title: Validation of the Alcohol Use Disorders Identification Test (AUDIT) in urban community outreach and de-addiction center samples in north India.
abstract: OBJECTIVE
  The Alcohol Use Disorders Identification Test (AUDIT) developed by the World Health Organization for screening disorders related to alcohol use has been shown to have robust psychometric properties. This study compared the performance of AUDIT with that of the Short Michigan Alcoholism Screening Test (SMAST) in a region of North India.
  
  
  METHODS
  A total of 297 consecutive subjects who had used alcohol in the past year were recruited from a de-addiction center (DAC) (n = 97) and a community outreach setting (n = 200) in West Delhi. Using International Classification of Diseases, Tenth Edition (ICD-10) criteria, the relative effectiveness of the AUDIT and the SMAST in identifying alcohol-use-related disorders was assessed and compared. Internal consistency and interscale correlations were evaluated, along with sensitivity, specificity and ROC curve analyses.
  
  
  RESULTS
  The AUDIT had very high internal reliability (alpha 0.92) in this Indian sample. There was, in general, good correlation between the total and factor scores of the AUDIT and SMAST (ranging from 0.28 to 0.97), which were higher in the community than in the DAC sample. The AUDIT (area under the curve [AUC] = 0.883) and SMAST (AUC = 0.870) were similar in detecting harmful use of alcohol. The AUDIT optimal cutoff score was 16 (sensitivity 85.3, specificity 89.4) for ICD-10 harmful use and 24 (sensitivity 69.4, specificity 87.5) for ICD-10 alcohol dependence.
  
  
  CONCLUSIONS
  The AUDIT and SMAST seem to be comparable in their ability to screen subjects with alcohol use disorders. The AUDIT score for screening harmful use in the sample appears to be higher than previously reported. The utility of such high cutoff for screening subjects for intervention is obvious, but it is quite likely that some positive cases might be missed.
authors.affiliation: National Drug Dependence Treatment Centre, All India Institute of Medical Sciences, New Delhi 110029, India. hemraj_pal@hotmail.com
authors.forename: Hem Raj
authors.initials: HR
authors.lastname: Pal
authors.forename: Renuka
authors.initials: R
authors.lastname: Jena
authors.forename: Deepak
authors.initials: D
authors.lastname: Yadav
mesh_terms: D000328:Adult; D020751:Alcohol-Induced Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007406:Interview, Psychological / Q000379:methods / Q000592:standards*; D008297:Male; D008875:Middle Aged; D016320:Substance Abuse Treatment Centers / Q000379:methods / Q000706:statistics & numerical data; D014504:Urban Health / Q000706:statistics & numerical data