title: Cross-national performance of the RAPS4/RAPS4-QF for tolerance and heavy drinking: data from 13 countries.
abstract: OBJECTIVE
  There are little data available on the performance of brief screening instruments for alcohol-use disorders cross-nationally; therefore, we analyzed the performance of one such instrument in a number of countries.
  
  
  METHODS
  Performance of the RAPS4 for tolerance and the RAPS4-QF for heavy drinking are analyzed from emergency room data across 13 countries included in the combined Emergency Room Collaborative Alcohol Analysis Project (ERCAAP) and the World Health Organization Collaborative Study on Alcohol and Injuries.
  
  
  RESULTS
  The RAPS4 showed good sensitivity and specificity for tolerance across most of the countries, but was higher in countries that were higher on societal-level detrimental drinking patterns. Prevalence of tolerance was also higher in those countries with high detrimental drinking pattern scores. Sensitivity of the RAPS4-QF for heavy drinking was uniformly high across countries, while maintaining good specificity, and did not vary by detrimental drinking patterns.
  
  
  CONCLUSIONS
  Findings suggest the RAPS4 and RAPS4-QF may hold promise cross-nationally. Future research should more fully address the performance of brief screening instruments for alcohol-use disorders (using standard diagnostic criteria) cross-nationally, with consideration of the impact of societal drinking patterns.
authors.affiliation: Alcohol Research Group, 2000 Hearst Avenue, Berkeley, California 94709, USA. ccherpitel@arg.org
authors.forename: Cheryl J
authors.initials: CJ
authors.lastname: Cherpitel
authors.forename: Yu
authors.initials: Y
authors.lastname: Ye
authors.forename: Jason
authors.initials: J
authors.lastname: Bond
authors.forename: Guilherme
authors.initials: G
authors.lastname: Borges
authors.forename: Mariana
authors.initials: M
authors.lastname: Cremonte
authors.forename: Sandra
authors.initials: S
authors.lastname: Marais
authors.forename: Vladimir
authors.initials: V
authors.lastname: Poznyak
authors.forename: Hana
authors.initials: H
authors.lastname: Sovinova
authors.forename: Jacek
authors.initials: J
authors.lastname: Moskalewicz
authors.forename: Grazyna
authors.initials: G
authors.lastname: Swiatkiewicz
mesh_terms: D000437:Alcoholism / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D006801:Humans; D007391:International Cooperation; D008403:Mass Screening / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires