title: Suitability of the PROMIS alcohol use short form for screening in a HIV clinical care setting.
abstract: At-risk alcohol use is important to identify in clinical settings to facilitate interventions. The Patient-Reported Outcomes Measurement Information System (PROMIS) Alcohol Use Short Form was developed through an item response theory process, but its utility as a screening instrument in clinical care has not been reported.
  
  
  
  To determine the ability of the PROMIS Alcohol Use Short Form to identify people with current or future at-risk alcohol use defined by the Alcohol Use Disorders Identification Test consumption (AUDIT-C) instrument.
  
  
  
  Observational study of people living with HIV (PLWH) in clinical care at four sites across the US. Patients completed a tablet-based clinical assessment prior to seeing their providers at clinic appointments. We used 3 definitions of clinically-relevant at-risk alcohol use and determined the proportion of PLWH with current or future at-risk drinking identified by the PROMIS instrument.
  
  
  
  Of 2497 PLWH who endorsed ≥1 drink in the prior 12 months, 1500 PLWH (60%) endorsed "never" for all PROMIS items. In that group, 26% had clinically-relevant at-risk alcohol use defined by one or more AUDIT-C definitions. At follow-up (N=1608), high baseline PROMIS scores had 55% sensitivity for at-risk drinking among those with at-risk drinking at baseline, and 22% sensitivity among those without baseline risk.
  
  
  
  The PROMIS Alcohol Use Short Form cannot be used alone to identify PLWH with clinically-relevant at-risk alcohol use. Optimal assessment of problem drinking behavior is not clear, but there does not seem to be an important role for the PROMIS instrument in this clinical setting.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Washington, 325 9th Ave., Box 359780, Seattle, WA 98104 USA. Electronic address: gibbonsl@uw.edu.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Gibbons
authors.affiliation: Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, 325 9th Ave., Box 359931, Seattle, WA 98104 USA.
authors.forename: Rob
authors.initials: R
authors.lastname: Fredericksen
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Washington, 325 9th Ave., Box 359780, Seattle, WA 98104 USA.
authors.forename: Joseph O
authors.initials: JO
authors.lastname: Merrill
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, 911 N Broadway, Baltimore, MD 21205 USA.
authors.forename: Mary E
authors.initials: ME
authors.lastname: McCaul
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Johns Hopkins University, 600 N Wolfe Street, Carnegie, Baltimore, MD 21287 USA.
authors.forename: Geetanjali
authors.initials: G
authors.lastname: Chander
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, 911 N Broadway, Baltimore, MD 21205 USA.
authors.forename: Heidi
authors.initials: H
authors.lastname: Hutton
authors.affiliation: School of Nursing, University of Washington, T615 Health Sciences 1959 NE Pacific St., Box 357266, Seattle, WA 98195 USA.
authors.forename: William B
authors.initials: WB
authors.lastname: Lober
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of California at San Diego, UCSD Medical Center, 8681, 200 W. Arbor Dr., San Diego, CA 92103 USA.
authors.forename: W Chris
authors.initials: WC
authors.lastname: Mathews
authors.affiliation: Fenway Institute and Division of Infectious Diseases, Department of Medicine, Harvard Medical School, 1340 Boylston Street 8th Floor, Boston, MA 02215 USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Mayer
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, 845 19th St S, Birmingham, AL 35205 USA.
authors.forename: Greer
authors.initials: G
authors.lastname: Burkholder
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, 1900 University Blvd Ste 215, Birmingham, AL 35233 USA.
authors.forename: James H
authors.initials: JH
authors.lastname: Willig
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, 150 Hill University Center, 1400 University Boulevard, Birmingham, AL 35294 USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mugavero
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, 150 Hill University Center, 1400 University Boulevard, Birmingham, AL 35294 USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Saag
authors.affiliation: Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, 325 9th Ave., Box 359931, Seattle, WA 98104 USA.
authors.forename: Mari M
authors.initials: MM
authors.lastname: Kitahata
authors.affiliation: Department of Health Services, School of Public Health, University of Washington, Box 359455, Seattle, WA 98195 USA.
authors.forename: Todd C
authors.initials: TC
authors.lastname: Edwards
authors.affiliation: Department of Health Services, School of Public Health, University of Washington, Box 359455, Seattle, WA 98195 USA.
authors.forename: Donald L
authors.initials: DL
authors.lastname: Patrick
authors.affiliation: Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, 325 9th Ave., Box 359931, Seattle, WA 98104 USA. Electronic address: hcrane@uw.edu.
authors.forename: Heidi M
authors.initials: HM
authors.lastname: Crane
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Washington, 325 9th Ave., Box 359780, Seattle, WA 98104 USA.
authors.forename: Paul K
authors.initials: PK
authors.lastname: Crane
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology; D000554:Ambulatory Care Facilities; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012309:Risk-Taking; D011795:Surveys and Questionnaires
keywords: At-risk alcohol use; Clinical care; HIV; Patient-reported outcomes; Screening