Screening for Unhealthy Alcohol Use with One or Two QuestionsJuly 15, 2005
Research Summary
Simplifying strategies to screen for unhealthy alcohol use (i.e., consumption of risky amounts or an alcohol use disorder) remains a formidable task. One desired outcome of simplification efforts is a briefer screening test. To compare the performances of some brief tests to detect unhealthy alcohol use, investigators screened 1,537 emergency department patients with an acute injury, 1,151 emergency patients with a medical illness, and 1,112 randomly selected people who were contacted by telephone.Researchers asked each subject a question about alcohol consumption in a day ("When was the last time you had more than X drinks in 1 day?" with X being 5 for men and 4 for women); a question about average consumption per occasion; and a standard question about drinking frequency. Diagnostic interviews determined the presence of an alcohol use disorder and validated calendar methods determined drinking amounts.
- The question about consumption in a day, when answered "in the past 3 months," performed the best. Its respective sensitivities and specificities were 85 percent and 70 percent in men and 82 percent and 77 percent in women.
- Findings were similar when screening was conducted in person or by telephone.
Comments by Jeffrey Samet, MD, MA, MPH:This study suggests that asking one straightforward question can identify unhealthy alcohol use, providing yet more evidence of the utility of very brief alcohol screening tests. Further, the efficacy of screening by phone may allow the collection of some alcohol-related data before the clinician-patient encounter.
Reference:
Canagasaby A, Vinson DC. Screening for hazardous or harmful drinking using one or two quantity-frequency questions. Alcohol Alcohol. 2005;40(3):208-213.
Reprinted with permission from Alcohol and Health: Current Evidence.
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