. Alcohol Clin Exp Res, 31, 1208-17. https://doi.org/10.1111/j.1530-0277.2007.00403.x
  4. Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA (1998). The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. ambulatory care quality improvement project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med, 158, 1789-95. https://doi.org/10.1001/archinte.158.16.1789
  5. Crawford EF, Fulton JJ, Swinkels CM, et al (2013). Diagnostic efficiency of the AUDIT-C in U.S. veterans with military service since September 11, 2001. Drug Alcohol Depend, 132, 101-6. https://doi.org/10.1016/j.drugalcdep.2013.01.012
  6. Dawson DA, Grant BF, Stinson FS, Zhou Y (2005). Effectiveness of the derived alcohol use disorders identification test (audit-c) in screening for alcohol use disorders and risk drinking in the US general population. Alcohol Clin Exp Res, 29, 844-54. https://doi.org/10.1097/01.ALC.0000164374.32229.A2
  7. Dawson DA, Smith SM, Saha TD, Rubinsky AD, Grant BF (2012). Comparative performance of the AUDIT-C in screening for DSM-IV and DSM-5 alcohol use disorders. Drug Alcohol Depend, 126, 384-8. https://doi.org/10.1016/j.drugalcdep.2012.05.029
  8. de Menezes RF, Bergmann A, Thuler LC (2013). Alcohol consumption and risk of cancer: a systematic literature review. Asian Pac J Cancer Prev, 14, 4965-72. https://doi.org/10.7314/APJCP.2013.14.9.4965
  9. Frank D, DeBenedetti AF, Volk RJ, et al (2008). Effectiveness of the AUDIT-C as a screening test for alcohol misuse in three race/ethnic groups. Gen Intern Med, 23, 781-7. https://doi.org/10.1007/s11606-008-0594-0
  10. Gomez A, Conde A, Santana JM, et al (2006). The diagnostic usefulness of AUDIT and AUDIT-C for detecting hazardous drinkers in the elderly. Aging Ment Health, 10, 558-61. https://doi.org/10.1080/13607860600637729
  11. Johnson JA, Lee A, Vinson D, Seale JP (2013). Use of AUDITbased measures to identify unhealthy alcohol use and alcohol dependence in primary care: a validation study. Alcohol Clin Exp Res, 37, 253-9. https://doi.org/10.1111/j.1530-0277.2012.01898.x
  12. Kaarne T, Aalto M, Koukkanen M, Seppa K (2010). AUDIT-C, AUDIT-3 and AUDIT-QF in screening risky drinking among Finnish occupational health-care patients. Drug Alcohol Rev, 29, 563-7. https://doi.org/10.1111/j.1465-3362.2010.00172.x
  13. Kelly TM, Dnovan JE, Chung T, Bukstein OG, Cornelius JR (2009). Brief screens for detecting alcohol use disorder among 18-20 year old young adults inn emergency departments: comparing AUDIT-C, CRAFFT, RAPS4-QF, FAST, RUFT-Cut, and DSM-IV 2-item scale. Addict Behav, 34, 668-74. https://doi.org/10.1016/j.addbeh.2009.03.038
  14. Nordqvist C, Johansson K, Bendtsen P (2004). Routine screening for risky alcohol consumption at an emergency department using the AUDIT-C questionnaire. Drug Alcohol Depend, 74, 71-5. https://doi.org/10.1016/j.drugalcdep.2003.11.010
  15. Osaki Y, Matsushita S, Shirasaka T, Hiro H, Higuchi S (2005). Nationwide survey of alcohol drinking and alcoholism among Japanese adults. Nihon Arukoru Yakubutsu Igakkai Zasshi, 40, 455-70.
  16. Osaki Y, Higuchi S, Matsushita S, Kishimoto T (2012). Social costs of alcohol misuse in Japan. Japanese Journal of Hygiene, 67, 320.
  17. Osaki Y (2013). Trends in drinking behavior and alcoholrelated disorders in Japan. Progress I Medicine, 33, 803-7.
  18. Rodriguez-Martos A, Santamarina E (2007). Does the short form of the Alcohol Use Disorders Identification Test (AUDIT-C) work at a trauma emergency department? Subst Use Misuse, 42, 923-32. https://doi.org/10.1080/10826080701351507
  19. Towers A, Stephens C, Dulin P, et al (2011). Estimating older hazardous and binge drinking prevalence using AUDIT-C and AUDIT-3 thresholds specific to older adults. Drug Alcohol Depend, 117, 211-218. https://doi.org/10.1016/j.drugalcdep.2011.02.008
  20. Tuunanen M, Aalto M, Seppa K (2007). Binge drinking and its detection among middle-aged men using AUDIT, AUDIT-C and AUDIT-3. Drug Alcohol Rev, 26, 295-299. https://doi.org/10.1080/09595230701247756
  21. WHO (2009). Global health risks: mortality and burden of disease attributable to selected major risks. World Health Organization, Geneva.
  22. Yaegashi Y, Onoda T, Morioka S, et al (2014). Joint effects of smoking and alcohol drinking on esophageal cancer mortality in Japanese men: findings from the Japan collaborative cohort study. Asian Pac J Cancer Prev, 15, 1023-9. https://doi.org/10.7314/APJCP.2014.15.2.1023
  23. Youden WJ (1950). Index for rating diagnostic tests. Cancer, 3, 32-5. https://doi.org/10.1002/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3

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