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Validation of a single screening question for problem drinking.

R Williams1, D C Vinson

  • 1The Center for Family Medicine Science, University of Missouri-Columbia, Columbia, MO 65212, USA.

The Journal of Family Practice
|April 13, 2001
PubMed
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A single screening question effectively identifies problem drinking in emergency department patients. This method shows high sensitivity and specificity for detecting hazardous drinking and alcohol use disorders.

Area of Science:

  • Emergency Medicine
  • Addiction Psychiatry
  • Public Health

Background:

  • Problem drinking is a significant public health concern, often underdiagnosed in emergency settings.
  • Screening tools are crucial for early identification and intervention of alcohol use disorders.
  • Existing screening methods can be time-consuming, necessitating efficient alternatives.

Purpose of the Study:

  • To validate the sensitivity and specificity of a single screening question for problem drinking.
  • To assess the utility of the question: "When was the last time you had more than X drinks in 1 day?" (X=4 for women, X=5 for men).

Main Methods:

  • A cross-sectional study involving 2517 adult patients in 3 emergency departments.
  • Patients were screened using the single question and compared against definitions of hazardous drinking and past-year alcohol use disorder.

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  • Data were analyzed for overall performance and stratified by sex.

    • Main Results:

    • The single screening question demonstrated 86% sensitivity and 86% specificity in identifying problem drinkers when "within the last 3 months" was considered positive.
    • Performance varied slightly by sex: men (88% sensitivity, 81% specificity) and women (83% sensitivity, 91% specificity).
    • The area under the receiver-operating characteristic curve was 0.90, indicating strong discriminative ability.

    Conclusions:

    • A single question regarding recent heavy drinking is a clinically valuable tool for screening hazardous drinking and alcohol use disorders.
    • This simple screening method offers a practical approach for use in emergency department settings.
    • The findings support the integration of this question into routine patient assessments for early intervention.