The Alcohol Use Disorders Identification Test (AUDIT): validation of a screening instrument for use in medical settings.

TLDR

AUDIT is a 10‑item Core and 8‑item Clinical questionnaire designed to identify hazardous, harmful, and dependent drinkers. The study assessed the concurrent, construct, and discriminant validity of the AUDIT. Sixty‑five known alcoholics and 187 general medical patients completed self‑report questionnaires, diagnostic interviews, physical examinations, and laboratory tests. AUDIT scores correlated with other screening tools and liver enzymes, and ROC analyses demonstrated that both Core and Clinical instruments were sensitive and specific, with the Core outperforming the MAST and Clinical for detecting hazardous and harmful drinking, making it useful for early detection while the Clinical is better for confirming dependence.

Abstract

Objective: The concurrent, construct, and discriminant validity of the Alcohol Use Disorders Identification Test (AUDIT) were evaluated. AUDIT consists of a 10-item Core questionnaire and an 8-item Clinical procedure. AUDIT was designed to identify hazardous drinkers (whose drinking increases their risk of alcohol-related problems, though alcohol-associated harm has not yet occurred); harmful drinkers (who have had recent physical or mental harm from their drinking, but who are not alcohol-dependent); and people with alcohol dependence. Method: Known alcoholics (n = 65) and general medical patients (n = 187) completed self-report questionnaires and underwent a diagnostic interview, physical examination and laboratory testing. Results: AUDIT scores correlated significantly with scores on the MAST and MacAndrew alcoholism screening tests, and with ALAT, ASAT, GGT and MCV levels, which reflect recent heavy drinking. AUDIT scores were correlated with measures of alcoholism vulnerability (e.g., familial alcoholism and sociopathy), and with somatic and affective consequences of drinking. Receiver operating characteristic and discriminant function analyses indicated that the AUDIT Core and Clinical Instruments were sensitive and specific in discriminating alcoholics from medical patients, most of whom were nonalcoholics. The AUDIT Core was superior to the MAST and the AUDIT Clinical in discriminating hazardous drinkers from nonhazardous drinkers. It was also superior to the AUDIT Clinical in discriminating harmful from nonharmful drinkers. Conclusions: The AUDIT Core Instrument is useful for early detection of hazardous or harmful drinking, while the AUDIT Clinical Instrument is better applied to identification and/or confirmation of cases of alcohol dependence.