title: Increased detection of alcohol consumption and at-risk drinking with computerized alcohol screening.
abstract: BACKGROUND
  The impact of alcohol use has been widely studied and is considered a public health issue. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends Screening and Brief Intervention and Referral Treatment (SBIRT), but the actual practice in the Emergency Department (ED) is constrained due to limited provider time and financial resources.
  
  
  OBJECTIVE
  To assess the effectiveness of alcohol screening using Computerized Alcohol Screening and brief Intervention (CASI) compared to alcohol screening by triage nurse during Medical Screening Examination (MSE) in the ED.
  
  
  METHODS
  Retrospective review of CASI/MSE database from January 2008 through December 2009, collected in the tertiary, Level I Trauma ED was performed. Inclusion criteria included age ≥18 years, and completion of both the MSE and CASI. We analyzed the database by comparing age, gender, primary language (English, Spanish), and Alcohol Use Disorders Identification Test scores using McNemar's test.
  
  
  RESULTS
  Data were available for 5835 patients. CASI showed a significant increase in detection of at-risk drinking over MSE across all ages, gender, and primary language (p < 0.05). MSE found 2.5% at-risk drinkers and CASI found 11.5% at-risk drinkers (odds ratio [OR] 8.88, 95% confidence interval [CI] 6.89-11.61). Similar results were found in 18- to 20-year-old patients. MSE identified 1.8% at-risk drinkers and CASI reported 15.94% (OR 19.33, 95% CI 6.30-96.47).
  
  
  CONCLUSIONS
  CASI increased detection of at-risk alcohol drinkers compared with MSE across all ages, gender, and primary language. CASI is a promising innovative method for alcohol screening in the ED for the adult population, including under-aged drinkers.
authors: Center for Trauma and Injury Prevention Research, Department of Emergency Medicine, University of California, Irvine - School of Medicine, Orange, CA 92868, USA.
authors: Shahram
authors: S
authors: Lotfipour
authors: James
authors: J
authors: Howard
authors: Samer
authors: S
authors: Roumani
authors: Wirachin
authors: W
authors: Hoonpongsimanont
authors: Bharath
authors: B
authors: Chakravarthy
authors: Craig L
authors: CL
authors: Anderson
authors: Jie W
authors: JW
authors: Weiss
authors: Victor
authors: V
authors: Cisneros
authors: Brad
authors: B
authors: Dykzeul
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000435:Alcoholic Intoxication / Q000175:diagnosis*; D000437:Alcoholism / Q000517:prevention & control*; D003194:Computer-Assisted Instruction; D003936:Diagnosis, Computer-Assisted; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult