title: Effectiveness of the AUDIT-C as a screening test for alcohol misuse in three race/ethnic groups.
abstract: BACKGROUND
  The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) is a brief validated screen for risky drinking and alcohol abuse and dependence (alcohol misuse). However, the AUDIT-C was validated in predominantly White populations, and its performance in different racial/ethnic groups is unclear.
  
  
  OBJECTIVE
  To evaluate the validity of the AUDIT-C among primary care patients from the predominant racial/ethnic subgroups within the United States: White, African American, and Hispanic.
  
  
  METHODS
  Cross-sectional interview validation study.
  
  
  METHODS
  1,292 outpatients from an academic family practice clinic in Texas (90% of randomly sampled eligible).
  
  
  RESULTS
  Race/ethnicity was self-reported. Areas under the receiver operating curve (AuROCs) evaluated overall AUDIT-C performance in the 3 racial/ethnic groups compared to diagnostic interviews for alcohol misuse. AUDIT-C sensitivities and specificities at recommended screening thresholds were compared across racial/ethnic groups. AuROCs were greater than 0.85 in all 3 groups, with no significant differences across racial/ethnic groups in men (P = .43) or women (P = .12). At previously recommended cut points, there were statistically significant differences by race in AUDIT-C sensitivities but not specificities. In women, the sensitivity was higher in Hispanic (85%) than in African-American (67%; P = .03) or White (70%; P = .04) women. In men, the sensitivity was higher in White (95%) than in African-American men (76%; P = .01), with no significant difference from Hispanic men (85%; P = .11).
  
  
  CONCLUSIONS
  The overall performance of the AUDIT-C was excellent in all 3 racial/ethnic groups as reflected by high AuROCs. At recommended cut points, there were significant differences in the AUDIT-C's sensitivity but not in specificity across the 3 racial/ethnic groups.
authors.affiliation: VA Puget Sound Health Services Research and Development, Seattle, WA 98101, USA. diegop@u.washington.edu
authors.forename: Danielle
authors.initials: D
authors.lastname: Frank
authors.forename: Anna F
authors.initials: AF
authors.lastname: DeBenedetti
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Volk
authors.forename: Emily C
authors.initials: EC
authors.lastname: Williams
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Kivlahan
authors.forename: Katharine A
authors.initials: KA
authors.lastname: Bradley
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D000428:Alcohol Drinking / Q000208:ethnology*; D019973:Alcohol-Related Disorders / Q000175:diagnosis* / Q000208:ethnology; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000592:standards; D008875:Middle Aged; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*; D044465:White People