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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


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


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.

Opportunistic cross-sectional survey.

10 emergency departments across England.

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

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.

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%).

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.


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.

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
Electronic ISSN 1741-3850
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 41
Issue 1
Pages e53-e60
Keywords Adolescent; Alcohol; Diagnosis; Screening
Public URL
Publisher URL


Article (158 Kb)

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

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