A Validation Study of the Brief Alcohol Use Disorder Identification Test (AUDIT): A Brief Screening Tool Derived from the AUDIT

다국어 초록 (Multilingual Abstract)

Background: The prevalence of alcohol use disorder (AUD) is very high in Korea. To identify AUD in the busy practice setting, brevity of screening tools is very important. We derived the brief Alcohol Use Disorders Identification Test (AUDIT)and evaluated its performance as a brief screening test.
Methods: One hundred male drinkers from Kangbuk Samsung Hospital primary care outpatient clinic and psychiatric ward for alcoholism treatment completed questionnaires including the AUDIT, cut down, annoyed, guilty, eye-opener (CAGE), and National Alcoholism Screening Test (NAST) from April to July, 2007. AUD (alcohol abuse and dependence),defined by a physician in accordance with Diagnostic and Statistical Manual of Mental Disorders-IV, was used as a diagnostic criteria. To derive the brief AUDIT, factor analysis was performed using the principal component extraction method with a varimax rotated solution. Receiver operating characteristic (ROC) curve analysis was performed to investigate the discrimination ability of the brief AUDIT. Areas under the ROC curve were compared performance of screening questionnaires with 95% confidence intervals.
Results: The derived brief AUDIT consists of 4 items: frequency of heavy drinking (item 3), impaired control over drinking (item 4), increased salience of drinking (item 5), and alcohol-related injury (item 9). Brief AUDIT exhibited an AUD screening accuracy better than CAGE, and equally to that of NAST. Areas under the ROC curves were 0.87 (0.80–0.94), 0.76(0.66–0.85), and 0.81 (0.73–0.90) for the brief AUDIT, CAGE, and NAST for AUD, and 0.97 (0.95–0.99), 0.93 (0.88–0.98) and 0.93 (0.88–0.98) for alcohol dependence.
Conclusion: The new brief AUDIT seems to be effective in detecting male AUD in the primary care setting in Korea. Further evaluation for women and different age groups is needed.

참고문헌 (Reference)

1 성정환, "일차진료에서 문제음주자 선별을 위한 Alcohol Use Disorders Identification Test Alcohol Consumption Questions (AUDIT-C)의 타당도 조사" 대한가정의학회 30 (30): 695-702, 2009

2 Gordon AJ, "Three questions can detect hazardous drinkers" 50 : 313-320, 2001

3 Kim KB, "The preliminary study of the Korean alcoholism screening test (III)" 30 : 569-581, 1991

4 Hodgson R, "The fast alcohol screening test" 37 : 61-66, 2002

5 Reinert DF, "The alcohol use disorders identification test: an update of research findings" 31 : 185-199, 2007

6 Allen JP, "The alcohol use disorders identification test: an aid to recognition of alcohol problems in primary care patients" 33 : 428-433, 2001

7 Ministry of Health and Welfare, "The Third Korea National Health and Nutrition Examination Survey" Ministry of Health and Welfare 2005

8 Selzer ML, "The Michigan alcoholism screening test: the quest for a new diagnostic instrument" 127 : 1653-1658, 1971

9 Mayfield D, "The CAGE questionnaire: validation of a new alcoholism screening instrument" 131 : 1121-1123, 1974

10 Park SH, "Secular trends in prevalence of alcohol use disorder and its correlates in Korean adults: results from Korea National Health and Nutrition Examination Survey 2005 and 2009" 33 : 327-335, 2012

11 Cherpitel CJ, "Screening for alcohol problems: comparison of the audit, RAPS4 and RAPS4-QF among African American and Hispanic patients in an inner city emergency department" 71 : 275-280, 2003

12 Cherpitel CJ, "Screening for alcohol problems in two emergency service samples in Poland: comparison of the RAPS4, CAGE and AUDIT" 80 : 201-207, 2005

13 Kim JS, "Screening criteria of alcoholism by alcohol use disorders identification test (AUDIT) in Korea" 20 : 1152-1159, 1999

14 Lee CK, "Psychiatric epidemiology in Korea. Part II: Urban and rural differences" 178 : 247-252, 1990

15 Lee CK, "Psychiatric epidemiology in Korea. Part I: Gender and age differences in Seoul" 178 : 242-246, 1990

16 Koh KH, "Estimates of alcohol consumption based on pure alcohol content and their comparison with data of other countries" 6 : 77-86, 2000

17 Piccinelli M, "Efficacy of the alcohol use disorders identification test as a screening tool for hazardous alcohol intake and related disorders in primary care: a validity study" 314 : 420-424, 1997

18 Gomez A, "Diagnostic usefulness of brief versions of Alcohol Use Disorders Identification Test (AUDIT) for detecting hazardous drinkers in primary care settings" 66 : 305-308, 2005

19 Saunders JB, "Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption-- II" 88 : 791-804, 1993

20 Hearne R, "Alcohol abuse: prevalence and detection in a general hospital" 95 : 84-87, 2002

21 Seongho Min, "Alcohol Dependence, Mortality, and Chronic Health Conditions in a Rural Population in Korea" 대한의학회 23 (23): 1-9, 2008

22 Babor TF, "AUDIT: the alcohol use disorders identification test: guidelines for use in primary health care" World Health Organization 2001

23 Allen JP, "A review of research on the Alcohol Use Disorders Identification Test (AUDIT)" 21 : 613-619, 1997