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.

Comments:

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

Reference:

Canagasaby
A, Vinson DC. Screening
for hazardous or harmful drinking using one or two quantity-frequency
questions. Alcohol Alcohol. 2005;40(3):208-213.