Identifying Aboriginal-specific AUDIT-C and AUDIT-3 cutoff scores for at-risk, high-risk, and likely dependent drinkers using measures of agreement with the 10-item Alcohol Use Disorders Identification Test

Addiction Science & Clinical Practice

Bianca Calabria³  Anton Clifford⁶  Anthony P Shakeshaft³  Katherine M Conigrave⁵  Lynette Simpson⁴  Donna Bliss²  Julaine Allan¹ 

[1] The Lyndon Community, Orange, NSW, Australia

[2] Yoorana Gunya Family Healing Centre Aboriginal Corporation, Forbes, NSW, Australia

[3] National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia

[4] Drug Health Services, South Western Sydney Local Health District, Croydon Health Centre, Croydon, NSW, Australia

[5] Sydney Medical School, University of Sydney, Sydney, NSW, Australia

[6] School of Population Health, University of Queensland, Brisbane, QLD, Australia

关键词: Aboriginal;    Measures;    Alcohol;    AUDIT-3;    AUDIT-C;    AUDIT;   

Others  :  1082107
DOI  :  10.1186/1940-0640-9-17

 received in 2013-08-29, accepted in 2014-08-20,  发布年份 2014

【 摘 要 】

Background

The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item alcohol screener that has been recommended for use in Aboriginal primary health care settings. The time it takes respondents to complete AUDIT, however, has proven to be a barrier to its routine delivery. Two shorter versions, AUDIT-C and AUDIT-3, have been used as screening instruments in primary health care. This paper aims to identify the AUDIT-C and AUDIT-3 cutoff scores that most closely identify individuals classified as being at-risk drinkers, high-risk drinkers, or likely alcohol dependent by the 10-item AUDIT.

Methods

Two cross-sectional surveys were conducted from June 2009 to May 2010 and from July 2010 to June 2011. Aboriginal Australian participants (N = 156) were recruited through an Aboriginal Community Controlled Health Service, and a community-based drug and alcohol treatment agency in rural New South Wales (NSW), and through community-based Aboriginal groups in Sydney NSW. Sensitivity, specificity, and positive and negative predictive values of each score on the AUDIT-C and AUDIT-3 were calculated, relative to cutoff scores on the 10-item AUDIT for at-risk, high-risk, and likely dependent drinkers. Receiver operating characteristic (ROC) curve analyses were conducted to measure the detection characteristics of AUDIT-C and AUDIT-3 for the three categories of risk.

Results

The areas under the receiver operating characteristic (AUROC) curves were high for drinkers classified as being at-risk, high-risk, and likely dependent.

Conclusions

Recommended cutoff scores for Aboriginal Australians are as follows: at-risk drinkers AUDIT-C ≥ 5, AUDIT-3 ≥ 1; high-risk drinkers AUDIT-C ≥ 6, AUDIT-3 ≥ 2; and likely dependent drinkers AUDIT-C ≥ 9, AUDIT-3 ≥ 3. Adequate sensitivity and specificity were achieved for recommended cutoff scores. AUROC curves were above 0.90.

【 授权许可】

   
2014 Calabria et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】

• [1]Laslett A-M, Catalano P, Chikritzhs T, Dale C, Doran C, Ferris J, Jainullabudeen T, Livingston M, Matthews S, Mugavin J, Room R, Schlotterlein M, Wilkinson C: The Range and Magnitude of Alcohol's Harm to Others. AER Centre for Alcohol Policy Research, Turning Point Alcohol and Drug Centre, Eastern Health: Canberra; 2010.
• [2]Australian Department of Human Services and Health: National Drug Strategy Household Survey: Urban Aboriginal and Torres Strait Islander Peoples Supplement 1994. Canberra: Australian Government Publishing Service; 1995.
• [3]Calabria B, Doran CM, Vos T, Shakeshaft AP, Hall W: Epidemiology of alcohol-related burden of disease among Indigenous Australians. Aust N Z J Public Health 2010, 34:S47-S51.
• [4]Australian Government Department of Health and Ageing: Helping You To Stay Healthy: Information on the Aboriginal and Torres Strait Islander Adult Health Check. Canberra: Australian Government Publishing Service; 2004.
• [5]Australian Government Department of Health and Ageing: Alcohol Treatment Guidelines for Indigenous Australians. Canberra: Commonwealth of Australia; 2007.
• [6]NACCHO and the Chronic Disease Alliance of NGOs: The well person's health check. In Aboriginal Primary Health Care: An Evidence-Based Approach. 3rd edition. Edited by Couzos S, Murray R. South Melbourne: Oxford University Press; 2008:131-194.
• [7]Clifford A, Shakeshaft A: Evidence-based alcohol screening and brief intervention in Aboriginal community controlled health services: experiences of health-care providers. Drug Alcohol Rev 2011, 30:55-62.
• [8]Conigliaro J, Lofgren RP, Hanusa BH: Screening for problem drinking: impact on physician behavior and patient drinking habits. J Gen Intern Med 1998, 13:251-256.
• [9]Jenkins R, McAlaney J, McCambridge J: Change over time in alcohol consumption in control groups in brief intervention studies: systematic review and meta-regression study. Drug Alcohol Depend 2009, 100:107-114.
• [10]Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M: Development of the alcohol use disorders idenfication test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction 1993, 88:791-804.
• [11]Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG: The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care. 2nd edition. Geneva: World Health Organization; 2001.
• [12]Conigrave KM, Hall WD, Saunders JB: The AUDIT questionnaire: choosing a cutoff score, alcohol use disorders identification test. Addiction 1995, 90:1349-1356.
• [13]Tsai M-C, Tsai T-F, Chen C-Y, Liu C-Y: Alcohol use disorders identification test (AUDIT): establishment of cutoff scores in a hospitalized Chinese population. Alcohol Clin Exp Res 2005, 29:53-57.
• [14]Reinert DF, Allen JP: The alcohol use disorders identification test: an update of research findings. Alcohol Clin Exp Res 2007, 31:185-199.
• [15]Brady M, Sibthorpe B, Bailie R, Ball S, Sumnerdodd P: The feasibility and acceptability of introducing brief intervention for alcohol misuse in an urban Aboriginal medical service. Drug Alcohol Rev 2002, 21:375-380.
• [16]Hearne R, Connolly A, Sheehan J: Alcohol abuse: prevalence and detection in a general hospital. J R Soc Med 2002, 95:84-87.
• [17]American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. 4th edition. Washington DC; 1994.
• [18]Britt H, Miller GC, Charles J, Henderson J, Bayram C, Pan Y, Valenti L, Harrison C, Fahridin S, O'Halloran J: General practice activity in Australia 2008–09: BEACH bettering the evaluation and care of health. In AIHW cat no GEP 25. Canberra: Australian Institute of Health and Welfare; 2009.
• [19]Calabria B, Clifford A, Shakeshaft A, Allan J, Bliss D, Doran C: The acceptability to Aboriginal Australians of a family-based intervention to reduce alcohol-related harms. Drug Alcohol Rev 2013, 32:328-332.
• [20]Conigrave K, Freeman B, Caroll T, Simpson L, Lee K, Wade V, Kiel K, Ella S, Becker K, Freeburn B: The Alcohol Awareness project: community education and brief intervention in an urban Aboriginal setting. Health Promotion J Austr 2012, 23:219-225.
• [21]Lemeshow S, Hosmer DW Jr, Klar J, Lwanga SK: Adequacy of Sample Size in Health Studies. Chichester: John Wiley & Sons Inc.; 1990.
• [22]Metz CE: Basic principles of ROC analysis. Seminars in Nuclear Medicine 1978, 8:283-298.
• [23]IBM: SPSS Statistics 19. 2010.
• [24]Microsoft: Excel. 2007.
• [25]National Health and Medical Research Council: Australian guidelines to reduce health risks from drinking alcohol. Canberra: Commonwealth of Australia; 2009.
• [26]Lee KSK, Dawson A, Conigrave KM: The role of an Aboriginal women’s group in meeting the high needs of clients attending outpatient alcohol and other drug treatment. Drug Alcohol Rev 2013, 32:618-626.
• [27]Hogan TP: Psychological Testing: A Practical Introduction. United States: John Wiley & Sons Inc.; 2003.
• [28]National Institute on Alcohol Abuse and Alcoholism: Assessing Alcohol Problems: A Guide for Clinicians and Researchers. Bethesda: National Institutes of Health; 1995.
• [29]Neumann T, Linnen H, Kip M, Grittner U, Weiβ-Gerlach E, Kleinwächter R, MacGuill M, Mutzke S, Spies C: Does the alcohol use disorders identification test-consumption identify the same patient population as the full 10-item alcohol use disorders identification test? J Subst Abuse Treat 2012, 43:80-85.