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Alcohol - problem drinking - Management
Basis for recommendation

Recommendations on the interpretation of screening are based on the public health guidance Alcohol-use disorders: preventing the development of hazardous and harmful drinking, published by the National Institute for Health and Clinical Excellence (NICE) [NICE, 2010c].

  • The Alcohol Use Disorders Identification Test (AUDIT) questionnaire is a 10-item questionnaire taking 2–5 minutes to complete. A comparative study has found that the AUDIT questionnaire [Coulton et al, 2006]:
    • Had a positive predictive value of 98% (95% CI 97 to 100) for hazardous drinking, and a negative predictive value of 97% (95% CI 94 to 100) for alcohol dependence.
    • Was better at predicting an alcohol problem than biochemical markers.
    • Was superior to the CAGE questionnaire for detecting hazardous and harmful drinking, but not necessarily for the detection of dependence.
  • NICE recommends that 'professional judgement' is used when interpreting AUDIT scores because some people are more vulnerable to the effects of alcohol than others.
    • This includes people with a low body mass index (BMI), women, older people, and some ethnic groups (who may not metabolize alcohol as efficiently).
    • Increasing the sensitivity of the questionnaire by reducing the cut-off point will be at the expense of the specificity of the tool (that is it will increase the chance of a false-positive result).

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