title: Identifying Aboriginal-specific AUDIT-C and AUDIT-3 cutoff scores for at-risk, high-risk, and likely dependent drinkers using measures of agreement with the 10-item Alcohol Use Disorders Identification Test.
abstract: BACKGROUND
  The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item alcohol screener that has been recommended for use in Aboriginal primary health care settings. The time it takes respondents to complete AUDIT, however, has proven to be a barrier to its routine delivery. Two shorter versions, AUDIT-C and AUDIT-3, have been used as screening instruments in primary health care. This paper aims to identify the AUDIT-C and AUDIT-3 cutoff scores that most closely identify individuals classified as being at-risk drinkers, high-risk drinkers, or likely alcohol dependent by the 10-item AUDIT.
  
  
  METHODS
  Two cross-sectional surveys were conducted from June 2009 to May 2010 and from July 2010 to June 2011. Aboriginal Australian participants (N = 156) were recruited through an Aboriginal Community Controlled Health Service, and a community-based drug and alcohol treatment agency in rural New South Wales (NSW), and through community-based Aboriginal groups in Sydney NSW. Sensitivity, specificity, and positive and negative predictive values of each score on the AUDIT-C and AUDIT-3 were calculated, relative to cutoff scores on the 10-item AUDIT for at-risk, high-risk, and likely dependent drinkers. Receiver operating characteristic (ROC) curve analyses were conducted to measure the detection characteristics of AUDIT-C and AUDIT-3 for the three categories of risk.
  
  
  RESULTS
  The areas under the receiver operating characteristic (AUROC) curves were high for drinkers classified as being at-risk, high-risk, and likely dependent.
  
  
  CONCLUSIONS
  Recommended cutoff scores for Aboriginal Australians are as follows: at-risk drinkers AUDIT-C ≥ 5, AUDIT-3 ≥ 1; high-risk drinkers AUDIT-C ≥ 6, AUDIT-3 ≥ 2; and likely dependent drinkers AUDIT-C ≥ 9, AUDIT-3 ≥ 3. Adequate sensitivity and specificity were achieved for recommended cutoff scores. AUROC curves were above 0.90.
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia. b.calabria@unsw.edu.au.
authors.forename: Bianca
authors.initials: B
authors.lastname: Calabria
authors.forename: Anton
authors.initials: A
authors.lastname: Clifford
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Shakeshaft
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Conigrave
authors.forename: Lynette
authors.initials: L
authors.lastname: Simpson
authors.forename: Donna
authors.initials: D
authors.lastname: Bliss
authors.forename: Julaine
authors.initials: J
authors.lastname: Allan
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis* / Q000208:ethnology; D063425:Binge Drinking / Q000175:diagnosis* / Q000208:ethnology; D055812:Community-Based Participatory Research; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D009517:New South Wales; D011594:Psychometrics; D015203:Reproducibility of Results; D012111:Residence Characteristics; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires / Q000592:standards*; D055815:Young Adult