Screening for Unhealthy Alcohol Use With 1 or 2 Questions
Simplifying strategies to screen for unhealthy alcohol use (i.e., consumption of risky amounts or an alcohol use disorder) remains a formidable task. One desired outcome of simplification efforts is a briefer screening test. To compare the performances of some brief tests to detect unhealthy alcohol use, investigators screened 1537 emergency department patients with an acute injury, 1151 emergency patients with a medical illness, and 1112 randomly selected people who were contacted by telephone.
Researchers asked each subject a question about alcohol consumption in a day ("When was the last time you had more than X drinks in 1 day?" with X being 5 for men and 4 for women); a question about average consumption per occasion; and a standard question about drinking frequency. Diagnostic interviews determined the presence of an alcohol use disorder and validated calendar methods determined drinking amounts.
- The question about consumption in a day, when answered "in the past 3 months," performed the best. Its respective sensitivities and specificities were 85% and 70% in men and 82% and 77% in women.
- Findings were similar when screening was conducted in person or by telephone.
This study suggests that asking one straightforward question can identify unhealthy alcohol use, providing yet more evidence of the utility of very brief alcohol screening tests. Further, the efficacy of screening by phone may allow the collection of some alcohol-related data before the clinician-patient encounter.Jeffrey H. Samet, MD, MA, MPH
Canagasaby A, Vinson DC. Screening for hazardous or harmful drinking using one or two quantity-frequency questions. Alcohol Alcohol. 2005;40(3):208-213.