title: Predictive validity of the AUDIT for hazardous alcohol consumption in recently released prisoners.
abstract: BACKGROUND
  This study aimed to assess the predictive validity of the Alcohol Use Disorders Identification Test (AUDIT) among adult prisoners with respect to hazardous drinking following release, and identify predictors of post-release hazardous drinking among prisoners screening positive for risk of alcohol-related harm on the AUDIT.
  
  
  METHODS
  Data came from a survey-based longitudinal study of 1325 sentenced adult prisoners in Queensland, Australia. Baseline interviews were conducted pre-release with follow-up at 3 and 6 months post-release. We calculated sensitivity, specificity and area under the receiver operating characteristic (AUROC) to quantify the predictive validity of the AUDIT administered at baseline with respect to post-release hazardous drinking. Other potential predictors of hazardous drinking were measured by self-report and their association with the outcome was examined using logistic regression.
  
  
  RESULTS
  At a cut-point of 8 or above, sensitivity of the AUDIT with respect to hazardous drinking at 3-month follow-up was 81.0% (95%CI: 77.9-84.6%) and specificity was 65.6% (95%CI: 60.6-70.3%). The AUROC was 0.78 (95%CI: 0.75-0.81), indicating moderate accuracy. Among those scoring 8 or above, high expectations to drink post-release (AOR: 2.49; 95%CI: 1.57-3.94) and past amphetamine-type stimulant (ATS) use (AOR: 1.64; 95%CI: 1.06-2.56) were significantly associated with hazardous drinking at 3 months post-release. Results were similar at 6 months.
  
  
  CONCLUSIONS
  Among adult prisoners in our sample, pre-release AUDIT scores predicted hazardous drinking six months after release with acceptable accuracy, sensitivity and specificity. Among prisoners screening positive on the AUDIT, expectations of post-release drinking and ATS use are potential targets for intervention to reduce future hazardous drinking.
authors.affiliation: Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Parkville, Victoria 3010, Australia. Electronic address: emma.thomas@unimelb.edu.au.
authors.forename: Emma
authors.initials: E
authors.lastname: Thomas
authors.affiliation: Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Parkville, Victoria 3010, Australia; National Drug and Alcohol Research Centre, University of New South Wales, 32 King St, Randwick, NSW 2031, Australia.
authors.forename: Louisa
authors.initials: L
authors.lastname: Degenhardt
authors.affiliation: School of Population Health, University of Queensland, Herston Road, Herston, Queensland 4006, Australia; Centre for Youth Substance Abuse Research, University of Queensland, Royal Brisbane and Women's Hospital, Herston, Queensland 4029, Australia.
authors.forename: Rosa
authors.initials: R
authors.lastname: Alati
authors.affiliation: Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Parkville, Victoria 3010, Australia; School of Medicine, University of Queensland, 288 Herston Road, Herston, Queensland 4006, Australia; School of Public Health and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, Victoria 3004, Australia; Murdoch Children's Research Institute Murdoch, Royal Children's Hospital, Flemington Road, Parkville 3052, Australia.
authors.forename: Stuart
authors.initials: S
authors.lastname: Kinner
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology / Q000639:trends*; D003625:Data Collection / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011237:Predictive Value of Tests; D011329:Prisoners / Q000523:psychology; D011793:Queensland / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
keywords: Alcohol; Alcohol Use Disorders Identification Test; Ex-prisoners; Predictive validity; Prisoners