Effectiveness of the AUDIT-C as a screening test for alcohol misuse in three race/ethnic groups.
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.
Frank
Danielle
D
VA Puget Sound Health Services Research and Development, Seattle, WA 98101, USA. diegop@u.washington.edu
DeBenedetti
Anna F
AF
Volk
Robert J
RJ
Williams
Emily C
EC
Kivlahan
Daniel R
DR
Bradley
Katharine A
KA
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