AUDIT-C, AUDIT-3 and AUDIT-QF in Screening Risky Drinking Among Occupational Health Care Patients - PDF Document

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  1. AUDIT-C, AUDIT-3 and AUDIT-QF in Screening Risky Drinking Among Occupational Health Care Patients Tiina Kaarne MD Occupational Health Care Varma Mutual Pension Insurance Company

  2. Finnish Occupational Health Care • statutory preventive work covers 90 % off all employees includes health checkups approximately once in every four year • voluntary medical work covers 80 % off all employees half of all the visits to general physician among Finns between 16-65 years is done by doctors of occupational health • One half of the expenses is paid by employers the other half by The Social Insurance Institution of Finland

  3. The primary tasks of Occupational Health Care: -Prevention of work-related health problems -Health promotion Still: alcohol-related issues are seldom discussed in occupational health care

  4. Background • Primary care physicians need a brief screening instrument to detect risky drinkers among their patients. • In previous studies the three first questions of the Alcohol Use Disorders Identification Test (AUDIT-C) and the third question on heavy episodic drinking alone (AUDIT-3) have been shown to be almost as effective as the whole AUDIT. • Also, AUDIT-QF (the first two questions of AUDIT - quantity-frequency) maybe a potential screening instrument. • However, the effectiveness of these short questionnaires has not been studied among the occupational health care patients.

  5. Methods • Patients visiting their doctor in six occupational health clinics were asked to complete a questionnaire • Alcohol Use Disorders Identification Test (AUDIT) and other questions concerning health. • 757 patients participated • Risky drinking men: score of 10 or more women: 8 or more in the AUDIT questionnaire. • Effectiveness of AUDIT-C, AUDIT-3 and AUDIT-QF scores were compared with the whole AUDIT in screening risky drinking.

  6. Participants • All Caucasian • 388 men, average age 45.7 years • 369 women, average age 46.3 years • wide range of occupations 330 of them (44%) were white-collar 169 (22%) blue-collar 257(34%) both

  7. Men% Women % Total % Score N=388 N=396 N=784 >21 3.1 < 0.3 1.7 >20 3.4 < 0.5 2.0 Cumulative Audit Score of the Occupational Health Care Patients >19 4.6 <0.8 2.8 >18 6.7 1.1 4.0 >17 7.7 1.4 4.6 >16 9.3 1.4 5.4 >15 10.8 1.4 6.2 >14 13.6 3.3 8.7 >13 16.8 3.3 10.1 >12 20.1 4.1 12.3 >11 24.2 5.4 15.2 >10 29.4 7.3 18.6 >9 34.3 10.8 22.8 >8 42.0 13.1 27.8 >7 49.7 15.8 33.1 >6 60.1 24.1 42.4

  8. Effectiveness of the short versions (AUDIT-C, AUDIT-3 and AUDIT-QF) of Alcohol Use Disorders Identification Test (AUDIT) compared to whole AUDIT detecting heavy drinking in men. Area under the curve Sensitivity Spesificity positive predictive value Negative predictive value AUDIT-C >4 >5 >6 >7 0,905(0,876- 0,935) 1,00 0,96 0,86 0,62 0,38 0,44 0,79 0,93 0,40 0,60 0,63 0,78 1,00 0,98 0,94 0,86 AUDIT-3 >1 >2 >3 0,857(0,816- 0,898) 0,99 0,88 0,39 0,18 0,75 0,97 0,33 0,59 0,85 0,98 0,94 0,80 AUDIT-QF >2 >3 >4 >5 0,828(0,786- 0,870) 1,0 0,98 0,82 0,45 0,20 0,37 0,66 0,91 0,38 0,43 0,53 0,73 1,0 0,97 0,88 0,81

  9. Effectiveness of the short versions (AUDIT-C, AUDIT-3 and AUDIT-QF) of Alcohol Use Disorders Identification Test (AUDIT) compared to whole AUDIT detecting heavy drinking in women. Area under the curve(95%) Sensitivity Spesificity Positive predictive value Negative predictive value AUDIT-C >4 >5 >6 >7 0,939(0,910- 0,968) 0,96 0,81 0,56 0,25 0,71 0,89 0,98 1,00 0,33 0,52 0,80 1,00 0,99 0,97 0,94 0,90 AUDIT-3 >1 >2 >3 0,887(0,840- 0,934) 1,00 0,63 0,17 0,48 0,96 1,00 0,23 0,72 1,00 1,00 0,95 0,89 AUDIT-QF >2 >3 >4 >5 0,854 (0,805-0,903) 1,0 0,88 0,64 0,19 0,36 0,64 0,88 0,99 0,22 0,30 0,49 0,92 1,0 0,97 0,93 0,87