A meta-analysis 5 included 135 discrete validation studies. Summary estimates indicated that the screening instruments performed well : area under the curve (AUC) 0.91 (95% CI 0.88 to 0.93); sensitivity 0.98 (0.95 to 0.99); specificity 0.78 (0.74 to 0.82). Noting a paucity of validation evidence for existing assessment instruments, aggregated reliability estimates suggest a reliability of 0.81 (0.78 to 0.83) adjusted for 10 items. AUDIT or AUDIT-C (the first three questions of AUDIT) were recommended.
A cross-sectional study 4 investigated w hether the AUDIT score is useful for predicting hazardous drinking and whether the AUDIT score was more useful than pre-existing laboratory tests. 334 outpatients who consulted internal medicine department in Japan completed self-reported questionnaires and underwent a diagnostic interview, physical examination, and laboratory testing. 40 (23 %) male patients reported daily alcohol consumption ≥ 40 g, and 16 (10 %) female patients reported consumption ≥ 20 g. The optimal cutoff values of hazardous drinking were calculated using a 10-fold cross validation, resulting in an optimal AUDIT score cutoff of 8.2, with a sensitivity of 95.5 %, specificity of 87.0 %, false positive rate of 13.0 %, false negative rate of 4.5 %, and area under the receiver operating characteristic curve of 0.97. Multivariate analysis revealed that the most popular short version of the AUDIT consisting solely of its 3 consumption items (AUDIT-C) and patient sex were significantly associated with hazardous drinking. The aspartate transaminase (AST)/alanine transaminase (ALT) ratio and mean corpuscular volume (MCV) were weakly significant.
A cross-sectional data 6 of health surveys from 5 401 university students in the Netherlands were used. 20 % of students were hazardous and harmful drinkers. The area under the ROC (receiver operating characteristic) curve was 0.922 (95% CI 0.914 to 0.930). At an AUDIT-C cutoff score of ≥7, sensitivity and specificity were both >80%, while other cutoffs showed less balanced results. A cutoff of ≥8 performed better among males, but for other subgroups ≥7 was most suitable.
In a comparative study 1 194 male primary care attendees completed an AUDIT questionnaire. A correlation was observed between alcohol consumption and score on the AUDIT (Pearson's correlation coefficient r = 0.74) and measures of gamma-glutamyltransferase (GGT) (r = 0.20) and per cent carbohydrate deficient transferring (CDT) (r = 0.36) but not aspartate aminotransferase (r = 0.08) or erythrocyte mean cell volume (r = 0.02). The AUDIT exhibited higher sensitivity, specificity, and positive predictive value than all of the biochemical markers for hazardous consumption (69%, 98%, and 95%), weekly binge consumption (75%, 90%, and 71%), monthly binge consumption (66%, 97%, and 91%), and alcohol dependence (84%, 83%, and 41%). The questionnaire was also more cost efficient, with a lower cost per true positive for all consumption outcomes.
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