The AUDIT Alcohol Consumption Questions (AUDIT-C)<subtitle>An Effective Brief Screening Test for Problem Drinking</subtitle>

TLDR

The study evaluates the AUDIT‑C as a brief screening tool for heavy drinking and/or active alcohol abuse or dependence. The authors mailed AUDIT‑C questionnaires to patients at three VA clinics, then conducted telephone interviews with a weighted sample of heavy drinkers (N = 447) to compute AUROCs comparing AUDIT‑C and the full AUDIT against heavy drinking, abuse/dependence, or either criteria. AUDIT‑C achieved higher accuracy for heavy drinking (AUROC 0.891 vs 0.881, P = .03) and comparable performance for combined heavy drinking or abuse/dependence (AUROC 0.880 vs 0.881), supporting its use as a practical primary‑care screening test.

Abstract

<h3>Objective</h3> To evaluate the 3 alcohol consumption questions from the Alcohol Use Disorders Identification Test (AUDIT-C) as a brief screening test for heavy drinking and/or active alcohol abuse or dependence. <h3>Methods</h3> Patients from 3 Veterans Affairs general medical clinics were mailed questionnaires. A random, weighted sample of Health History Questionnaire respondents, who had 5 or more drinks over the past year, were eligible for telephone interviews (N=447). Heavy drinkers were oversampled 2:1. Patients were excluded if they could not be contacted by telephone, were too ill for interviews, or were female (n=54). Areas under receiver operating characteristic curves (AUROCs) were used to compare mailed alcohol screening questionnaires (AUDIT-C and full AUDIT) with 3 comparison standards based on telephone interviews: (1) past year heavy drinking (&gt;14 drinks/week or ≥5 drinks/occasion); (2) active alcohol abuse or dependence according to the<i>Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition</i>, criteria; and (3) either. <h3>Results</h3> Of 393 eligible patients, 243 (62%) completed AUDIT-C and interviews. For detecting heavy drinking, AUDIT-C had a higher AUROC than the full AUDIT (0.891 vs 0.881;<i>P</i>=.03). Although the full AUDIT performed better than AUDIT-C for detecting active alcohol abuse or dependence (0.811 vs 0.786;<i>P</i>&lt;.001), the 2 questionnaires performed similarly for detecting heavy drinking and/or active abuse or dependence (0.880 vs 0.881). <h3>Conclusions</h3> Three questions about alcohol consumption (AUDIT-C) appear to be a practical, valid primary care screening test for heavy drinking and/or active alcohol abuse or dependence.