Identifying Aboriginal-specific AUDIT-C and AUDIT-3 cut off scores for at-risk, high-risk and likely dependent drinkers using measures of agreement with the 10-item Alcohol Use Disorders Identification Test

Bianca Calabria; Anton Clifford; Anthony P Shakeshaft; Katherine M Conigrave; Lynette Simpson; Donna Bliss; Julaine Allan

doi:10.1186/1940-0640-9-17

Identifying Aboriginal-specific AUDIT-C and AUDIT-3 cut off scores for at-risk, high-risk and likely dependent drinkers using measures of agreement with the 10-item Alcohol Use Disorders Identification Test

Bianca Calabria, Anton Clifford, Anthony P Shakeshaft, Katherine M Conigrave, Lynette Simpson, Donna Bliss, Julaine Allan

Research output: Contribution to journal › Article › peer-review

40 Citations (Scopus)

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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.

Original language	English
Article number	17
Pages (from-to)	1-12
Number of pages	12
Journal	Addiction science & clinical practice
Volume	9
DOIs	https://doi.org/10.1186/1940-0640-9-17
Publication status	Published - 2014

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Calabria, B., Clifford, A., Shakeshaft, A. P., Conigrave, K. M., Simpson, L., Bliss, D., & Allan, J. (2014). Identifying Aboriginal-specific AUDIT-C and AUDIT-3 cut off scores for at-risk, high-risk and likely dependent drinkers using measures of agreement with the 10-item Alcohol Use Disorders Identification Test. Addiction science & clinical practice, 9, 1-12. Article 17. https://doi.org/10.1186/1940-0640-9-17

@article{247f5d6b23a14c99b16959c0df894364,

title = "Identifying Aboriginal-specific AUDIT-C and AUDIT-3 cut off 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.",

keywords = "Alcoholism, Australia, Binge drinking, Demography, EMTREE medical terms: adult, Ethnology, Female, Human, Male, Mass screening, Middle aged, Oceanic ancestry group, Participatory research, Psychometry, Questionnaire, Reproducibility, Severity of illness index, Standards, Validation study, Young adult",

author = "Bianca Calabria and Anton Clifford and Shakeshaft, {Anthony P} and Conigrave, {Katherine M} and Lynette Simpson and Donna Bliss and Julaine Allan",

note = "Includes bibliographical references.",

year = "2014",

doi = "10.1186/1940-0640-9-17",

language = "English",

volume = "9",

pages = "1--12",

journal = "Addiction science & clinical practice",

issn = "1940-0632",

publisher = "BioMed Central Ltd.",

}

Calabria, B, Clifford, A, Shakeshaft, AP, Conigrave, KM, Simpson, L, Bliss, D & Allan, J 2014, 'Identifying Aboriginal-specific AUDIT-C and AUDIT-3 cut off scores for at-risk, high-risk and likely dependent drinkers using measures of agreement with the 10-item Alcohol Use Disorders Identification Test', Addiction science & clinical practice, vol. 9, 17, pp. 1-12. https://doi.org/10.1186/1940-0640-9-17

Identifying Aboriginal-specific AUDIT-C and AUDIT-3 cut off scores for at-risk, high-risk and likely dependent drinkers using measures of agreement with the 10-item Alcohol Use Disorders Identification Test. / Calabria, Bianca; Clifford, Anton; Shakeshaft, Anthony P et al.
In: Addiction science & clinical practice, Vol. 9, 17, 2014, p. 1-12.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Identifying Aboriginal-specific AUDIT-C and AUDIT-3 cut off scores for at-risk, high-risk and likely dependent drinkers using measures of agreement with the 10-item Alcohol Use Disorders Identification Test

AU - Calabria, Bianca

AU - Clifford, Anton

AU - Shakeshaft, Anthony P

AU - Conigrave, Katherine M

AU - Simpson, Lynette

AU - Bliss, Donna

AU - Allan, Julaine

N1 - Includes bibliographical references.

PY - 2014

Y1 - 2014

N2 - 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.

AB - 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.

KW - Alcoholism

KW - Australia

KW - Binge drinking

KW - Demography

KW - EMTREE medical terms: adult

KW - Ethnology

KW - Female

KW - Human

KW - Male

KW - Mass screening

KW - Middle aged

KW - Oceanic ancestry group

KW - Participatory research

KW - Psychometry

KW - Questionnaire

KW - Reproducibility

KW - Severity of illness index

KW - Standards

KW - Validation study

KW - Young adult

U2 - 10.1186/1940-0640-9-17

DO - 10.1186/1940-0640-9-17

M3 - Article

C2 - 25179547

SN - 1940-0632

VL - 9

SP - 1

EP - 12

JO - Addiction science & clinical practice

JF - Addiction science & clinical practice

M1 - 17

ER -

Calabria B, Clifford A, Shakeshaft AP, Conigrave KM, Simpson L, Bliss D et al. Identifying Aboriginal-specific AUDIT-C and AUDIT-3 cut off scores for at-risk, high-risk and likely dependent drinkers using measures of agreement with the 10-item Alcohol Use Disorders Identification Test. Addiction science & clinical practice. 2014;9:1-12. 17. doi: 10.1186/1940-0640-9-17