title: Reliability and Validity of a Two-Question Alcohol Screen in the Pediatric Emergency Department.
abstract: A multisite study was conducted to determine the psychometric properties of the National Institute of Alcohol Abuse and Alcoholism (NIAAA) 2-question alcohol screen within pediatric emergency departments (PEDs).
  
  
  
  Participants (N = 4838) included 12- to 17-year-old subjects treated in 1 of the 16 participating PEDs across the United States. A criterion assessment battery (including the NIAAA 2-question alcohol screen and other measures of alcohol, drug use, and risk behaviors) was self-administered on a tablet computer. A subsample (n = 186) was re-administered the NIAAA 2-question screen 1 week later to assess test-retest reliability.
  
  
  
  Moderate to good test-retest reliability was demonstrated. A classification of moderate risk or higher on the screen had the best combined sensitivity and specificity for determining a diagnosis of alcohol use disorder (AUD) for all students. Any past year drinking among middle school students increased the odds of a diagnosis of an AUD according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria, whereas the optimal cutoff for high school ages was ≥3 drinking days in the past year. The optimal cutoff for drinking days determining a positive Alcohol Use Disorders Identification Test score among middle school subjects was ≥1 drinking day, whereas the optimal cutoff for high school subjects was ≥2 drinking days.
  
  
  
  The NIAAA 2-question screen is a brief, valid approach for alcohol screening in PEDs. A positive screen suggests that referral for further evaluation is indicated to determine if an adolescent has an AUD.
authors.affiliation: Departments of Psychiatry & Human Behavior and.
authors.forename: Anthony
authors.initials: A
authors.lastname: Spirito
authors.affiliation: Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.|Department of Emergency Medicine, Rhode Island Hospital, Providence, Rhode Island; and.
authors.forename: Julie R
authors.initials: JR
authors.lastname: Bromberg
authors.affiliation: Department of Pediatrics & PECARN Data Coordinating Center, University of Utah, Salt Lake City, Utah.
authors.forename: T Charles
authors.initials: TC
authors.lastname: Casper
authors.affiliation: Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.|Department of Emergency Medicine, Rhode Island Hospital, Providence, Rhode Island; and.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Chun
authors.affiliation: Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.|Department of Emergency Medicine, Rhode Island Hospital, Providence, Rhode Island; and.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mello
authors.affiliation: Department of Pediatrics & PECARN Data Coordinating Center, University of Utah, Salt Lake City, Utah.
authors.forename: J Michael
authors.initials: JM
authors.lastname: Dean
authors.affiliation: Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island; james_linakis_phd@brown.edu.|Department of Emergency Medicine, Rhode Island Hospital, Providence, Rhode Island; and.
authors.forename: James G
authors.initials: JG
authors.lastname: Linakis
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000453:epidemiology*; D002648:Child; D016001:Confidence Intervals; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000379:methods*; D010372:Pediatrics; D011594:Psychometrics; D012372:ROC Curve; D015203:Reproducibility of Results; D018570:Risk Assessment; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology