Some clinicians have questioned whether blood tests are better than self-report questionnaires for alcohol screening. To compare these screening methods, researchers in Wales first assessed 1,794 men with the Alcohol Use Disorders Identification Test (AUDIT), a 10-item alcohol screening questionnaire that, for this study, was embedded in a general lifestyle questionnaire. They then conducted blood tests in 112 men who screened positive on the AUDIT (score of 8 or higher) and 82 who screened negative.

• For unhealthy alcohol use, sensitivity and specificity* were highest for the AUDIT (69 percent and 98 percent, respectively).
• For alcohol dependence, sensitivity and specificity were also highest for the AUDIT (84 percent and 83 percent, respectively).
• The cost of identifying a patient with unhealthy alcohol use was lowest for the AUDIT ($12.48, versus four other screening methods ranging from $72.59 to $291.89).**

Comments by Richard Saitz, MD, MPH:

The results of this study confirm that a validated questionnaire is more sensitive, more specific, and cheaper than blood tests, and therefore is the best way to screen for unhealthy alcohol use.

*Sensitivity is the proportion of patients with the disorder that test positive; specificity is the proportion of patients without the disorder who test negative.

**Costs were converted from British pounds to US dollars in early March 2006.

Reference:

Coulton S, Drummond C, James D, et al. Opportunistic screening for alcohol use disorders in primary care: a comparative study. BMJ. 2006;332(7540):511–517.

Reprinted with permission from Alcohol and Health: Current Evidence.