title: Adding an alcohol-related risk score to an existing categorical risk classification for older adults: sensitivity to group differences.
abstract: OBJECTIVE
  To evaluate a new alcohol-related risk score for research use.
  
  
  METHODS
  Using data from a previously reported trial of a screening and education system for older adults (Computerized Alcohol-Related Problems Survey), secondary analyses were conducted comparing the ability of two different measures of risk to detect post-intervention group differences: the original categorical outcome measure and a new, finely grained quantitative risk score based on the same research-based risk factors.
  
  
  METHODS
  Three primary care group practices in southern California.
  
  
  METHODS
  Six hundred sixty-five patients aged 65 and older.
  
  
  METHODS
  A previously calculated, three-level categorical classification of alcohol-related risk and a newly developed quantitative risk score.
  
  
  RESULTS
  Mean post-intervention risk scores differed between the three experimental conditions: usual care, patient report, and combined report (P<.001). The difference between the combined report and usual care was significant (P<.001) and directly proportional to baseline risk. The three-level risk classification did not reveal approximately 57.3% of the intervention effect detected by the risk score. The risk score also was sufficiently sensitive to detect the intervention effect within the subset of hypertensive patients (n=112; P=.001).
  
  
  CONCLUSIONS
  As an outcome measure in intervention trials, the finely grained risk score is more sensitive than the trinary risk classification. The additional clinical value of the risk score relative to the categorical measure needs to be determined.
authors.affiliation: Department of Health Services Research, Palo Alto Medical Foundation Research Institute, Palo Alto, California 94301, USA. wilsons@pamfri.org
authors.forename: Sandra R
authors.initials: SR
authors.lastname: Wilson
authors.forename: Arlene
authors.initials: A
authors.lastname: Fink
authors.forename: Shinu
authors.initials: S
authors.lastname: Verghese
authors.forename: John C
authors.initials: JC
authors.lastname: Beck
authors.forename: Khue
authors.initials: K
authors.lastname: Nguyen
authors.forename: Philip
authors.initials: P
authors.lastname: Lavori
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D000437:Alcoholism / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D002140:California; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening; D010353:Patient Education as Topic; D011320:Primary Health Care; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires