title: The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) in the assessment of alcohol use disorders among acute injury patients.
abstract: BACKGROUND
  The Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) is a brief alcohol screening test and a candidate for inclusion in recommended screening and brief intervention protocols for acute injury patients. The objective of the current study was to examine the performance of the AUDIT-C to risk stratify injury patients with regard to their probability of having an alcohol use disorder.
  
  
  METHODS
  Participants (n = 1,004) were from a multisite Australian acute injury study. Stratum-specific likelihood ratio (SSLR) analysis was used to examine the performance of previously recommended AUDIT-C risk zones based on a dichotomous cut-point (0 to 3, 4 to 12) and risk zones derived from SSLR analysis to estimate the probability of a current alcohol use disorder.
  
  
  RESULTS
  Almost a quarter (23%) of patients met criteria for a current alcohol use disorder. SSLR analysis identified multiple AUDIT-C risk zones (0 to 3, 4 to 5, 6, 7 to 8, 9 to 12) with a wide range of posttest probabilities of alcohol use disorder, from 5 to 68%. The area under receiver operating characteristic curve (AUROC) score was 0.82 for the derived AUDIT-C zones and 0.70 for the recommended AUDIT-C zones. A comparison between AUROCs revealed that overall the derived zones performed significantly better than the recommended zones in being able to discriminate between patients with and without alcohol use disorder.
  
  
  CONCLUSIONS
  The findings of SSLR analysis can be used to improve estimates of the probability of alcohol use disorder in acute injury patients based on AUDIT-C scores. In turn, this information can inform clinical interventions and the development of screening and intervention protocols in a range of settings.
authors.affiliation: Australian Centre for Posttraumatic Mental Health, University of Melbourne, East Melbourne, Vic., Australia.
authors.forename: Darryl
authors.initials: D
authors.lastname: Wade
authors.forename: Tracey
authors.initials: T
authors.lastname: Varker
authors.forename: David
authors.initials: D
authors.lastname: Forbes
authors.forename: Meaghan
authors.initials: M
authors.lastname: O'Donnell
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D019973:Alcohol-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D001315:Australia / Q000453:epidemiology; D010054:Brief Psychiatric Rating Scale / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000639:trends*; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires / Q000592:standards; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult
keywords: Alcohol; Alcohol Use Disorder Identification Test; Injury; Screening; Stratum-Specific Likelihood Ratio