Dataset Information

Using the alcohol use disorders identification test to predict hospital admission for alcohol-related conditions in the Danish general population: a record-linkage study.

ABSTRACT:

Background and aims

Most studies validating the alcohol use disorders identification test (AUDIT) have either assessed its factor structure and/or test-retest reliability or used diagnostic interviews as validators of current alcohol use disorders. The aim of the present study was to determine whether AUDIT and AUDIT-Consumption (AUDIT-C) scores are associated with subsequent risk of hospital admission for alcohol-related disorders and diseases (ARDDs).

Design

We used a historical cohort study. Using national registers, survey respondents were tracked from 1 September 2011 to hospitalization for an ARDD, emigration, death, or 31 December 2018, whichever occurred first.

Setting

Denmark.

Participants

Respondents (n = 4522) from a Danish national survey conducted in autumn 2011.

Measurements

Outcome was incident ARDD admission recorded in the National Patient Register. Predictors were AUDIT and AUDIT-C scores, and covariates were age, gender, highest level of education and previous psychiatric disorder.

Findings

During the study period, 56 respondents had a first-time ARDD admission. Respondents who scored above the 8-point AUDIT cut-off and respondents who scored above the 5-point AUDIT-C cut-off had a significantly increased risk of being admitted for an ARDD compared with respondents who scored below the cut-offs, (AUDIT: hazard ratio (HR), 4.72; 95% CI, 2.59-8.60; AUDIT-C: HR, 7.97; 95% CI, 3.66-17.31).

Conclusions

Scores above alcohol use disorders identification test (AUDIT) and AUDIT-Consumption (AUDIT-C) cut-offs are associated with an increased risk of long-term alcohol-related hospital admissions. At widely used cut-offs, the AUDIT-C is a better predictor of alcohol-related hospitalizations among members of the general population than the full AUDIT.

SUBMITTER: Brummer J

PROVIDER: S-EPMC10087303 | biostudies-literature | 2023 Jan

REPOSITORIES: biostudies-literature

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Publications

Using the alcohol use disorders identification test to predict hospital admission for alcohol-related conditions in the Danish general population: a record-linkage study.

Brummer Julie J Bloomfield Kim K Karriker-Jaffe Katherine J KJ Pedersen Michael Mulbjerg MM Hesse Morten M

Addiction (Abingdon, England) 20220907 1

<h4>Background and aims</h4>Most studies validating the alcohol use disorders identification test (AUDIT) have either assessed its factor structure and/or test-retest reliability or used diagnostic interviews as validators of current alcohol use disorders. The aim of the present study was to determine whether AUDIT and AUDIT-Consumption (AUDIT-C) scores are associated with subsequent risk of hospital admission for alcohol-related disorders and diseases (ARDDs).<h4>Design</h4>We used a historical ...[more]

PMID: 35993432

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Project description:BackgroundEarly identification of potential alcohol-problems is central for timely intervention and treatment referral. The Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-Consumption (AUDIT-C) serve as globally recognized and validated screening tools for this purpose. We aimed to evaluate the diagnostic validity of internationally recommended AUDIT cut-off scores ≥ 8, ≥16, ≥ 20, and AUDIT-C cut-off scores ≥ 4, ≥5 using the Danish language versions of questionnaires in a hospital setting.MethodsQuestionnaire data were collected from 2/15/2023, to 4/27/2023 at the Department of Gastroenterology and Hepatology, Odense University Hospital, Denmark. We tested the World Health Organization's recommended AUDIT cut-offs: ≥8 for hazardous use, ≥ 16 suggestive of dependence, ≥ 20 high likelihood of dependence, along with AUDIT-C ≥ 4 and ≥ 5 using the following reference standard: Danish low-risk drinking guidelines (≤ 10 standard drinks/week) for hazardous use and self-reported ICD-10 alcohol dependence criteria for alcohol dependence. Analyses included ROC curves, AUC, sensitivity, specificity, predictive values, and agreement.ResultsThree hundred patients participated, mean age 52 years (SD 17.4, median 54) and 51.3% males. Mean AUDIT score was 4.5 (SD 5.8, median 3) with fourteen (4.7%) meeting at least three self-reported ICD-10 criteria for alcohol dependence. The prevalence of hazardous use was 10.7%. AUDIT ≥ 8 exhibited a sensitivity of 56% (95% CI 40.6-73.6) and specificity 91% (95% CI 87.8-94.5) for detecting hazardous use. Against at least three self-reported ICD-10 criteria for alcohol dependence, AUDIT cut-off ≥ 16 showed a sensitivity of 85% (95% CI 66.1-98.2) with 97% specificity (95% CI 96.0-99.2), while cut-off ≥ 20 had a sensitivity of 71% (95% CI 49.2-91.6) with 99% specificity (95% CI 98.1-99.9). The AUDIT-C cut-offs ≥ 4 and ≥ 5 exhibited low positive predictive values in detecting hazardous use (30.8% for ≥ 4 and 36.8% for ≥ 5) and dependence (13.5% for ≥ 4 and 18.4% for ≥ 5) and demonstrated a specificity ranging from 68.5 to 82.1% with negative predictive values from 98.2 to 100%.ConclusionIn Danish gastroenterology and hepatology departments, the AUDIT and AUDIT-C may be used to identify patients who are unlikely to have an alcohol problem, while positive screen results should be carefully considered and followed by more exhaustive assessment.

Project description:BackgroundExisting studies on intellectual consequences of alcohol-related disorders are primarily cross-sectional and compare intelligence test scores of individuals with and without alcohol-related disorders, hence mixing the influence of alcohol-related disorders and predisposing factors such as premorbid intelligence. In this large-scale study, the primary aim was to estimate associations of alcohol-related disorders with changes in intelligence test scores from early adulthood to late midlife.MethodsData were drawn from a follow-up study on middle-aged men, which included a re-examination of the same intelligence test as completed in young adulthood at military conscription (total analytic sample = 2,499). Alcohol-related hospital diagnoses were obtained from national health registries, whereas treatment for alcohol problems was self-reported at follow-up. The analyses included adjustment for year of birth, retest interval, baseline intelligence quotient (IQ) score, education, smoking, alcohol consumption, and psychiatric and somatic comorbidity.ResultsIndividuals with alcohol-related hospital diagnoses (8%) had a significantly lower baseline IQ score (95.0 vs. 100.5, p < 0.001) and a larger decline in IQ scores from baseline to follow-up (-8.5 vs. -4.8, p < 0.001) than individuals without such diagnoses. The larger decline in IQ scores with alcohol-related hospital diagnoses remained statistically significant after adjustment for all the covariates. Similar results were revealed when IQ scores before and after self-reported treatment for alcohol problems (10%) were examined.ConclusionsIndividuals with alcohol-related disorders have a lower intelligence test score both in young adulthood and in late midlife, and these disorders, moreover, seem to be associated with more age-related decline in intelligence test scores. Thus, low mean intellectual ability observed in individuals with alcohol-related disorders is probably a result of both lower premorbid intelligence and more intellectual decline.

Dataset Information

Using the alcohol use disorders identification test to predict hospital admission for alcohol-related conditions in the Danish general population: a record-linkage study.

Background and aims

Design

Setting

Participants

Measurements

Findings

Conclusions

Publications

Using the alcohol use disorders identification test to predict hospital admission for alcohol-related conditions in the Danish general population: a record-linkage study.

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