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

J Public Health (Oxf). 2019 Mar 1;41(1):e53-e60. doi: 10.1093/pubmed/fdy049.

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.

Keywords: adolescent; alcohol; diagnosis; screening.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Alcoholism / diagnosis*
  • Alcoholism / epidemiology
  • Child
  • Cross-Sectional Studies
  • Emergency Service, Hospital
  • England / epidemiology
  • Female
  • Humans
  • Male
  • Psychiatric Status Rating Scales / standards*
  • Sensitivity and Specificity