Opportunistic screening for alcohol use problems in adolescents attending emergency departments: an evaluation of screening tools

Coulton, Simon; Alam, M Fasihul; Boniface, Sadie; Deluca, Paolo; Donoghue, Kim; Gilvarry, Eilish; Kaner, Eileen; Lynch, Ellen; Maconochie, Ian; McArdle, Paul; McGovern, Ruth; Newbury-Birch, Dorothy; Patton, Robert; Phillips, Ceri J; Phillips, Thomas; Rose, Hannah; Russell, Ian; Strang, John; Drummond, Colin

Abstract

Objective
To estimate and compare the optimal cut-off score of Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-C in identifying at-risk alcohol consumption, heavy episodic alcohol use, ICD-10 alcohol abuse and alcohol dependence in adolescents attending ED in England.

Design
Opportunistic cross-sectional survey.

Setting
10 emergency departments across England.

Participants
Adolescents (n = 5377) aged between their 10th and 18th birthday who attended emergency departments between December 2012 and May 2013.

Measures
Scores on the AUDIT and AUDIT-C. At-risk alcohol consumption and monthly episodic alcohol consumption in the past 3 months were derived using the time-line follow back method. Alcohol abuse and alcohol dependence was assessed in accordance with ICD-10 criteria using the MINI-KID.

Findings
AUDIT-C with a score of 3 was more effective for at-risk alcohol use (AUC 0.81; sensitivity 87%, specificity 97%), heavy episodic use (0.84; 76%, 98%) and alcohol abuse (0.98; 91%, 90%). AUDIT with a score of 7 was more effective in identifying alcohol dependence (0.92; 96%, 94%).

Conclusions
The 3-item AUDIT-C is more effective than AUDIT in screening adolescents for at-risk alcohol use, heavy episodic alcohol use and alcohol abuse. AUDIT is more effective than AUDIT-C for the identification of alcohol dependence.

Citation

Coulton, S., Alam, M. F., Boniface, S., Deluca, P., Donoghue, K., Gilvarry, E., Kaner, E., Lynch, E., Maconochie, I., McArdle, P., McGovern, R., Newbury-Birch, D., Patton, R., Phillips, C. J., Phillips, T., Rose, H., Russell, I., Strang, J., & Drummond, C. (2019). Opportunistic screening for alcohol use problems in adolescents attending emergency departments: an evaluation of screening tools. Journal of Public Health, 41(1), e53-e60. https://doi.org/10.1093/pubmed/fdy049

• Journal Article Type: Article
• Acceptance Date: Feb 28, 2018
• Online Publication Date: Mar 26, 2018
• Publication Date: 2019-03
• Deposit Date: Jun 8, 2018
• Publicly Available Date: Jun 11, 2018
• Journal: Journal of public health (Oxford, England)
• Print ISSN: 1741-3842
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 41
• Issue: 1
• Pages: e53-e60
• DOI: https://doi.org/10.1093/pubmed/fdy049
• Keywords: Adolescent; Alcohol; Diagnosis; Screening
• Public URL: https://hull-repository.worktribe.com/output/869286
• Publisher URL: https://academic.oup.com/jpubhealth/advance-article/doi/10.1093/pubmed/fdy049/4953708
• Contract Date: Jun 11, 2018