THE FAST ALCOHOL SCREENING TEST

TLDR

The study developed the FAST screening test using AUDIT as the gold standard for busy medical settings. The authors derived a two‑stage four‑item test from AUDIT responses of 666 A&E patients, using principal components analysis and sensitivity/specificity metrics, and then validated it in 100‑patient samples across A&E, fracture clinic, primary health centre, and dental hospital settings. FAST demonstrated good sensitivity and specificity across multiple settings and allows rapid screening, as over half of patients are classified with a single question.

Abstract

— Using the Alcohol Use Disorders Identification Test (AUDIT) as the gold standard, the Fast Alcohol Screening Test (FAST) was developed for use in busy medical settings. AUDIT questionnaires were completed by 666 patients in two London accident & emergency (A&E) departments. Using a principal components analysis, as well as sensitivity and specificity indices, a two-stage screening test was developed, using four of the AUDIT items. The first stage involved one item that identified >50% of patients as either hazardous or non-hazardous drinkers. The second stage made use of the other three items to categorize the rest. The performance of this four-item questionnaire was then tested across a range of settings. Opportunistic samples of 100 patients completed AUDIT questionnaires in each of the following National Health Service settings: A&E department, fracture clinic, primary health centre and a dental hospital. It was concluded that the four-item FAST questionnaire had good sensitivity and specificity, across a range of settings, when the AUDIT score was used as the gold standard. The FAST questionnaire is quick to administer, since >50% of patients are categorized using just one question.