A community screening test for high alcohol consumption using biochemical and haematological measures

A discriminant function based on a number of biochemical and haematological tests from an extended multiple biochemical analysis and full blood count, together with weight, smoking status and systolic blood pressure is developed. The function was far more effective at detecting high alcohol use (greater than 40 g ethanol per day) than serum gamma-glutamyl transpeptidase (GGT) or the Short Michigan Alcoholism Screening Test (SMAST) in a community sample of adult males. When classifying high alcohol consumption by GGT only, several division criteria were considered, the most effective being at 40 i.u./l. In terms of identifying high alcohol consumers, rather than alcoholics, the SMAST was no better than GGT, and both had unacceptably low sensitivity (49%, 51%) and poor performance on other measures, thus limiting their use as community screening tools. The discriminant function, however, had an estimated community sensitivity of 78%, was similarly high on other performance measures, and would perform satisfactorily as a community screening tool, particularly in situations where there was a tendency for individuals to under-report their alcohol consumption.