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Evidence-based assessment/Instruments/Alcohol Use Disorders Identification Test

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Wikipedia has more about this subject: Alcohol Use Disorders Identification Test

The Alcohol Use Disorders Identification Test (AUDIT) is a ten-question test developed by a World Health Organization-sponsored collaborative project to determine if a person may be at risk for alcohol abuse problems [1]. The test was designed to be used internationally, and was validated in a study drawing patients from six countries [1]. It performs well in medical settings like primary health care, outpatient settings, and hospital units [2].

The AUDIT alcohol consumption questions (AUDIT-C) is a 3-question screening test for problem drinking used frequently in primary care settings [3].

Psychometrics

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Reliability

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Evaluation for norms and reliability for the AUDIT
Criterion Rating (adequate, good, excellent) Explanation with references
Norms Good Multiple studies tested AUDIT for possible sex[4], ethnic[5], and age[6] differences
Internal consistency Good A review of 18 studies reported a median Cronbach's alpha of 0.8[7]
Test-retest reliability Good r = 0.81 among 126 primary care patients over 6 weeks[8]; 69% to 89% of subjects fall into the same category after 6-week interval[8]
Inter-rater reliability Not applicable Can be completed as a clinician-administered interview or a self-report questionnaire

Validity

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Evaluation of validity and utility for the AUDIT
Criterion Rating (adequate, good, excellent) Explanation with references
Content validity Good Covers drinking behaviors, adverse psychological reactions, alcohol-related problems, and alcohol consumption[1]
Construct validity Good Studies generally supported a two-factor model with a consumption factor and an adverse consequences of drinking factor[9]
Validity generalization Excellent Used both as a clinician-administered interview and a self-report questionnaire; used in college students[10] and psychiatric patients[11]; translated into multiple languages with satisfactory psychometric qualities[11]

Scoring and interpretation

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Scoring the AUDIT is based on a 0-4 point scale. Six of the ten questions ask about the frequency of certain alcohol abuse behaviors and are scored by the following responses:

  • 0 points: "Never"
  • 1 point: "Less than monthly"
  • 2 points: "Monthly"
  • 3 points: "Weekly"
  • 4 points: "Daily, or almost daily"

The other four questions vary in participant response choice but are scored on a 0-4 point scale.

Item breakdown

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The questions measure different domains of alcohol consumption problems. The breakdown is as follows:

  • 1-3: Measure frequency in alcohol consumption
  • 4-6: Measure alcohol dependence
  • 7-10: Measure alcohol related problems

Interpretation of scores

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In order to score the AUDIT, point values of each answer choice are summed together and then interpreted based on the following criteria.

  • A score of 8 or more in men (7 in women) indicates a strong likelihood of hazardous or harmful alcohol consumption.
  • A score of 20 or more is suggestive of alcohol dependence (although some authors quote scores of more than 13 in women and 15 in men as indicating likely dependence).[12]
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References

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  1. ↑ 1.0 1.1 1.2 Saunders, JB; Aasland, OG; TF, Babor; de la Fuente, JR; Grant, M (1993). "Development of the Alcohol Use Disorders Identification Test (AUDIT):WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption 1.". Addiction 88 (12): 791–804. doi:10.1111/j.1360-0443.1993.tb02093.x. PMID 8329970. 
  2. ↑ Bohn, MJ; Babor, TF; Kranzler, HR. (July, 1995). "The Alcohol Use Disorders Identification Test (AUDIT): validation of a screening instrument for use in medical settings". Journal of studies on alcohol, 56 (4), 423-432. doi:10.15288/jsa.1995.56.423
  3. ↑ Bush, K; Kivlahan, DR; McDonell, MB; Fihn, SD; Bradley, KA; Ambulatory Care Quality Improvement Project. (September, 1998). "The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking". Archives of internal medicine, 158 (16):1789-1795. doi:10.1001/archinte.158.16.1789
  4. ↑ Cherpitel, CJ. (January, 1995). "Analysis of cut points for screening instruments for alcohol problems in the emergency room.". Journal of studies on alcohol, 56 (6): 695-700.
  5. ↑ Cherpitel, CJ. (1998). "Differences in performance of screening instruments for problem drinking among blacks, whites and Hispanics in an emergency room population.". Journal of Studies on Alcohol, 59 (4): 420-426.
  6. ↑ Foster, AI; Blondell, RD; Looney, SW. (March, 1997). "The practicality of using the SMAST and AUDIT to screen for alcoholism among adolescents in an urban private family practice.". The Journal of the Kentucky Medical Association, 95 (3): 105-107.
  7. ↑ Reinert, DF; Allen, JP. (April, 2002). "The alcohol use disorders identification test (AUDIT): a review of recent research.". Alcoholism: Clinical and Experimental Research, 26 (2): 272-279.
  8. ↑ 8.0 8.1 Daeppen, JB; Yersin, B; Landry, U; Pécoud, A; Decrey, H. (April, 2000). "Reliability and validity of the Alcohol Use Disorders Identification Test (AUDIT) imbedded within a general health risk screening questionnaire: results of a survey in 332 primary care patients.". Alcoholism: Clinical and Experimental Research, 24 (5): 659-665.
  9. ↑ de Meneses-Gaya, C; Zuardi, AW; Loureiro, SR; Crippa, JAS. (2009). "Alcohol Use Disorders Identification Test (AUDIT): An updated systematic review of psychometric properties." Psychology & Neuroscience, 2 (1): 83.
  10. ↑ Kokotailo, PK; Egan, J; Gangnon, R; Brown, D; Mundt, M; Fleming, M. (May, 2004). "Validity of the alcohol use disorders identification test in college students.". Alcoholism: Clinical and Experimental Research, 28 (6): 914-920.
  11. ↑ 11.0 11.1 Reinert, DF; Allen, JP. (January, 2007). "The alcohol use disorders identification test: an update of research findings.". Alcoholism: Clinical and Experimental Research, 31 (2): 185-199.
  12. ↑ AUDIT: The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Care, second edition, by Thomas F. Babor, John C. Higgins-Biddle, John B. Saunders, and Maristela G. Monteiro. Retrieved June 24, 2006.


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