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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

Authors

Simon Coulton

M Fasihul Alam

Sadie Boniface

Paolo Deluca

Kim Donoghue

Eilish Gilvarry

Eileen Kaner

Ellen Lynch

Ian Maconochie

Paul McArdle

Ruth McGovern

Dorothy Newbury-Birch

Robert Patton

Ceri J Phillips

Hannah Rose

Ian Russell

John Strang

Colin Drummond



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.

Journal Article Type Article
Publication Date 2019-03
Journal Journal of public health (Oxford, England)
Print ISSN 1741-3842
Electronic ISSN 1741-3850
Publisher Oxford University Press (OUP)
Peer Reviewed Peer Reviewed
Volume 41
Issue 1
Pages e53-e60
APA6 Citation Coulton, S., Alam, M. F., Boniface, S., Deluca, P., Donoghue, K., Gilvarry, E., …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
DOI https://doi.org/10.1093/pubmed/fdy049
Keywords Adolescent; Alcohol; Diagnosis; Screening
Publisher URL https://academic.oup.com/jpubhealth/advance-article/doi/10.1093/pubmed/fdy049/4953708
Copyright Statement © The Author(s) 2018. Published by Oxford University Press on behalf of Faculty of Public Health.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited

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Copyright Statement
© The Author(s) 2018. Published by Oxford University Press on behalf of Faculty of Public Health.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited





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