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The Motivation for Alcohol Reward: Predictors of Progressive-Ratio Intravenous Alcohol Self-Administration in Humans

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Estimating the prevalence of drinking problems among physicians.

Friedrich M Wurst¹, Hans-Jürgen Rumpf, Gregory E Skipper

¹Department of Psychiatry and Psychotherapy II, Christian-Doppler-Hospital, Paracelsus-Medical University, A-5020, Salzburg, Austria.

General Hospital Psychiatry

|July 10, 2013

Summary

Uncorrected screening for physician alcohol problems using the AUDIT or AUDIT-C significantly overestimates prevalence. Corrected estimates reveal lower rates, emphasizing the need for accurate diagnostic methods in physician health assessments.

Keywords:

Alcohol Use Disorders Identification Test Bias Correction Physician Prevalence

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Area of Science:

Medical research
Public health
Epidemiology

Background:

Physician alcohol use is commonly assessed using the Alcohol Use Disorders Identification Test (AUDIT) or its shorter version, AUDIT-C.
Prevalence estimates from these screening tools depend on test accuracy and chosen cutoff values.

Purpose of the Study:

To derive more precise prevalence estimates of alcohol problems in physicians.
To correct for false-positive and false-negative results in alcohol use screening among physicians.

Main Methods:

A survey using the AUDIT was distributed to 2484 physicians in Salzburg, Austria, with 456 participants.
A published correction formula, incorporating general population data and test sensitivity/specificity, was applied to estimate true prevalence.

Main Results:

Uncorrected AUDIT-C screening showed 15.7% of females and 37.7% of males positive. Corrected rates were 4.0% (female) and 9.5% (male).
Uncorrected full AUDIT screening showed 19.6% of females and 48% of males positive. Corrected rates were 6.3% (female) and 15.5% (male).

Conclusions:

Uncorrected screening results for physician drinking problems can markedly overestimate their actual prevalence.
Accurate prevalence estimation requires correcting for screening test inaccuracies.