Danish validation of the Alcohol Use Disorder Identification Test (AUDIT).

Area of Science:

• Public Health
• Clinical Psychology
• Epidemiology

Background:

• Alcohol Use Disorder Identification Test (AUDIT) and AUDIT-Consumption (AUDIT-C) are widely used screening tools.
• Assessing their diagnostic accuracy in diverse populations is crucial for effective public health interventions.
• Danish general population data provides a unique context for evaluating these instruments.

Purpose of the Study:

• To evaluate the diagnostic accuracy of AUDIT and AUDIT-C for hazardous use, harmful use, and alcohol dependence.
• To determine optimal cut-off scores for these conditions within the Danish adult population.
• To compare the performance of AUDIT and AUDIT-C in this specific demographic.

Main Methods:

• A cross-sectional study utilizing an anonymous online questionnaire.
• Data collected from 17,959 adults aged 25+ in Denmark.
• Analysis included receiver operating characteristic curves (AUC) and diagnostic properties, comparing self-reported ICD-10 criteria for alcohol dependence and harmful alcohol use.

Main Results:

• AUDIT demonstrated strong diagnostic discrimination for hazardous use (AUC=0.89) and dependence (AUC=0.96), but not for harmful use (AUC=0.61).
• AUDIT-C also showed good accuracy for hazardous use (AUC=0.92) and dependence (AUC=0.92), with lower performance for harmful use (AUC=0.58).
• Recommended AUDIT cut-offs were supported, with variations noted for women and older adults (65+). Optimal AUDIT-C cut-offs were identified as 6 for hazardous use and 6 for dependence, with age and sex adjustments.

Conclusions:

• AUDIT and AUDIT-C are effective in identifying hazardous alcohol use and possible dependence, but less so for harmful use.
• AUDIT-C can serve as an initial screening tool, with the full AUDIT used for more detailed assessments.
• Consideration of local demographics and circumstances is recommended when establishing cut-off points for AUDIT and AUDIT-C.