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Journal of General Internal Medicine
Published in: Journal of General Internal Medicine 6/2008

01-06-2008 | Original Article

Effectiveness of the AUDIT-C as a Screening Test for Alcohol Misuse in Three Race/Ethnic Groups

Authors: Danielle Frank, MD, MPH, Anna F. DeBenedetti, BA, Robert J. Volk, PhD, Emily C. Williams, MPH, Daniel R. Kivlahan, PhD, Katharine A. Bradley, MD, MPH

Published in: Journal of General Internal Medicine | Issue 6/2008

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Summary

Background

The Alcohol Use Disorders Identification Test—Consumption (AUDIT-C) is a brief validated screen for risky drinking and alcohol abuse and dependence (alcohol misuse). However, the AUDIT-C was validated in predominantly White populations, and its performance in different racial/ethnic groups is unclear.

Objective

To evaluate the validity of the AUDIT-C among primary care patients from the predominant racial/ethnic subgroups within the United States: White, African American, and Hispanic.

Design

Cross-sectional interview validation study.

Participants

1,292 outpatients from an academic family practice clinic in Texas (90% of randomly sampled eligible).

Measurements and Main Results

Race/ethnicity was self-reported. Areas under the receiver operating curve (AuROCs) evaluated overall AUDIT-C performance in the 3 racial/ethnic groups compared to diagnostic interviews for alcohol misuse. AUDIT-C sensitivities and specificities at recommended screening thresholds were compared across racial/ethnic groups. AuROCs were greater than 0.85 in all 3 groups, with no significant differences across racial/ethnic groups in men (P = .43) or women (P = .12). At previously recommended cut points, there were statistically significant differences by race in AUDIT-C sensitivities but not specificities. In women, the sensitivity was higher in Hispanic (85%) than in African-American (67%; P = .03) or White (70%; P = .04) women. In men, the sensitivity was higher in White (95%) than in African-American men (76%; P = .01), with no significant difference from Hispanic men (85%; P = .11).

Conclusions

The overall performance of the AUDIT-C was excellent in all 3 racial/ethnic groups as reflected by high AuROCs. At recommended cut points, there were significant differences in the AUDIT-C’s sensitivity but not in specificity across the 3 racial/ethnic groups.
Appendix
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Metadata
Title
Effectiveness of the AUDIT-C as a Screening Test for Alcohol Misuse in Three Race/Ethnic Groups
Authors
Danielle Frank, MD, MPH
Anna F. DeBenedetti, BA
Robert J. Volk, PhD
Emily C. Williams, MPH
Daniel R. Kivlahan, PhD
Katharine A. Bradley, MD, MPH
Publication date
01-06-2008
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue 6/2008
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-008-0594-0

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